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An Open-Label Randomized Controlled Trial of Efficacy

A. Marco van Coevorden, MD; Willeke G. Kamphof, MD; Eric van Sonderen, PhD; Derk P. Bruynzeel, MD, PhD; Pieter-Jan Coenraads, MD, PhD, MPH

Arch Dermatol. 2004;140:1463-1466.

Objective  To study whether oral psoralen–UV-A (PUVA) with a portable tanning unit at home is as effective as hospital-administered bath PUVA in patients with chronic hand eczema.

Design  Open-label randomized controlled trial, with a 10-week treatment period and an 8-week follow-up period.

Setting  Two university hospital dermatology departments in the Netherlands, specializing in hand eczema.

Patients  One hundred fifty-eight patients with moderate to severe chronic hand eczema (more than 1 year in duration).

Interventions  Oral PUVA using methoxsalen capsules and a simple portable commercial facial tanning unit, or hospital-administered bath PUVA with trioxsalen.

Main Outcome Measures  The primary outcome was clinical assessment by a hand eczema score (evaluation of desquamation, erythema, vesiculation, infiltration, fissures, itch, and pain, each on a 4-point scale) after 10 weeks of treatment. The secondary outcome was hand eczema score at 8 weeks of follow-up, after completion of treatment. The tertiary outcome was travel cost and time off work.

Results  Both groups showed a comparable and substantial decrease in hand eczema score (meaningful clinical improvement). This decrease was maintained during the follow-up period. Patients treated with oral PUVA at home had lower travel costs and less time off work.

Conclusions  Oral PUVA at home has a clinically relevant efficacy, similar to that of hospital-administered bath PUVA. This effect was maintained during an 8-week follow-up period. It resulted in lower travel costs and less time off work.

Author Affiliations: Department of Dermatology, University Hospital Groningen, Groningen, the Netherlands (Drs van Coevorden and Coenraads); Department of Dermatology, VU Medical Centre, Amsterdam, the Netherlands (Drs Kamphof and Bruynzeel); and Northern Centre for Healthcare Research, University of Groningen (Dr van Sonderen).

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THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

PUVA for Chronic Hand Eczema: Better to Stay at Home
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