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Dermatomyositis occurring during psoralen A (PUVA) therapy
P A Sinoway1, C L Davidson, J P Callen
1University of Louisville, Department of Medicine, KY.
The Journal of Rheumatology
|February 1, 1994
Summary
Psoralen ultraviolet-A (PUVA) therapy may trigger dermatomyositis (DM), a rare autoimmune condition. This case report highlights a patient who developed DM following PUVA treatment for psoriasis.
Area of Science:
- Dermatology
- Rheumatology
- Immunology
Background:
- Psoralen ultraviolet-A (PUVA) therapy is a common photochemotherapy for inflammatory skin conditions like psoriasis.
- The potential for iatrogenic induction of autoimmune diseases by therapeutic interventions requires careful consideration.
Observation:
- A 35-year-old woman developed symptoms of dermatomyositis (DM) after two months of PUVA therapy for presumed psoriasis.
- Clinical presentation included symmetrical proximal muscle weakness and characteristic cutaneous lesions of DM.
Findings:
- Laboratory investigations revealed a positive antinuclear antibody (ANA) and elevated muscle enzymes, creatine kinase (CK) and aldolase.
- This represents the first documented case of DM developing subsequent to PUVA therapy.
Implications:
- The findings suggest a potential link between PUVA therapy and the iatrogenic development of dermatomyositis.
- Further research is warranted to elucidate the pathomechanisms and incidence of phototherapy-induced DM.
- Clinicians should maintain a high index of suspicion for autoimmune myopathies in patients undergoing PUVA treatment.