PUVA more effective than NB-UVB for treating psoriasis.

Two treatments for chronic plaque psoriasis were tested head to head in the UK. Researchers examined the effects of Psoralen-UV-A (PUVA) therapy against narrowband UV-B (NB-UVB) therapy. PUVA was found to be more effective.

PUVA is a combination of an oral medication (8-methoxypsoralen) and exposure to UV-A (long wave) radiation. NV-UVB involves exposure to UV-B (short wave) radiation only.

The July issue of the Archives of Dermatology reports that researchers studied 93 people with moderate-to-severe chronic plaque psoriasis. They were divided into two groups that received either PUVA or NB-UVB. Both groups were treated twice a week, either until their skin cleared or up to a maximum of 30 sessions.

For patients with fairer skin, PUVA was 84 percent effective at clearing skin, compared to 65 percent for NB-UVB. To attain clear skin, patients receiving PUVA required fewer treatments (17) compared with 28.5 treatments for NB-UVB.

PUVA also had longer term effects, as six months after initial skin clearance, 68% of PUVA patients were still clear, compared with only 35% of NB-UVB patients.

Although PUVA was very effective at skin clearance, it did lead to redness of the skin in almost half of the patients in the PUVA group. PUVA has other contraindications: it may cause nausea, it can not be used during pregnancy, and this treatment carries a risk of skin cancer.

For patients who can withstand the nausea, are not pregnant and who do not have an elevated risk of skin cancer, PUVA may offer reliable, effective treatment for chronic plaque psoriasis.