A new investigational treatment for severe psoriasis has been introduced,1,2 but it is being widely used in an uncontrolled fashion. This treatment is a form of photochemotherapy known as PUVA (psoralen with ultraviolet light in the A range) and consists of total body irradiation with high-intensity, long-wave-length, ultraviolet light of a narrow band (320 to 400 nm) after oral administration of 8-methoxypsoralen (methoxsalen).
The mechanism by which PUVA produces therapeutic results is thought to be the formation of psoralen-DNA photo adducts that decrease cellular replication in the epidermis. PUVA is known to cause mutations to mammalian cells in vitro3,4 and to produce chromosomal damage in vivo5,6; these changes in DNA have been linked experimentally to teratogenesis and carcinogenesis.
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