PUVA-bath photochemotherapy (PUVA-soak therapy) of recalcitrant dermatosesof the palms and soles

PUVA-bath therapy has proven to avoid many side effects associated with ora l 8-methoxypsoralen (8-MOP) treatment. In order to investigate the effectiv eness of topical PUVA-bath therapy (PUVA-soak therapy) on chronic palmoplan tar dermatoses, 30 patients with plaque-type psoriasis, pustular psoriasis, endogenous eczema, dyshidrotic eczema and hyperkeratotic dermatitis of the palms and soles were treated over 8 weeks with PUVA-soak using 8-MOP. No a dditional treatment except skin moisturising cream such as unguentum emulsi ficans aquosum was used during the study period. The single UVA-doses appli ed ranged from 0.3 to 3.0 J/cm(2) (mean single dose of 1.8 J/cm(2)), with a mean cumulative dose of 48.6 J/cm(2) per patient. Altogether 26 of 30 pati ents responded well within 8 weeks of treatment with 63% of all patients sh owing a complete remission and 23% showing considerable improvement, as sho wn by flattening of plaques, decreased scaling and erythema, as well as dec reased vesicle and pustule formation. The condition responding best to our therapy was palmoplantar psoriasis followed by atopic eczema. Hyperkeratoti c dermatitis displayed the poorest responding rates in this study. Unwanted side effects such as erythema, pain, blistering or patchy hyperpigmentatio n were not observed in any of the patients. We conclude that PUVA-soak ther apy can be highly efficient in the treatment of palmoplantar dermatoses, es pecially in the management of palmoplantar psoriasis.