PUVA-BAth treatment of palmoplantar psoriasis in children

Palmoplantar psoriasis in children is characterized with sharp demarcated lesions, scaling and fissuring. The lesions may be palm-sized or distributed as smaller units over palms and soles. Palmoplantar psoriasis in children can be treated by conventional therapy (topical keratolytics, topical steroids), PUVA-bath and retinoids.We report our results of PUVA-bath therapy in four children with extensive palmoplantar psoriasis which was poorly responsive to conventional therapy. Hyperkeratotic psoriatic lesions were primarly treated with topical keratolytics under occlusive dressings during three days. For PUVA – bath therapy children immersed palms and soles for 20 minutes in 1 mg/L water solution of 8-MOP at a temperature of 37, 5°C. Immediately after the bath the skin of palms and soles is dried gently and exposed to UVA radiation. Treatments were performed four times a week during four weeks. After the treatment bland emollients were used. Results: After 4-weeks treatment psoriatic leasions disappeared almost completly, only slight erythema were visible. Treatment was tolerated well by all children and no side effects were reported.PUVA-bath therapy is an effective, safe and low-cost therapeutic modality for palmoplantar psoriasis in children which is not responsive to conventional therapy.