Low-dose broad-band UVA in morphea using a new method for evaluation

Until recently, various therapies for localized scleroderma have been used with limited success, Recently phototherapy, with or without psoralen, was proposed as a successful treatment modality. The aim of this study was to e valuate the effect of broad-band low-dose ultraviolet A (UVA) phototherapy in patients with localized scleroderma, using a new method for evaluation, Twelve patients complaining of morphea were exposed to UVA irradiation at a dose of 20 J/cm(2) 3 times per week for 20 sessions. Selected covered plaq ues served as internal controls. The efficacy of therapy was judged clinica lly by sequential inspection and palpation. In biopsy specimens from expose d and covered plaques stained with hematoxylin and eosin (H & E) and Masson trichrome stains, the concentration of collagen per dermal surface area wa s measured with the use of a computerized image analyzer. All patients repo rted remarkable softening of skin lesions, confirmed by sequential palpator y assessment. A significant reduction in the mean concentration of collagen per surface area was detected in the plaques exposed to UVA (the P value b eing 0.007, P<0.01), whereas in the covered plaques the difference was not statistically significant (the P value being 0.10, P>0.05), The conclusion is that low-dose broadband UVA phototherapy is a very effective and safe tr eatment modality for localized scleroderma.