Combined treatment of psoriasis with acitretin and UVB phototherapy compared with acitretin alone and UVB alone

The administration of UVB phototherapy and low-dose acitretin (0.34-0.44 mg/kg body weight) was compared with the effect of acitretin alone and UVB phototherapy alone in 41 patients with plaque-type psoriasis. Of these patients, 32 received standard UVB phototherapy without acitretin. The other nine were treated with acitretin and the effect of UVB irradiation (Sylvania UV 21-tubes), applied to one half of the body, was assessed. Clearance was defined as 80-100% improvement and this occurred in eight out of the nine patients (89%) treated with acitretin-UVB (ReUVB) and, in two of them (23%), on the untreated side. Clearance occurred in 20 of the 32 (62.5%) patients given UVB alone. The improvement score was significantly higher for the ReUVB side than the acitretin side. Patients treated with ReUVB showed a statistically higher therapeutic score (95-100% clearance) than those receiving UVB alone. However, taking 80-100% improvement as the criterion, no significant difference was found. The number of treatments to clearance was significantly less for the patients treated with ReUVB than for the UVB (19.3 as compared with 24.9). The total UVB dose and the number of minimal erythema doses (MEDs) could be reduced by approximately 20% in the ReUVB group relative to the UVB group.