Influence of UVA on the erythematogenic and therapeutic effects of UVB irradiation in psoriasis; photoaugmentation effects.

The effect of repeated exposure to an additive dose of long ultraviolet (UVA) radiation on the erythemogenic and therapeutic effects of middle ultraviolet (UVB) irradiation was investigated in 8 patients with psoriasis. The surface of the backs of these patients was divided into 2 parts, 1 of which received only UVB irradiation 4 times a week and the other UVA + UVB. UVB was provided by Philips TL-12 lamps and UVA by glass-filtered Philips TL-09 lamps. UVA was held constantly at 10 J/cm2, whereas UVB was increased. The erythemogenic effects of UVA + UVB and UVB alone were evaluated by 4 tests during the treatment to determine the minimal erythema dose (MED). Test I (at the start of the therapy) showed a photoaugmentative effect which was no longer apparent in test III (third week). Test III showed a reversal of the ratios of the MEDs of the sites irradiated with UVA + UVB and UVB (MED A + B/MED B). This is ascribed to the marked pigmentation which appeared after repeated irradiation with the UVA + UVB combination. Comparison showed for the improvement of the psoriasis no distinct differences between UVA + UVB irradiation and UVB alone, but the former had the cosmetic advantage of giving pleasing tan.