Treatment of psoriatic arthritis with extracorporeal photochemotherapy and conventional psoralen–ultraviolet A irradiation

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Abstract
Objective. To study the use of combined photopheresis and psoralen–ultraviolet A irradiation (PUVA) in the treatment of psoriatic arthritis. Methods. Eight patients with psoriasis and sero‐negative arthritis received photopheresis for 12 weeks, followed by photopheresis plus PUVA for another 12 weeks. Clinical and laboratory examinations were performed every 3 months for up to 1 year after therapy. Results. Four patients experienced a marked improvement of joint symptoms that lasted for ≥12 months post‐therapy (74% decrease in the Ritchie articular index; P < 0.01). Prior to therapy, these patients had a higher CD4:CD8 ratio than the poor responders. Only minor laboratory changes occurred. Conclusion. A more extensive trial of photopheresis plus PUVA in psoriatic arthritis is warranted.