Chronic Hand Eczema Improved With Narrowband UVB, Psoralen UVA

Eczema on a woman's hand
Eczema on a woman’s hand
For patients with chronic palmar hand eczema, both psoralen ultraviolet A and narrowband ultraviolet B treatment improve the severity of the disease.

HealthDay News — Both psoralen ultraviolet A (PUVA) and narrowband ultraviolet B (NBUVB) improve the severity of chronic palmar hand eczema, according to a pilot study published online in the British Journal of Dermatology.

David Brass, from Newcastle Hospitals NHS Trust in the United Kingdom, and colleagues compared immersion PUVA with NBUVB for the treatment of chronic hand eczema that is unresponsive to topical steroids in 60 patients. The authors performed a randomized controlled trial in which treatment was given twice weekly for 12 weeks with assessments every 4 weeks.

Twenty-three of 30 patients in each treatment arm completed the study. The researchers found that 5 patients in the PUVA arm achieved “clear” and 8 achieved “almost clear” on Physician’s Global Assessment treatment response, while 2 in the NBUVB group achieved “clear” and 5 “almost clear.”

Median modified Total Lesion and Symptom Score scores were similar between the groups at baseline and at 12 weeks. Similar improvements were seen in the Dermatology Life Quality index for both groups.

“The trial demonstrated that both PUVA and NBUVB improved the severity of chronic palmar hand eczema,” the authors write. “The study was not designed to demonstrate superiority of one treatment and a larger adequately powered randomized controlled trial will be required to investigate this.”

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Brass D, Fouweather T, Stocken DD, et al. An observer blinded randomised controlled pilot trial comparing localised immersion psoralen ultraviolet A (PUVA) with localised narrowband ultraviolet B (NBUVB) for the treatment of palmar hand eczema [published online December 13, 2017]. Brit J Dermatol. doi: 10.1111/bjd.16238