Targeted Medium Dose UVA-1 Phototherapy for the Treatment of Localized Scleroderma in the Skin of Color: Pros and Cons

Morphea is a connective tissue disorder characterized by skin homogenization. No protocol of therapy is agreed upon, due to the variation in disease presentations as well as follows up methods. UVA-1 is an effective therapy due to deep penetration of the skin. The aim of the study was to evaluate the efficacy, safety and side effects of medium dose (30 J/cm ) UVA-1 phototherapy for the treatment of cases of morphea 2 in darker skin types (Skin type III and IV). Twenty patients with plaque or linear morphea, received 30 sessions of medium dose UVA-1 phototherapy (30 J/cm ), at a rate of 3 sessions per week for 10 weeks. Assessment was 2 done by clinical score, collagen homogenization scores, MMP-1 immunohistochemistry and ultrasound (50 MHz) assessment of skin thickness before and 6 months after treatment. Results: Significant improvement on clinical assessment (p=0.003), increase in collagen breakdown marked by significant increase of MMP-1 staining (p=0.000) and decrease skin thickness by ultrasound (p=0.015). It can be concluded that medium dose UVA-1 phototherapy is effective and safe tool for the treatment of morphea in skin of color.