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PUVA Treatment of Alopecia Areata

PUVA Treatment of Alopecia Areata Abstract • Twenty-three patients with alopecia areata were treated with photochemotherapy combining oral or topical methoxsalen and UV-A irradiation of the scalp or of the whole body. Eleven of 17 patients with multiple plaques of alopecia areata, alopecia totalis, and alopecia universalis, who were treated with oral methoxsalen and total body irradiation, had complete or more than 90% hair regrowth. Three patients had a relapse. The mean energy required was 505 joules/sq cm. In six cases, topical applications of methoxsalen or oral methoxsalen combined with local irradiation of the scalp were treatment failures. In the patients responding to treatment, the result did not seem to depend on the age of onset or the extent or duration of disease. However, patients with long-lasting alopecia had a higher risk of recurrence notwithstanding a good initial regrowth of hair. Few side effects of psoralens and UV-A (PUVA) treatment were noted. The mean follow-up period was 18.6 months after the completion of treatment. We discuss the possible mechanisms of action of PUVA in the treatment of alopecia areata. (Arch Dermatol 1983;119:975-978) References 1. Ikeda T: A new classification of alopecia areata . Dermatologica 1965;131:421-445.Crossref 2. Unger WP, Schemmer J: Corticosteroids in the treatment of alopecia totalis . Arch Dermatol 1978;114:1486-1490.Crossref 3. Happle R, Cebulla K, Echternacht-Happle K: Dinitrochlorobenzene therapy for alopecia areata . Arch Dermatol 1978;114:1629-1631.Crossref 4. Ralfs I: Treatment of alopecia areata . Int J Dermatol 1981;20:168-170.Crossref 5. De Prost Y, Paquez F, Touraine R: Dinitrochlorobenzene treatment of alopecia areata . Arch Dermatol 1982;118:542-545.Crossref 6. Weissman I, Hofmann C, Wagner G, et al: PUVA-therapy for alopecia areata . Arch Dermatol Res 1978;262:333-336.Crossref 7. Lassus A, Kianto U, Johansson E, et al: PUVA treatment for alopecia areata . Dermatologica 1980;161:298-304.Crossref 8. Zheltakov MM, Vinokurov IN: Psoralen treatment of alopecia areata in children . Pediatria 1967;2:45. 9. Rollier R, Warcewski Z: Le traitement de la pelade par la méladinine . Bull Soc Fr Derm Syph 1974;81:97. 10. Claudy AL, Gagnaire D: Photochemotherapy for alopecia areata . Acta Derm Venereol 1980;60:171-173. 11. Burger PM, Tijssen JGP, Suurmond D: Photochemotherapy of psoriasis: Clinical study of clearing and long-term maintenance treatment . Dermatologica 1981;163:213-228.Crossref 12. Parrish JA: Phototherapy and photochemotherapy of skin diseases . J Invest Dermatol 1981;77:167-171.Crossref 13. Ortonne JP, Claudy AL, Alario A, et al: Impairment of thymus-derived rosette forming cells during photochemotherapy (psoralen-UVA) . Arch Dermatol Res 1978;262:143-151.Crossref 14. Gu SQ, Ros AM, Thyresson N, et al: Blood lymphocyte subpopulations and antibody-dependent, cell mediated cytotoxicity (ADCC) in alopecia areata and universalis . Acta Derm Venereol 1981;61:125-129. 15. Gianetti A, Di Silverio A, Castellazi AM, et al: Evidence for defective T cell function in patients with alopecia areata . Br J Dermatol 1978;98:361.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Dermatology American Medical Association

PUVA Treatment of Alopecia Areata

Archives of Dermatology , Volume 119 (12) – Dec 1, 1983

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Publisher
American Medical Association
Copyright
Copyright © 1983 American Medical Association. All Rights Reserved.
ISSN
0003-987X
eISSN
1538-3652
DOI
10.1001/archderm.1983.01650360021007
Publisher site
See Article on Publisher Site

Abstract

Abstract • Twenty-three patients with alopecia areata were treated with photochemotherapy combining oral or topical methoxsalen and UV-A irradiation of the scalp or of the whole body. Eleven of 17 patients with multiple plaques of alopecia areata, alopecia totalis, and alopecia universalis, who were treated with oral methoxsalen and total body irradiation, had complete or more than 90% hair regrowth. Three patients had a relapse. The mean energy required was 505 joules/sq cm. In six cases, topical applications of methoxsalen or oral methoxsalen combined with local irradiation of the scalp were treatment failures. In the patients responding to treatment, the result did not seem to depend on the age of onset or the extent or duration of disease. However, patients with long-lasting alopecia had a higher risk of recurrence notwithstanding a good initial regrowth of hair. Few side effects of psoralens and UV-A (PUVA) treatment were noted. The mean follow-up period was 18.6 months after the completion of treatment. We discuss the possible mechanisms of action of PUVA in the treatment of alopecia areata. (Arch Dermatol 1983;119:975-978) References 1. Ikeda T: A new classification of alopecia areata . Dermatologica 1965;131:421-445.Crossref 2. Unger WP, Schemmer J: Corticosteroids in the treatment of alopecia totalis . Arch Dermatol 1978;114:1486-1490.Crossref 3. Happle R, Cebulla K, Echternacht-Happle K: Dinitrochlorobenzene therapy for alopecia areata . Arch Dermatol 1978;114:1629-1631.Crossref 4. Ralfs I: Treatment of alopecia areata . Int J Dermatol 1981;20:168-170.Crossref 5. De Prost Y, Paquez F, Touraine R: Dinitrochlorobenzene treatment of alopecia areata . Arch Dermatol 1982;118:542-545.Crossref 6. Weissman I, Hofmann C, Wagner G, et al: PUVA-therapy for alopecia areata . Arch Dermatol Res 1978;262:333-336.Crossref 7. Lassus A, Kianto U, Johansson E, et al: PUVA treatment for alopecia areata . Dermatologica 1980;161:298-304.Crossref 8. Zheltakov MM, Vinokurov IN: Psoralen treatment of alopecia areata in children . Pediatria 1967;2:45. 9. Rollier R, Warcewski Z: Le traitement de la pelade par la méladinine . Bull Soc Fr Derm Syph 1974;81:97. 10. Claudy AL, Gagnaire D: Photochemotherapy for alopecia areata . Acta Derm Venereol 1980;60:171-173. 11. Burger PM, Tijssen JGP, Suurmond D: Photochemotherapy of psoriasis: Clinical study of clearing and long-term maintenance treatment . Dermatologica 1981;163:213-228.Crossref 12. Parrish JA: Phototherapy and photochemotherapy of skin diseases . J Invest Dermatol 1981;77:167-171.Crossref 13. Ortonne JP, Claudy AL, Alario A, et al: Impairment of thymus-derived rosette forming cells during photochemotherapy (psoralen-UVA) . Arch Dermatol Res 1978;262:143-151.Crossref 14. Gu SQ, Ros AM, Thyresson N, et al: Blood lymphocyte subpopulations and antibody-dependent, cell mediated cytotoxicity (ADCC) in alopecia areata and universalis . Acta Derm Venereol 1981;61:125-129. 15. Gianetti A, Di Silverio A, Castellazi AM, et al: Evidence for defective T cell function in patients with alopecia areata . Br J Dermatol 1978;98:361.Crossref

Journal

Archives of DermatologyAmerican Medical Association

Published: Dec 1, 1983

References