Successful treatment of resistant alopecia areata with a phototoxic dose of ultraviolet A after topical 8-methoxypsoralen application.

BACKGROUND

The efficacy of a phototoxic dose of ultraviolet A (UVA) after topical application of 8-methoxypsoralen (8-MOP) in the treatment of alopecia areata (AA) was evaluated previously in only one study. However, the possibility of spontaneous regrowth of hair cannot be excluded as sessions were carried out every 3 months.

OBJECTIVE

To determine the efficacy of a phototoxic dose of UVA after topical application of 8-MOP in the treatment of AA resistant to other lines of treatment.

SUBJECTS/METHODS: Thirty-five patients with AA were treated by topical 8-MOP application to the lesions followed by UVA irradiation using a phototoxic dose every 3 months for a maximum of four sessions. Severity grading of AA was carried out using the Severity of Alopecia Tool (SALT) score before and after treatment.

RESULTS

Fifty-seven percent of patients showed a positive treatment response (40% showed complete and 17% showed partial response) with significant improvement of SALT score. The mean cumulative UVA dose was 22±8.3 J/cm(2). Mild reversible side effects were observed in 63% of patients after the first session.

CONCLUSION

Phototoxic psoralen and ultraviolet A therapy after topical application of 0.1% 8-MOP is an effective treatment option for resistant AA, with low total cumulative UVA dose, few treatment sessions, and minimal reversible side effects.