Abstract

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.