UVA1 phototherapy for cutaneous diseases: an experience of 92 cases in the United States Chanisada Tuchinda 1 , Holly A. Kerr 1 , Charles R. Taylor 2 , Heidi Jacobe 3 , Bettany M. Bergamo 4 , Craig Elmets 4 , Jennifer Rivard 1 , Henry W. Lim 1 1 Department of Dermatology, Henry Ford Hospital, Detroit, MI, USA, 2 Department of Dermatology, Massachusetts General Hospital, Boston, MA, USA, 3 Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, TX, USA, and 4 Department of Dermatology, University of Alabama, Birmingham, AL, USA Background: The efficacy and safety of UVA1 (340– 400 nm) phototherapy were established by studies from European countries. Purpose: Evaluate experience with UVA1 photother- apy for patients with cutaneous diseases in the United States. Methods: A retrospective analysis of 92 cases of UVA1-treated cutaneous conditions from four medical centers in the United States was performed. Results: Two-third of the patients showed a fair to good response (26–100% improvement) and one-third of the patients showed a poor response (0–25% im- provement). Diseases with a moderate to good re- sponse (51–100% improvement) included scleredema adultorum, hand or foot dermatitis, atopic dermatitis, morphea (medium or medium- to high-dose UVA1), systemic sclerosis, and urticaria pigmentosa. Besides tanning, other adverse effects were found in 15% of patients, which include pruritus, erythema, tenderness, and burning sensation. Patients with skin types I–III responded better that those with a darker skin type. Conclusion: UVA1 phototherapy is a useful and well- tolerated treatment option for a variety of skin condi- tions. Key words: phototherapy; UVA1. U VA1 phototherapy is now recognized as one of the first-line treatments for several sclerotic diseases and in several inflammatory dermatoses. The development of a lamp emitting radiation pre- dominantly in the UVA1 range was described in 1981 (1). The advantage of UVA1 for cutaneous diseases was first reported in 1992, for treatment of patients with acute exacerbation of atopic dermatitis (2, 3). In 1995, UVA1 was reported to be beneficial for the treatment of localized scleroderma (4). UVA1 radia- tion induces collagenase activity, which results in degradation of collagen in sclerotic lesion (5, 6). Clinical improvement as well as a decrease in dermal thickness measured by 20 MHz ultrasounds in 10 localized scleroderma patients receiving low-dose UVA1 (20 J/cm 2 ), four times a week for 6 weeks, was reported (4). Since then, UVA1 phototherapy has shown promise for a variety of skin conditions such as atopic dermatitis, morphea, systemic sclerosis, extragenital lichen sclerosus, chronic sclerodermic graft-versus-host disease, POEMS (polyneuropathy, organomegaly, endocrinopathy, monoclonal gammo- pathy, skin changes) syndrome, systemic lupus erythe- matosus, cutaneous mastocytosis, hypereosinophilic syndrome, granuloma annulare, sarcoidosis, keloids, idiopathic follicular mucinosis, pityriasis lichenoides, and cutaneous T-cell lymphoma (7–29). Most reports regarding UVA1 originate in Europe; there are few published studies reporting the use of UVA1 from the United States despite the use of this therapy in the US since 1997. The purpose of this study is to evaluate the experience in four US medical centers involving 92 patients treated with UVA1. Patients and methods Data were collected from four medical centers: Henry Ford Hospital, Detroit, MI; Massachusetts General Hospital, Boston, MA; University of Texas South- western Medical Center, Dallas, TX; and University of Alabama, Birmingham, AL. Each center retrospec- tively reviewed patient charts and filled in a standar- Photodermatol Photoimmunol Photomed 2006; 22: 247–253 Blackwell Munksgaard r 2006 The Authors. Journal compilation r 2006 Blackwell Munksgaard 247