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  • Q&A with Australian Health Practitioners

    Can photochemotherapy be used to treat eczema?

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    The role of the Eczema Association of Australasia Inc (EAA) is to be a supportive body for eczema sufferers and carers, to increase public awareness … View Profile

      PUVA (photochemotherapy)

    What is PUVA?

    PUVA or photochemotherapy is a type of ultraviolet radiation treatment (phototherapy) used for severe skin diseases.

    PUVA is a combination treatment which consists of Psoralens (P) and then exposing the skin to UVA (long wave ultraviolet radiation). It has been available in its present form since 1976.

    Psoralens are compounds found in many plants which make the skin temporarily sensitive to UVA. The ancient Egyptians were the first to use psoralens for the treatment of skin diseases thousands of years ago. Medicine psoralens include methoxsalen (8-methoxypsoralen), 5-methoxypsoralen and trisoralen.

    Whole body PUVA

    For oral PUVA, methoxsalen capsules are taken two hours before the appointment for treatment. For bathwater PUVA, the patient soaks in a bath containing a solution of psoralens. In most cases, treatment is undertaken two or three times each week.

    During treatment, the patient usually stands in a cabinet containing 24 or more 6-foot long UVA fluorescent bulbs.

    The patient should always wear goggles to protect the eyes from exposure to the radiation.

    Usually, he or she is dressed only in underpants for whole body exposure. Sometimes just arms and legs may be exposed to the radiation, in which case the patient should wear the same clothing each treatment to prevent inadvertently exposing a new area of skin.

    The UVA lamps stay on for increasing lengths of time, starting with about one minute and extending for up to half an hour. Their may be fans and/or air conditioning to cool the cabinet, as it tends to get very warm with more prolonged treatment times.

    Localised PUVA

    Those patients requiring treatment to small areas only may be treated using a smaller hand and foot unit. Bathwater PUVA may be suitable. In this case the hands and/or feet are soaked in a dilute solution of methoxsalen for 30 minutes, then immediately exposed to UVA.

    A few patients may be treated with topical PUVA – a psoralens lotion or gel is applied to the affected areas 10 minutes before UVA exposure.

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