The efficacy of PUVA and UVB 311 nm in small plaque parapsoriasis

Introduction. Small plaque parapsoriasis (SPP), a disease with a characteristic clinical presentation, was for many years regarded as belonging to the group of cutaneous lymphomas. At present, it is no longer considered a precursor of mycosis fungoides. Although lesions may resolve spontaneously in response to sun exposure, the condition can be im­proved with topical corticosteroid therapy but, primarily, with various forms of phototherapy.

Objective. To compare the efficacy of two SPP treatment modalities: UVB 311 nm irradiation and PUVA.

Material and methods. The study was conducted in 88 consecutive patients with histopathologically verified diagnosis of SPP who were treated in the Dermatology Department in Warsaw between 2001 and 2013. UVB 311 nm phototherapy (TL-01 lamps) was administered to a total of 53 pa­tients (21 women and 32 men). PUVA therapy involving oral psoralens was given to 35 patients (13 women and 22 men).

Results. Complete regression of skin lesions was achieved in all the patients. The mean duration of UVB 311 nm phototherapy was 10 weeks, which was equivalent to the mean UV dose of 22 J/cm². The mean duration of PUVA treatment was 7 weeks (43.6 J/cm²). Relapse of the disease occurred in 60.3% of patients treated with UVB 311 nm irradiation after an average of 12.2 months. In the PUVA group, relapse was observed in 60% of the study patients after an average of 13.8 months.

Conclusions. The study provided evidence for the high efficacy of UVB 311 nm irradiation, which was shown to be comparable to the efficacy of PUVA. Considering the chronic and recurrent nature of the disease, which necessitates multiple courses of treatment, UVB 311 nm should be recommended as a treatment of choice for SPP.