Low‐dose UVA₁ phototherapy for scleroderma: what benefit can we expect?

<jats:title>Abstract</jats:title><jats:p><jats:bold>Background </jats:bold> The first reports of the application of ultravioletA<jats:sub>1</jats:sub> (UVA<jats:sub>1</jats:sub>) phototherapy for scleroderma go back only to 1995, but since then, several studies have proven its effectiveness in this disease.</jats:p><jats:p><jats:bold>Objectives </jats:bold> To evaluate the effectiveness of low‐dose (35 J/cm<jats:sup>2</jats:sup>) UVA<jats:sub>1</jats:sub> phototherapy in patients with scleroderma, trying to define the subgroups that benefit most from this treatment.</jats:p><jats:p><jats:bold>Methods </jats:bold> Retrospective analysis of patients diagnosed with clinical and/or histological scleroderma, undergoing low‐dose UVA<jats:sub>1</jats:sub> phototherapy between 2003 and 2010.</jats:p><jats:p><jats:bold>Results </jats:bold> We studied 21 patients (20 women and one man) aged 10–75 years (mean 50). Eighteen with morphea performed a total of 29 treatments, with an average of 33 sessions per treatment per patient, a mean dose of 31 J/cm<jats:sup>2</jats:sup> per session and an average cumulative dose of 1662 J/cm<jats:sup>2</jats:sup> (310–4270). The three patients with systemic scleroderma underwent a total of five treatments, with an average of 26 sessions per treatment per patient, a mean dose of 29.5 J/cm<jats:sup>2</jats:sup> per session and an average cumulative dose of 1160 J/cm<jats:sup>2</jats:sup> (660–1695). Using the modified Rodnan skin score, in the group of patients with morphea, a marked improvement was found in 77.8% patients and a moderate improvement was found in 11.1% patients. In the systemic scleroderma group, a patient with complete remission of the skin sclerosis is emphasized.</jats:p><jats:p><jats:bold>Conclusions </jats:bold> Our experience allows us to conclude that low‐dose UVA<jats:sub>1</jats:sub> phototherapy is a well tolerated option, with excellent results mainly in patients with morphea. This treatment is a valuable contribution to these patients, given the limited therapeutic options available.</jats:p>