PUVA Photochemotherapy is widely used for treating widespread vitiligo. This white patches on skin treatment is a combination of psoralen + UVA (PUVA) light. The Psoralen is given orally before giving the UVA light treatment. The same treatment also is done with a combination of trimethylpsoralen and sunlight or with the combination of Trisoralen/Oxsoralen with Ultra artificial UVA light. Ophthalmologic examination and ANA blood tests are taken prior to the PUVA treatment for white patches.
Combination of trimethylpsoralen and sunlight:
This therapy is initiated with 0.6 mg/kg Trisoralen doses. The patient has to wait for 2 hours before getting exposed to sunlight for 3 to 5 min. This treatment is given for 2 sessions per week and where the sessions are given in equal gaps. The duration of pf sunlight exposure increases with the observance of improvement signs.
Combination of Trisoralen/Oxsoralen with Ultra artificial UVA light:
For these white patches on skin treatment, either 0.4 mg/kg of Oxsoralen-Ultra or 0.6 mg/kg of Trisoralen is given. While Oxsoralen-Ultra may cause nausea, Trisoralen causes very little nausea. Once they are given, the patient is initially exposed to 1.0 J UVA. This treatment is also given twice a week with equally gapped sessions. Gradually the doses of Oxsoralen-Ultra and Trisoralen may be increased if no signs of phototoxicity are observed. The treatment sustained until repigmentation occurs.
The PUVA treatment for white patches is given for patients with over 70% vitiligo widespread in the face, neck, arms or legs. This treatment is not used for treating genital areas. The treatment risk may include nausea, upset stomach, sunburn, hyperpigmentation, or acute dryness in the skin. It has been seen that the patients who respond to PUVA white patches on skin treatment are less likely to develop new vitiligo patches.