The therapeutic technique of PUVA therapy has found wide application in dermatology. With its help, even those skin diseases that are not amenable to conventional drug treatment are treated.
Most often PUVA-therapy is used to treat the following pathologies:
- atopic dermatitis,
- alopecia (alopecia),
- fungoid mycosis,
- Bowen's disease,
- basal cell carcinoma of the skin,
- Vulgar acne and other pathologies characterized by pathological changes in skin cells.
Therapy using this technique can be prescribed at any stage of the development of the disease.
PUVA therapy is also used to combat the effects of photoaging of the skin of the hands and face. This improves the condition of the skin and increases its elasticity by stimulating the production of collagen.
PUVA-therapy for various pathologies
The PUVA technique was originally developed to combat an almost incurable autoimmune pathology called psoriasis, characterized by the appearance on the body of scaly, itchy areas of the cornified skin, the cause of which was the pathologically rapid growth of cells. Seeing the good effectiveness of the method on the example of psoriasis, doctors began to apply it for the treatment of other skin diseases.
PUVA-therapy is considered indispensable for the treatment of psoriasis, characterized by extensive localization or severe course. This is a pathology in which the total area affected by the disease of the skin is from 20 to 30% of the total area of the skin.
PUVA therapy shows sufficient effectiveness in such severe forms of pathology as the common plaque form, exudative, erythrodermal and pustular psoriasis, as well as in the drop-shaped and palmar-plantar type of psoriasis, which, because of its localization, causes the greatest discomfort in patients. It is used as the last hope with the ineffectiveness of other methods of fighting the disease.
Promising results show PUVA therapy and with alopecia. The idea to apply this method for the therapy of baldness has arisen in connection with the moment that catches eye when observing such patients. Patients, for a short time under the influence of sunlight, hair growth was more active than those who avoided the open sun. However, there were cases and exacerbations of the disease in the summer, but it was worth a try.
Treatment of mild and moderate severity is done locally, and in severe pathology a general approach is required with irradiation of the entire affected surface.
The results of treatment of many patients with focal alopecia showed that after 5 and a half months (more precisely 24 weeks) complete hair restoration is observed in 8 patients out of 9. This is quite a good indicator.
True there were cases and relapse of the disease after a reduction in the dose of irradiation. The symptoms of the disease were manifested after 2.5 months after the end of treatment. In order to prevent relapses, use topical corticosteroids, aromatic retinoids, anthralin and other drugs that gradually reduce the dose without negative consequences.
PUVA therapy is also actively used in the treatment of vitiligo. For this pathology, the disappearance of pigmentation in some parts of the body is characteristic. Under the influence of PUVA therapy, melanin synthesis is activated on the affected areas and the skin color gradually becomes equal.
In small light areas of the skin, treatment is performed locally for as little as 1 or 2 weeks. If the area of the lesion exceeds 20% of the entire skin, a systematic approach is required, and the number of necessary procedures can reach 100, and in some severe cases, 150 procedures.
Positive result in the case of treatment of vitiligo by PUVA therapy is observed in more than 50% of patients.
Phototherapy can help patients with connective tissue diseases. For example, PUVA therapy is used for scleroderma. The disease is chronic and manifests itself in the form of compaction and scarring of connective tissue.
The long-wavelength light flux of the UV spectrum is able to act not only on the surface layers of the skin, but also penetrate deep inside. Light energy, converted to thermal triggers chemical processes, leading to positive changes in the structure of cells. In addition, phototherapy has a bactericidal effect, which prevents inflammation in the connective tissue, leading to densification of skin cells.
The effectiveness of such treatment depends on the dose of irradiation and psoralens, as well as on the individual characteristics of the organism. Abroad, the technique of PUVA therapy has become widespread, as it allows for treatment of different population groups, especially children, with minimal risk to health.
Effective replacement of corticosteroids is considered to be PUVA therapy for atopic dermatitis (another name is neurodermatitis ), which is one of the types of inflammatory skin diseases. PUVA therapy is used mainly during periods of exacerbations of often recurrent pathology and mainly in adult patients.
The number of sessions needed to relieve the symptoms of exacerbation of the heavily flowing neurodermatitis is 59. This is a lot, but the results of such treatment are not only good, but also long-term. The main thing is a gradual cancellation of the procedure with a decrease in the dose of UV radiation and psoralens.
In the case of mild disease, 10 to a maximum of 30 sessions are sufficient. But remission after such treatment can be delayed for several years, which significantly improves the quality of life of patients.
We examined the use of PUVA therapy for the treatment of intractable pathologies, but there are many other more or less serious diseases in which PUVA therapy shows worthy results in favor of this method of phototherapy, which is much more effective than conventional skin irradiation with UV rays.