Oral PUVA therapy of progressive systemic sclerosis

We described two patients with progressive systemic sclerosis (PSS) treated with oral PUVA therapy. Case 1. 63-year-old woman had been suffering from skin swelling and tightness and Raynoud's phenomenon on her hands and fingers for several years. Case 2.56-year-old woman had been suffering from skin swelling and tightness on her forearms, hands and fingers and pulmonary fibrosis for one year. In both cases oral corticosteroid therapy were little effective to skin lesions. PUVA therapy was commenced with the oral administration of 8-methoxypsoralen (30 mg) and UVA irradiation. UVA irradiation was started at 2 J/cm² on a part of skin lesions, and then increased gradually up to 5 J/cm² and, over the whole body. Significant skin softing was observed and edema decreased after 6 treatments (15 J/cm²). Total UVA doses were 186 J/cm² (left forearm), 155 J/cm² (right forearm), 105 J/cm² (whole body except for both forearms) in case 1, 109 J/cm² (right upper extrmity), 97 J/cm² (left upper extrmity and trunk), 72 J/cm² (face and lower extrmities) in case 2. Skin thickening and joint mobility improved in both patients, but pulmonary fibrosis was not changed after PUVA treatments. Oral PUVA therapy may be beneficial in early phase of PSS.