Observation Of Therapeutic Effect Of PUVA-turban In The Treatment Of Alopecia Areata

Objectives:Alopecia Areata is a nonscarring, autoimmune , inflammatory , hair loss on the scalp , and/or body.Orally administered PUVA therapy has been shown among numerous systemic and topical treatment modalities to be a therapeutic alternative,however,the clinical use of oral PUVA is often limited by systemic side effects. Bath-PUVA therapy offers an alternative solution because of the negligible systemic absorption of psoralen with this technique.But it is incovenient to administer the bath-PUVA solution to the entire body.PUVA-turban treatment is a modification of Bath-PUVA therapy,it was applied by Behrens-Williams et al and had shown itself to be a well curative effect in the treatment of alopecia areata in 2001.Through use of a"PUVA-turban"it is now possible to administer a dilute bathwater solution containing 8-methoxypsoralen(8-MOP)to the scalp . Which is ideal because it offers the ability of treating only the scalp rather than the entire body for a scalp problem.The purpose of this study was to determine whether puva-turban therapy is effective in treating alopecia areata,and the effects of different doses of UVA on the curative effect,to offer a evidence for clinical use.Methods:Total patients selected with alopecia areata were made definite diagnosis in out-patient clinic of dalian medical university affiliated hospital No.1.They were separated for two groups randomly.At each treatment session a cotton towel was soaked with a 0.0001%8-MOP solution(1mg/l) at 37℃, wrung gently to remove excess water ,and wrapped around the patient,s head in a turban fashion for 20 minutes.This was directly followed by UVA radiation.Treatment sessions were initially performed two times per week.The starting dosage of irradiation ranged from 0.3-0.5J/cm~2, with increasing increments of 0.3-0.5J/cm~2 every one(one group) or two(anither group) course.The single dose ranged from 0.3-6.5 J/cm~2.Calculated the cumulative dose and response rate of the two groups.The data of results were analyzed by SPSS11.5 software.Results:The first group 12 patients((7 women, 5 men), the age of the patients ranged from 19 to 58 years(mean,41 years);the second group 12 patients((6 women, 6 men), the age of the patients ranged from 22 to 53 years(mean,39 years).The cumulative UVA doses of the two groups were 10.4J/cm~2(fourth week),47.0 J/cm~2(tenth week) and 14.8 J/cm~2(fourth week),53.4 J/cm~2(tenth week) respectively.The response rate for the two groups were 67% and 75% respectively.There was non correlation between the UVA irradiation increasing increment and the curative effect of the patients. No obvious adverse reactions were discovered.Conclusions:1.PUVA-turban therapy can be considered a useful method of administering a dilute psoralen solution selectively to the scalp of patients .2.PUVA-turban therapy is the lack of systemic side effects and,it has been shown to be a well-tolerated and minor adverse effect .3.No significant difference between the UVA irradiation increasing increment and the curative effect of the patients.