Comparative analysis of the efficiency of low-intensity laser irradiation and PUVA therapy for the treatment of psoriasis

A total of 66 patients presenting with psoriasis were hospitalized for intravenous irradiation of the blood and allocated to two representative groups. Patients of group 1 (n = 39) were subjected to intravenous laser treatment of the blood (IVLTB), in group 2 (n = 27) they were managed using PUVA therapy. Comparative analysis revealed regression of the symptoms of psoriasis in both groups. IVLTB decreased pruritus after the fourth, oedema and skin exfoliation after the sixth sessions. PUVA-therapy produced similar effects after 8-10 and 14 procedures respectively. Moreover, PUVA-therapy accelerated elimination of psoriatic plaques (their size significantly decreased by the 14th procedure and practically disappeared by the 20th one) whereas IVLTB caused reduction of infiltration signs in all patients. Worthy of note is much more pronounced beneficial effect of IVLTB on the enhanced activity of indicator enzymes (AST and ALT), elevated glucose and total cholesterol levels compared with the action of PUVA-therapy. These effects were practically absent in patients showing normal values of these parameters. Investigation of skin microcirculation by laser Doppler flowmetry demonstrated substantial improvement of microhemodynamic characteristics in patients of group 1. Also, they showed significantly higher remission indices (19.4 months versus 13.5 months in the control group). It should be emphasized that relapses following IVLTB were milder and of more local character than after PUVA-therapy. Moreover, they were easier to correct by pharmacotherapy. Taken together, these observations may be useful for the development of a pathogenetically substantiated therapeutic strategy and the reduction of adverse effects of drug therapy used to treat psoriasis.

psoriasis, PUVA therapy, laserotherapy, intravenous irradiation of blood