Erna Snellman, Tapio Rantanen
DOI: 10.1080/000155501750376230

A trioxysalen bath is a safe alternative to systemic 8-methoxypsoralen in long-term psoralen plus ultraviolet A (PUVA) treatment. The kinetics of its main side-effect, the strong phototoxicity, has not been thoroughly studied. This study determined the degree and persistence of phototoxicity after a single 10min bath at a trioxysalen concentration of 0.33mg/l. The buttock skin of 16 healthy volunteers was irradiated with UVA 10min, and 1, 3, 9 and 24h after the bath. The minimal phototoxic dose (MPD) was assessed 48, 72 and 96h after the bath. In general, the 96h reading showed the lowest values of MPD; for example, a median of 0.14J/cm2 (95% confidence interval 0.10-0.14J/cm2) at sites irradiated 10min after the bath. The values increased progressively with later irradiation, and the maximum dose applied, 18.32J/cm2, failed to produce any redness when irradiation was given 24h after the bath. Substantial phototoxicity persists up to at least 9h after the trioxysalen bath, making it wise for patients to avoid sunshine for at least the rest of the day.