Low-dose UVA₁ phototherapy for scleroderma: what benefit can we expect?

BACKGROUND

The first reports of the application of ultravioletA₁ (UVA₁) phototherapy for scleroderma go back only to 1995, but since then, several studies have proven its effectiveness in this disease.

OBJECTIVES

To evaluate the effectiveness of low-dose (35 J/cm(2) ) UVA(1) phototherapy in patients with scleroderma, trying to define the subgroups that benefit most from this treatment.

METHODS

Retrospective analysis of patients diagnosed with clinical and/or histological scleroderma, undergoing low-dose UVA(1) phototherapy between 2003 and 2010.

RESULTS

We studied 21 patients (20 women and one man) aged 10-75 years (mean 50). Eighteen with morphea performed a total of 29 treatments, with an average of 33 sessions per treatment per patient, a mean dose of 31 J/cm(2) per session and an average cumulative dose of 1662 J/cm(2) (310-4270). The three patients with systemic scleroderma underwent a total of five treatments, with an average of 26 sessions per treatment per patient, a mean dose of 29.5 J/cm(2) per session and an average cumulative dose of 1160 J/cm(2) (660-1695). Using the modified Rodnan skin score, in the group of patients with morphea, a marked improvement was found in 77.8% patients and a moderate improvement was found in 11.1% patients. In the systemic scleroderma group, a patient with complete remission of the skin sclerosis is emphasized.

CONCLUSIONS

Our experience allows us to conclude that low-dose UVA(1) phototherapy is a well tolerated option, with excellent results mainly in patients with morphea. This treatment is a valuable contribution to these patients, given the limited therapeutic options available.