PSORALENS USED FOR COSMETIC SUN TANNING - AN UNUSUAL CAUSE OF EXTENSIVE BURN INJURY

Psoralen combined with long-wave ultraviolt radiation (UV-A) has becom e a standard method of psoriasis treatment. A well-known and often app reciated 'side-effect' is the hyperpigmentation mused by this treatmen t. Three patients demonstrating a novel cause of severe skin loss, 'ps oralen burn' are presented. No patient was afflicted by psoriasis and all three had used psoralen and ultraviolet exposure with the intent t o enhance sun tanning. In the case histories presented, it is notable that two of the patients share an alarmingly extensive skin injury (90 -95 per cent body surface area), while the third had an extensive but rather superficial injury. In addition, a very similar time-table for the development of the injury could be observed, with a maximum distri bution of skin loss not reached until 7 or 8 days after exposure. Psor elen-UV-A can cause life-threatening skin losses when used in an errat ic manner. Early recognition of the nature and knowledge of the time-c ourse in the development of these lesions is necessary for optimal tre atment. Some principles of treatment are discussed. Dermatologists pre scribing PUVA treatment should further increase their warnings of unco ntrolled use of psoralens in non-psoriatics. Copyright (C) 1996 Elsevi er Science Ltd for ISBI.