Liver biopsies from patients with psoriasis related to photochemotherapy (PUVA): findings before and after 1 year of therapy in twelve patients. A blind study and review of literature on hepatotoxicity of PUVA.
In each of twelve patients with psoriasis, a liver biopsy was taken before and after 1 year of photochemotherapy (psoralen and long-wave ultraviolet light; PUVA). The mean dose of psoralen was 3,204 mg (range, 1360-5300) at the time of the latter liver biopsy, whereas the mean number of treatments was seventy-nine (range, 34-126 treatments). Analysis by the sign test showed no statistically significant differences in any of the light microscopic variables comparing pre- and posttherapy liver biopsies. No changes were found that appeared to be specific for PUVA therapy. Psoralen, in the doses given as part of PUVA therapy for 1 year in a limited number of patients, seems to have little hepatotoxicity. The literature on the possible hepatotoxicity after treatment with psoralen followed by ultraviolet A irradiation is reviewed. Patients receiving PUVA therapy should have only limited alcohol intake. From this reading, psoralens as part of PUVA therapy appear to have little or no hepatotoxicity.