Ultraviolet A1 phototherapy: One center's experience

Ultraviolet A1(UVA1) phototherapy is increasingly being used in the treatment of morphea, atopic dermatitis, lupus and some other recalcitrant dermatoses. We present a retrospective review of our experience with this modality.

To evaluate the treatment response rates for various dermatoses and adverse effects of UVA1 phototherapy.

We reviewed phototherapy notes along with electronic and/or paper case records for all patients treated with UVA1 phototherapy from October 1996 to December 2008.

A total of 269 patients (outcomes available for 247) had 361 treatment courses (treatment data available for 317 courses) over this period. We found phototherapy to be beneficial in 28 (53%) of 53 patients with atopic dermatitis and 19 (51%) of 37 patients with morphea. A beneficial outcome was recorded in all six (100%) cases of urticaria and six (85.7%) of seven patients treated for a polymorphic light eruption. Benefit was also recorded in systemic lupus erythematosus (8 (44.4%) of 18), lichen sclerosus (6 (42.9%) of 14), mastocytosis (2 (33.3%) of 6), necrobiosis lipoidica (4 (30.8%) of 13), granuloma annulare (2 (25%) of 8), scleroderma (2 (22.2%) of 9) and keloids (1 (7.7%) of 13). Overall, treatment was well tolerated with no patients having to stop treatment due to adverse effects.

This is a retrospective study with no control group. Subjective/recall bias is quite possible as a number of patients were followed up over the phone.

Our data suggest that ultraviolet A1 can be considered for the treatment of selected dermatoses. However, long-term malignancy risk is as yet unknown.