Effectiveness of medium-dose ultraviolet A1 phototherapy in localized scleroderma.

Ozlem Su, Nahide Onsun, Hulya Kapran Onay, Yeliz Erdemoglu, Dilek Biyik Ozkaya, Filiz Cebeci, Adnan Somay

Department of Dermatology, Bezmialem Vakif University, Faculty of Medicine Neoson Imaging Center, Radiology Department of Pathology, Vakif Gureba Teaching and Research Hospital, Istanbul, Turkey.

Background  Recently, ultraviolet (UV) A1 phototherapy has been suggested as an effective treatment for localized scleroderma (LS); however, the optimal dose of UVA1 still has not been determined. Objective  We aimed to evaluate the therapeutic effectiveness of medium-dose (30 J/cm(2)) UVA1 phototherapy and to show that 13 MHz ultrasound is a valuable tool for assessing the results of UVA1 phototherapy in LS. Methods  Thirty-five patients with LS were treated with medium-dose (30 J/cm(2)) UVA1. In total, 30-45 treatments and 900-1350 J/cm(2) cumulative UVA1 doses were evaluated by clinical scoring in all patients. In 14 patients, skin thickness was also determined by 13 MHz ultrasound examination. Results  In all patients, medium-dose UVA1 therapy softened sclerotic plaques, and marked clinical improvement was observed in 29 of 35 (82. 85%) patients. Ultrasound measurements showed that skin thickness was significantly reduced. No side effects were observed during or after treatment. Conclusion  Medium-dose UVA1 phototherapy is a highly effective, safe, and well-tolerated therapeutic modality for treatment of all types of LS. A 13 MHz ultrasound probe may be used for evaluating UVA1 phototherapy results.