Treatment Guidelines


PUVA For Psoriasis

72hrs-MPD

  1. Initial dose: - 70% of MED.

  2. Increment: - If No erythema on normal skin -> Increase 0.5-1.0 J/cm2 /Week

  3. No of Sittings: 3-4 sitting / week.

  4. Followup: - 80% improvement: -> Hold last dose.

  5. - 90% Maintenance: 4 ttt/w -> 2 ttt/2w -> 2 ttt/m

    -Erythema during maintenance: -> Decrease dose by 25%.

    - Relapse: -> Increase frequency of ttt.

  • Missed sittings:
  • - 1-2 missed sittings: -> previous dose

    - 3 missed sittings: -> dose prior to last dose

    - 4 missed sittings: -> 40% of last dose.

    - month: -> repeat phototest.

  • Adverse Effects:
  • - Mild erythema: same previous dose.

    - Moderate erythema: same previous dose, next sitting->Increase 10% thereafter.

    - Severe erythema: No ttt sitting (steroids, NSAIDs) & repeat phototest.

    - Itching: -> Emollient + Antihistamine.

    - Facial erythema:-> Sunscreen.

  • Remarks:
  • limit the use of topical steroids and encourage frequent use of emollient before treatment by applying a very thin layer of emollient.

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