Background: Localized skin lesions of the genito-anal region such as in lichen sclerosus et atrophicus or in lichen planus are a burden for many patients, and therapeutic efforts, including therapies with potentially hazardous side-effects, are often unsatisfactory. Recently, PUVA bath photochemotherapy has been proven highly effective in the treatment of various inflammatory skin diseases, including localized scleroderma. Another form of topical PUVA therapy, 8-methoxypsoralen-containing cream or gel preparations, has been proven to be as effective as PUVA bath therapy for palmoplantar dermatoses. Objective: We evaluated the clinical effects of PUVA cream photochemotherapy in patients with genital lesions of inflammatory skin diseases. Methods: Twelve patients with lichen sclerosus et atrophicus, lichen planus, vulvar eczema and pruritus vulvae were included in the study. PUVA cream therapy was performed up to 4 times a week. Results: PUVA cream photochemotherapy induced a significant clinical improvement of genital lesions in most patients, as revealed by clinical examination. Clinical improvement (reduction in size of lesions of erythema, and/or of pruritus) was achieved in most patients after 10–20 treatments and was reduced in patients that had only received 5–15 treatments. Cumulative doses ranged between 4.5 and 180 J/cm2; all patients tolerated PUVA cream phototherapy well without any side-effects. Conclusion: PUVA cream phototherapy represents a highly effective therapy that should be further investigated as an alternative treatment for patients with genital lesions of inflammatory skin diseases.

1.
Katta R: Lichen planus. Am Fam Physician 2000;61:3319–3324, 3327–3328.
2.
Powell JJ, Wojnarowska F: Lichen sclerosus. Lancet 1999;353:1777–1783.
3.
Garcia-Bustinduy M, Noda A, Sanchez R, Gonzalez de Mesa MJ, Guimera F, Garcia-Montelongo R: PUVA therapy in localized scleroderma. J Eur Acad Dermatol Venereol 1998;10:283–284.
4.
Grundmann-Kollmann M, Ochsendorf F, Zollner TM, Spieth K, Sachsenberg-Studer E, Kaufmann R, Podda M: PUVA cream photochemotherapy for the treatment of localized scleroderma. J Am Acad Dermatol 2000;43:675–678.
5.
von Kobyletzki G, Hoffmann K, Kerscher M, Altmeyer P: Plasma levels of 8-methoxypsoralen following PUVA-bath photochemotherapy. Photodermatol Photoimmunol Photomed 1998;14:136–138.
6.
Stege H, Berneburg M, Ruzicka T, Krutmann J: Cream PUVA photochemotherapy. Hautarzt 1997;48:89–93.
7.
Grundmann-Kollmann M, Behrens S, Peter RU, Kerscher M: Treatment of severe recalcitrant dermatoses of the palms and soles with PUVA-bath versus PUVA-cream therapy. Photodermatol Photoimmunol Photomed 1999;15:87–89.
8.
Karrer S, Eholzer C, Ackermann G, Landthaler M, Szeimies RM: Phototherapy of psoriasis: Comparative experience of different phototherapeutic approaches. Dermatology 2001;202:108–115.
9.
Aragane Y, Kawada A, Maeda A, Isogai R, Isogai N, Tezuka T: Disseminated scleroderma of a Japanese patient successfully treated with bath PUVA photochemotherapy. J Cutan Med Surg 2001;5:135–139.
10.
Bethea D, Fullmer B, Syed S, et al: Psoralen photobiology and photochemotherapy: 50 years of science and medicine. J Dermatol Sci 1999;19:78–88.
11.
Wlaschek M, Wenk J, Brenneisen P, Briviba K, Schwarz A, Sies H, Scharffetter-Kochanek K: Singlet oxygen is an early intermediate in cytokine-dependent ultraviolet A induction of interstitial collagenase in human dermal fibroblasts in vitro. FEBS Lett 1997;413:239–242.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.