[Balneologic photochemotherapy of prurigo simplex subacuta]

Seventeen patients with extensive subacute prurigo, often resistant to different regimens of prior external and internal therapy, were treated with PUVA bath photochemotherapy (psoralen bath followed by UVA irradiation) using bath water containing 0.5 mg/l of 8-methoxypsoralen (8-MOP). In 15 of 17 patients treated, the skin lesions showed a significant improvement or even complete clearance within 8 weeks of therapy. In two patients, only limited clinical improvement was achieved. Follow-up after 6 weeks revealed sustained improvement in the successfully treated patients. The mean cumulative UVA dose given until clearance was 30.3 (SD +/- 12.6) J/cm2. Therefore, a mean of 24.1 (SD +/- 5.3) PUVA bath treatments was necessary. No side effects were seen except phototoxic reactions in two patients manifested as slight erythema. The results of this trial show that PUVA bath photochemotherapy with 8-MOP is an effective therapeutic alternative to other known therapies in subacute prurigo. Compared to oral PUVA therapy or other topical and systemic treatments, PUVA bath photochemotherapy with 8-MOP shows an excellent efficiency-side effect ratio. The clearance of chronic skin lesions refractive to other topical or systemic treatments by PUVA bath photochemotherapy with 8-MOP demonstrates that this therapy can be even superior to other common therapeutic modalities used for subacute prurigo.