Use of topical daylight psoralen UVA (PUVA) therapy successfully treated post-burn leukoderma, according to case report findings published in Dermatologic Therapy.
Hypopigmentation, or leukoderma, is a complication of burn injuries that dermatologists often find difficult to treat. Various treatment modalities such as tattooing, split thickness skin grafting, punch grafting, suction blister epidermal grafting, and non-cultured melanocyte-keratinocyte transplantation often result in variable outcomes. PUVA is known to stimulate melanogenesis yet the efficacy of PUVA for post-burn leukoderma has not been previously reported.
Dermatologists reported on a 56-year-old woman who presented with post-burn leukoderma on the dorsal aspects of both hands secondary to burns sustained from a boiling water injury 8 months prior. Several weeks after the injury, depigmented patches formed in the affected areas. Topical daylight PUVA therapy was initiated 3 times per week for 6 months and consisted of compound 8-methoxypsoralen (8-MOP) 1% lotion applied 1 hour before sunset for 30 minutes followed by 5 minutes of outdoor, shaded exposure. The duration of the outdoor, shaded exposure was increased by 1 minute for subsequent weeks as tolerated. To alleviate anticipated erythema, the patient was prescribed tacrolimus 0.1% ointment (twice daily on weekdays) and clobetasol 0.05% ointment (twice daily on weekends).
After 6 months of topical daylight PUVA therapy, the treatment was well tolerated, and the patient displayed excellent improvement with almost complete repigmentation.
A limitation of this study is the concurrent use of topical immunomodulators.
Overall, the researchers believe PUVA therapy is a “simple and cheap alternative treatment option” for postburn leukoderma with the advantage of the convenience of performing PUVA at home.
Alzahrani Z, Ghobara YA, AlJasser MI. Postburn leukoderma successfully treated with topical daylight psoralen UVA therapy [published online February 5, 2020]. Dermatologic Ther. Dermatol Ther. doi:10.1111/dth.13248