No systematic reviews were found. PUVA versus UVA
In a double-blind randomised within-patient trial of 15 patients with chronically relapsing vesicular hand eczema, topical PUVA and UVA treatment showed improvement of the severity score over the 8-week treatment period but no statistical difference between the treated hands at any stage.22
Eighteen patients with chronic hand eczema resistant to conventional topical therapy with potent corticosteroids were randomly divided into three treatment groups: UVB of the hands only, placebo irradiation, and whole-body UVB irradiation.23 Local UVB irradiation of the hands was significantly better than placebo; whole-body UVB irradiation with additional irradiation of the hands was significantly better than the continuing local treatment alone (not specified) according to a simple clinical grading (cleared, improved, unchanged/worse). A 3-month follow up demonstrated the fast relapse of hand eczema.
In a left-right design, there was little difference between topical 8-methoxypsoralen (8-MOP) bath PUVA and topical 8-MOP lotion PUVA therapy in 24 patients with chronic hand or foot eczema; there was greater than 80% clearing with both modalities.24 After 1 month the most successful treatment was continued on both sides until lesions cleared; there was no difference in the length of the relapse-free period. A small controlled pilot trial comparing topical PUVA, systemic PUVA and topical corticosteroids was inconclusive.25
This was compared in a right-left (within-patient) study of seven patients with dyshidrotic hand eczema.26 All patients responded and remained disease-free on a maintenance schedule for 2-6 months. Out of 20 patients with different conditions, five patients with endogenous eczema were treated in a controlled study of PUVA therapy versus no treatment but it was unclear how many of the treated hands responded.27
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