Abstract
Palmoplantar pustulosis (PPP) is recalcitrant to traditional topical and systemic therapies. Ultraviolet A1 (UVA1) phototherapy, a new therapeutic approach, has recently been shown good efficacy in the treatment of PPP. The purpose of this study was to evaluate the efficacy and safety of UVA1 therapy for the treatment of PPP. Patients with PPP were treated with UVA1 irradiation three times a week for up to 30 sessions and had a 3-month follow-up visit. UVA1 therapy was conducted with a fixed dose (80 J/cm2). Clinical evaluation was based on the Palmoplantar Pustular Psoriasis Area and Severity Index (PPPASI) score. Totally, 62 patients completed the study. The mean PPPASI score decreased from a baseline value of 9.4 ± 2.8 to a value of 4.9 ± 2.4 at 15 sessions, 1.7 ± 1.9 at 30 sessions, and 2.0 ± 2.1 at follow-up visit. A reduction of 75 % in the PPPASI score was observed in 4 (6.5 %) patients at 15 sessions and 45 (72.6 %) patients at 30 sessions. The adverse effects were limited including burning sensation, pruritus, and hyperpigmentation. UVA1 is an effective therapy for PPP with mild side effects.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Hellgren L, Mobacken H (1971) Pustulosis Palmaris et plantaris. Prevalence, clinical observations and prognosis. Acta Derm Venereol 51:284–288
Hagforsen E, Edvinsson M, Nordlind K, Michaelsson G (2002) Expression of nicotinic receptors in the skin of patients with palmoplantar pustulosis. Br J Dermatol 146:383–391
Brunasso AM, Puntoni M, Aberer W, Delfino C, Fancelli L, Massone C (2013) Clinical and epidemiological comparison of patients affected by palmoplantar plaque psoriasis and palmoplantar pustulosis: a case series study. Br J Dermatol 168:1243–1251
Akiyama T, Seishima M, Watanabe H, Nakatani A, Mori S, Kitajima Y (1995) The relationships of onset and exacerbation of pustulosis palmaris et plantaris to smoking and focal infections. J Dermatol 22:930–934
Miot HA, Miot LD, Lopes PS, Haddad GR, Marques SA (2009) Association between palmoplantar pustulosis and cigarette smoking in Brazil: a case-control study. J Eur Acad Dermatol Venereol 23:1173–1177
Giménez-García R, Sánchez-Ramón S, Cuellar-Olmedo LA (2003) Palmoplantar pustulosis: a clinicoepidemiological study. The relationship between tobacco use and thyroid function. J Eur Acad Dermatol Venereol 17:276–279
Layton AM, Sheehan-Dare R, Cunliffe WJ (1991) A double-blind, placebo-controlled trial of topical PUVA in persistent palmoplantar pustulosis. Br J Dermatol 124:581–584
Nisticò SP, Saraceno R, Stefanescu S, Chimenti S (2006) A 308-nm monochromatic excimer light in the treatment of palmoplantar psoriasis. J Eur Acad Dermatol Venereol 20:523–526
Nisticò SP, Saraceno R, Chiricozzi A, Giunta A, Di Stefani A, Zerbinati N (2013) UVA-1 Laser in the treatment of palmoplantar pustular psoriasis. Photomed Laser Surg 31:434–438
Bhushan M, Burden AD, McElhone K, James R, Vanhoutte FP, Griffiths CE (2001) Oral liarozole in the treatment of palmoplantar pustular psoriasis: a randomized, double-blind, placebo-controlled study. Br J Dermatol 145:546–553
Furuhashi T, Torii K, Kato H, Nishida E, Saito C, Morita A (2011) Efficacy of excimer light therapy (308 nm) for palmoplantar pustulosis with the induction of circulating regulatory T cells. Exp Dermatol 20:768–770
Fumimori T, Tsuruta D, Kawakami T, Ohata C, Furumura M, Hashimoto T (2013) Effect of monochromatic excimer light on palmoplantar pustulosis: a clinical study performed in a private clinic by a dermatological specialist. J Dermatol 40:1004–1007
York NR, Jacobe HT (2010) UVA1 phototherapy: a review of mechanism and therapeutic application. Int J Dermatol 49:623–630
Gambichler T, Terras S, Kreuter A (2013) Treatment regimens, protocols, dosage, and indications for UVA1 phototherapy: facts and controversies. Clin Dermatol 31:438–454
Skov L, Hansen H, Allen M, Villadsen L, Norval M, Barker JN et al (1998) Contrasting effects of ultraviolet A1 and ultraviolet B exposure on the induction of tumour necrosis factor-alpha in human skin. Br J Dermatol 138:216–220
Krutmann J, Grewe M (1995) Involvement of cytokines, DNA damage, and reactive oxygen intermediates in ultraviolet radiation-induced modulation of intercellular adhesion molecule-1 expression. J Invest Dermatol 105:67S–70S
Szegedi A, Simics E, Aleksza M, Horkay I, Gaál K, Sipka S et al (1995) Ultraviolet-A1 phototherapy modulates Th1/Th2 and Tc1/Tc2 balance in patients with systemic lupus erythematosus. Rheumatology (Oxford) 44:925–931
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Ethics statement
This study was approved by the Ethics Committee of Shanghai Skin Disease Hospital and performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.
Additional information
Li-na Su and Xin Xu contributed equally to this work.
Rights and permissions
About this article
Cite this article
Su, Ln., Xu, X., Tang, L. et al. UVA1 phototherapy in the treatment of palmoplantar pustulosis: a pilot prospective study. Lasers Med Sci 31, 1641–1643 (2016). https://doi.org/10.1007/s10103-016-2031-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10103-016-2031-7