Comparison of localized high-dose UVA1 irradiation versus topical cream psoralen-UVA for treatment of chronic vesicular dyshidrotic eczema

Vesicular dyshidrotic palmoplantar eczema is a common disorder but treatment is difficult. Localized photochemotherapy (cream psoralen-UVA [PUVA]) has widely been used for therapy. Although the efficacy of cream PUVA therapy is well known, potential side effects may occur. Therefore, a more standardized safe and effective UV therapy should be carried out. This study compared the effects of localized high-dose UVA1 irradiation versus topical cream PUVA for treatment of chronic vesicular dyshidrotic eczema. On the basis of the assessment of the Dyshidrotic Area and Severity Index, the decrease of score points on the UVA1-treated side was compared with the decrease on the cream PUVA–treated side in 27 patients. In addition, analysis of serum markers was performed. Of 27 patients, 24 showed a good response to localized UVA1 irradiation or cream PUVA. Dyshidrotic Area and Severity Index scores significantly decreased on both sides and were reduced to half of the pretreatment values. No statistically significant differences between localized UVA1 irradiation or cream PUVA could be detected. This study demonstrates that localized UVA1 phototherapy is easy to perform and appears to be an effective and safe treatment for vesicular dyshidrotic eczema.