Livedoid vasculitis responding to PUVA therapy

Background Livedoid vasculitis is a chronic disorder manifested as recurren t, painful, reticulated, and ulcerative lesions of the legs, which result i n ivory atrophic scars with peripheral telangiectasia and hyperpigmentation . Its etiology remains obscure and therapy is difficult. In this study, we evaluated the clinical efficacy of psoralen plus UVA (PUVA) therapy and its side-effects in the treatment of livedoid vasculitis. Methods Eight South Korean patients with livedoid vasculitis were treated w ith UVA and 8-methoxypsoralen (8-MOP). Systemic PUVA was started with 4 J/c m(2) of UVA two or three times a week, and then the dose was increased by 0 .5 or 1 J/cm(2) increments at each subsequent treatment as tolerated. The e ffects of treatment were evaluated using photographs of before, during, and after the study. Results All patients experienced rapid cessation of new lesion formation, s ignificant symptom relief, and complete healing of primary lesions. The mea n times for each of the above were 3.6, 5.9, and 10 weeks, and the mean cum ulative doses of UVA for each of the above were 55.9, 96.8, and 197.9 J/cm( 2), respectively. The patients tolerated PUVA therapy well without unaccept able side-effects. Conclusions We propose that systemic PUVA using 8-MOP should be investigate d further as an alternative treatment for patients with livedoid vasculitis .