Effects of low dose ultraviolet A-1 phototherapy on morphea

Aim: The effects of low dose ultraviolet A-1 (UVA-1) phototherapy on differ ent clinical stages of morphea (localized scleroderma) were analyzed in thi s case study, Based on these data, the different types of phototherapy desc ribed in the literature and currently used for treatment of morphea are com pared. Methods: Three patients with severe plaque type morphea in different stages were studied: one patient with late-stage lesions having stable sclerotic plaques; another patient with active inflammatory lesions; and a third pati ent with late-stage lesions associated with overlying lichen sclerosus et a trophicus (LSA), The treatment given was low dose UVA-1 phototherapy with s ingle doses of 20 J/cm(2) administered four times a week for 6 weeks, and o nce a week for another 6 weeks, Results: Following UVA-1 phototherapy, the sclerotic plaques resolved, leav ing smooth and soft tanned skin with normal structure, consistency and fold ing capability, In morphea with overlying LSA the elastic fibers did not co mpletely return to the superficial papillary dermis despite the clinical cl earance of both morphea and LSA, These data suggest that low dose UVA-1 pho totherapy may improve, but not completely reverse, the histopathological ch anges of LSA, No side effects were observed during or after treatment. Conc lusion: Our observations show in three patients that low-dose UVA-1 phototh erapy is highly effective for treatment of all stages of morphea, including early inflammatory and late sclerotic lesions, and morphea with overlying lichen sclerosus et atrophicus, Because of its safety and efficacy, low dos e UVA-1 phototherapy appears to be the treatment modality of choice.