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Influence of UVA on the erythematogenic and therapeutic effects of UVB irradiation in psoriasis; photoaugmentation effects.

Boer J, Schothorst AA, Suurmond D.

Abstract

The effect of repeated exposure to an additive dose of long ultraviolet (UVA) radiation on the erythemogenic and therapeutic effects of middle ultraviolet (UVB) irradiation was investigated in 8 patients with psoriasis. The surface of the backs of these patients was divided into 2 parts, 1 of which received only UVB irradiation 4 times a week and the other UVA + UVB. UVB was provided by Philips TL-12 lamps and UVA by glass-filtered Philips TL-09 lamps. UVA was held constantly at 10 J/cm2, whereas UVB was increased. The erythemogenic effects of UVA + UVB and UVB alone were evaluated by 4 tests during the treatment to determine the minimal erythema dose (MED). Test I (at the start of the therapy) showed a photoaugmentative effect which was no longer apparent in test III (third week). Test III showed a reversal of the ratios of the MEDs of the sites irradiated with UVA + UVB and UVB (MED A + B/MED B). This is ascribed to the marked pigmentation which appeared after repeated irradiation with the UVA + UVB combination. Comparison showed for the improvement of the psoriasis no distinct differences between UVA + UVB irradiation and UVB alone, but the former had the cosmetic advantage of giving pleasing tan.

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