Combined treatment with calcipotriol ointment and low-dose ultraviolet A1 phototherapy in childhood morphea

Various therapies for morphea have been used with limited success, includin g ones with potentially hazardous side effects. When morphea occurs in chil dhood it may lead to progressive and long-lasting induration of the skin an d subcutaneous tissue, growth retardation, and muscle atrophy. We report an open prospective study in which the efficacy of a combined treatment with calcipotriol ointment and low-dose ultraviolet A1 (UVA1) phototherapy in ch ildhood morphea was investigated, Nineteen children (mean age 8.5 years, ra nge 3-13 years) with morphea were exposed to UVA1 (340-400 nm) phototherapy at a dose of 20 J/cm(2) four times a week for 10 weeks. Forty phototherapy sessions resulted in a cumulative dose of 800 J/cm(2) UVA1. In addition, c alcipotriol ointment (0.005%) was applied twice a day, After in weeks, palp ation and inspection showed a remarkable softening and repigmentation of fo rmerly affected skin resulting in a highly significant (p < 0.001) decrease of the mean clinical score from 7.3 <plus/minus> 0.9 at the beginning to 2 .4 +/- 0.9 (relative reduction 67.1%) at the end of combined therapy. Our r esults indicate that a combined therapy with calcipotriol ointment and low- dose UVA1 phototherapy is highly effective in childhood morphea, Further co ntrolled studies are necessary to investigate whether this combined therapy is superior to UVA1 phototherapy alone.