Cost-effectiveness of PUVA
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Excerpt
Five years ago a new form of systemic therapy for psoriasis was introduced.1 The treatment combines the oral injestion of methoxsalen followed by increasing light (long-wave ultraviolet light [UVA]) given in special phototherapy boxes in established centers. This outpatient form of therapy has proved highly effective in two large cooperative studies2,3 in the United States and also has been confirmed as standard therapy worldwide. The short-term side effects have been minimal and acceptable. Long-term side effects are yet to be determined, but one study4 has suggested increased incidence of skin cancer, especially squamous cell carcinoma, but other studies5,6 have argued that patients with severe psoriasis may have increased incidence of skin cancer because of exposure to other carcinogens such as x-ray, ultraviolet light in the sunlight range (UVB) for Goeckerman therapy, and other chemotherapeutic drugs. PUVA may increase the risk of skin cancer but no more than
