UVB 308-nm excimer light and bath PUVA: combination therapy is very effective in the treatment of prurigo nodularis

• Published in: Journal of the European Academy of Dermatology and Venereology Vol. 25; no. 7; pp. 799 - 803
• Main Authors: Hammes, S., Hermann, J., Roos, S., Ockenfels, H.M.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01-07-2011
• Subjects: Aged; Aged, 80 and over; excimer; Female; Humans; Male; Middle Aged; Prospective Studies; Prurigo - drug therapy; prurigo nodularis; PUVA; PUVA Therapy; Ultraviolet Rays; UVB
• ISSN: 0926-9959; 1468-3083
• DOI: 10.1111/j.1468-3083.2010.03865.x

Background  Prurigo nodularis (PN) is a chronic inflammatory skin disease with nodular itching lesions. UV therapy – both PUVA and NUVB – are known to clear up PN temporarily due to the antipruritic effect of UV light. However, relapse after treatment is common in PN, which means that either long‐term therapy is necessary or the treatment protocols have to be optimized to minimize side‐effects.
Objective  The aim of this study was to evaluate the effect that combining bath PUVA and targeted UVB 308 nm excimer radiation has on recalcitrant nodular prurigo.
Methods  In a prospective trial, 22 patients with PN were treated with either PUVA alone or with a combination of PUVA and excimer UVB. The end point was complete or almost complete remission of PN.
Results  Adding a 308‐nm excimer UVB to the treatment of the pruritic nodules sped up the healing process; 30% less PUVA radiation was needed.
Conclusion  The combination of PUVA and excimer UVB in PN appears to be very efficacious. Reducing psoralen UVA doses by 30% offered long‐term benefits in phototherapy of chronic recalcitrant diseases like PN.