Psoralen plus UVA vs. UVB-311 nm for the treatment of lichen planus
Article first published online: 25 JAN 2007
Photodermatology, Photoimmunology & Photomedicine
Volume 23, Issue 1, pages 15–19, February 2007
How to Cite
Wackernagel, A., Legat, F. J., Hofer, A., Quehenberger, F., Kerl, H. and Wolf, P. (2007), Psoralen plus UVA vs. UVB-311 nm for the treatment of lichen planus. Photodermatology, Photoimmunology & Photomedicine, 23: 15–19. doi: 10.1111/j.1600-0781.2007.00261.x
- Issue published online: 25 JAN 2007
- Article first published online: 25 JAN 2007
- Accepted for publication 4 August 2006
- Lichen planus;
- psoralen plus UVA (PUVA);
- UVB-311 nm
Background: The purpose of this study was to evaluate and compare the short- and long-term therapeutic efficacy of psoralen plus UVA (PUVA) vs. UVB-311 nm in the treatment of patients with disseminated lichen planus.
Methods: A computerized data bank search and chart review revealed that data from a total of 28 patients, including 15 patients [11 women, four men; mean age 47 years (range, 16–65 years)] treated between 1998 and 2004 with PUVA and 13 patients [10 women, three men; mean age 51 years (range, 19–69 years)] treated with UVB-311 nm, were available at our institution for retrospective analysis.
Results: All 15 patients (100%) treated with oral PUVA had a complete [n=10 (67%)] or partial [n=5 (33%)] clinical response, whereas 10 of 13 patients (77%) treated with UVB-311 nm showed complete [n=4 (31%)] or partial [n=6 (46%)] clinical response. Statistical analysis revealed that the initial response to PUVA was superior to that of UVB-311 nm (P=0.0426; Wilcoxon's exact test). There were no statistically significant differences between the PUVA- and UVB-311 nm-treated patient groups with regard to mean therapy duration (10.5 vs. 8.2 weeks; P=0.1107; unpaired, two-tailed Student's t test) or mean number of treatment exposures (25.9 vs. 22.5; P=0.1775). After a mean follow-up period of 20.5 months (range, 2–49 months) and 35.7 months (range, 3–60 months), respectively, disease recurrence or deterioration was observed in seven of 15 PUVA-treated patients (47%) and three of 10 UVB-311 nm-treated patients (30%). Kaplan–Meier lifetime table analysis revealed no statistically significant difference between the 2 treatment groups in terms of sustained overall (i.e., partial and complete) clinical response rate (P=0.8593; log-rank test).
Conclusions: Even though oral PUVA produces a better initial clinical response rate, both oral PUVA and UVB-311 nm are effective treatments for lichen planus that produce similar long-term outcomes.