PUVA treatment of alopecia areata

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Abstract
Patients (23) with alopecia areata were treated with photochemotherapy combining oral or topical methoxsalen and UV-A irradiation of the scalp or of the whole body. Of 17 patients with multiple plaques of alopecia areata, alopecia totalis and alopecia universalis, who were treated with oral methoxsalen and total body irradiation, 11 had complete or > 90% hair regrowth. Three patients had a relapse. The mean energy required was 505 Jo/cm2. In 6 cases, topical applications of methoxsalen or oral methoxsalen combined with local irradiation of the scalp were treatment failures. In the patients responding to treatment, the result did not seem to depend on the age of onset or the extent or duration of disease. Patients with long-lasting alopecia had a higher risk of recurrence notwithstanding a good initial regrowth of hair. Few side effects of psoralens and UV-A (PUVA) treatment were noted. The mean follow-up period was 18.6 mo. after the completion of treatment. The possible mechanisms of action of PUVA in the treatment of alopecia areata are discussed.