Guidelines for topical PUVA: a report of a workshop of the British Photodermatology Group

Psoralen photochemotherapy [psoralen ultraviolet A (PUVA)] plays an importa nt part in dermatological therapeutics, being an effective and generally sa fe treatment for psoriasis and other dermatoses. In order to maintain optim al efficacy and safety, guidelines concerning best practice should be avail able to operators and supervisors. The British Photodermatology Group (BPG) have previously published recommendations on PUVA, including UVA dosimetry and calibration, patient pretreatment assessment, indications and contrain dications, and the management of adverse reactions.(1) While most current k nowledge relates to oral PUVA, the use of topical PUVA regimens is also pop ular and presents a number of questions peculiar to this modality, includin g the choice of psoralen, formulation, method of application, optimal timin g of treatment, UVA regimens and relative benefits or risks as compared wit h oral PUVA. Bath PUVA, i.e. generalized immersion, is the most frequently used modality of topical treatment, practised by about 100 centres in the U .K., while other topical preparations tend to be used for localized disease s such as those affecting the hands and feet. This paper is the product of a recent workshop of the BPG and includes guidelines for bath, local immers ion and other topical PUVA. These recommendations are based, where possible , on the results of controlled studies, or otherwise on the consensus view on current practice.