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Definition of PUVA

PUVA: PUVA stands for psoralen (P) and ultraviolet A (UVA) therapy in which the patient is exposed first to psoralens (drugs containing chemicals that react with ultraviolet light) and then to UVA light.

PUVA is used to treat vitiligo (white patches on the skin). It is time-consuming and care must be taken to avoid side effects, which can sometimes be severe. The treatment involves taking psoralen by mouth (orally) or applying it to the skin (topically). This is followed by carefully timed exposure to ultraviolet A (UVA) light from a special lamp or to sunlight. Patients usually receive treatments in their doctors' offices so they can be carefully watched for any side effects. Patients must minimize exposure to sunlight at other times. The goal of PUVA therapy in vitiligo is to repigment the white patches.

PUVA is also highly effective in treating severe psoriasis, a common chronic disorder of the skin characterized by reddish, scaly patches of inflammation, most commonly affecting the elbows, knees, scalp, or groin. Psoriasis can be mild or severe. When severe, it can adversely affect functions of daily living including work and social activities. About 10-15% of people with psoriasis develop arthitis -- psoriatic arthritis.

However, PUVA therapy has its hazards. It increases the risk for cancer of the skin, a risk that includes melanoma, a highly malignant and sometimes fatal form of skin cancer. Patients who receive long-term PUVA treatment should therefore be carefully monitored throughout their lives. These patients should also report to their healthcare practitioners any peculiar skin abnormalities, including abnormally pigmented areas and skin that is changing color or size, itching, or painful.

The mechanism by which PUVA promotes skin cancer may sometimes involve the human papillomavirus (HPV). There is an increased prevalence of HPV in hairs plucked from patients with psoriasis treated with PUVA. HPV is tumorigenic (it causes the formation of tumors).

PUVA treatment is also called psoralen photochemotherapy.


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