HAND AND FOOT TOPICAL PUVA THERAPY

PATIENT INSTRUCTION SHEET

 

 

What is Oxsoralen ointment?

 

Oxsoralen ointment is a drug which has been shown to be effective in the treatment of certain skin diseases when combined with exposure to a very specific kind of light called UVA.  In the treatment of any skin disease, the use of the drug must be combined with exposure to the special light to produce effective therapy.

 

What is the special light?

 

Light is classified into many different parts. One part is known as ultraviolet light, which is a normal component of sunlight.  Artificial or man-made light sources can also produce the special part of light (ultraviolet "A") necessary for the most effective therapy.

 

What is "PUVA"?

 

"PUVA" is the name of the ultraviolet light treatment used for certain skin diseases and stands for the use of Psoralen drug (Oxsoralen) in combination with Ultraviolet A light.

 

What is topical PUVA?

 

Topical PUV A is the addition of the psoralen drug to Aquaphor ointment, which is applied directly to the affected areas of the hands and feet for a period of time (usually 30 minutes) prior to UVA light exposure.

 

What should I do before PUV A therapy?

 

Certain medications can increase the skin's sensitivity to PUVA therapy.  In addition, certain other medical conditions can be aggravated by this treatment.  Before starting therapy it is important to tell your doctor or phototherapy nurse if you have experienced any of the following:

 

1. Had a reaction to any psoralen medications.
2. Had recent radiation treatment or are planning any.
3. History of skin cancer.
4. Have a history of melanoma in the family.
5. Have any medical condition that requires you to stay out of the sun, such as lupus erythematosus.
6. Are taking any drugs (either prescription or nonprescription).  Some drugs can increase your sensitivity to ultraviolet light.  Examples of such drugs include: tranquilizers, sulfa drugs, antibiotics or drugs used for the treatment of infection, medications for the treatment of diabetes, griseofulvin products and thiazide-containing diuretics (blood pressure or water-elimination drugs).

 

If you begin any new medications or re-start a medication that you used to take, please inform the phototherapy staff.

 

7. You should also tell your doctor if your skin sunburns very easily, if there is a chance that you are pregnant, or if you are attempting to become pregnant, if you have taken medicines containing arsenic in the past, or if you have problems with your immune system.

 

How do I take my hand and foot topical PUVA treatment?

 

Your pharmacist will prepare the Oxsoralen ointment.  Bring this to the Phototherapy Treatment Center in Pavilion A at the time of your first topical PUVA appointment.  The nurse will apply the ointment to your hands and/or feet approximately 30 minutes prior to your UVA light treatment.  It is very important that you tell the phototherapy staff (prior to treatment) if you have experienced any redness, blistering or tenderness of your skin (such as a sunburn) since the last topical PUVA treatment.

 

What precautions should be taken during and after PUVA therapy?

 

1. Eye protection - Eye protection will be provided for you in the light treatment room.  This should be worn during light treatment.

 

2. Skin Protection - Do not allow exposure of your treated skin to sunlight for 8 hours after treatment.

 

What medications may I put on my skin after treatment?

 

In general, you may apply a bland moisturizer to your skin between treatments such as petrolatum or hydrophilic ointment.  You may also use any topical medications as prescribed by your doctor.  You should ask your doctor or the phototherapy staff about any other medications before applying them to your skin while on PUVA therapy.

 

*** MOISTURIZERS, CREAMS OR TOPICAL MEDICATIONS SHOUD NOT BE USED PRIOR TO YOUR PUVA TREATMENT.

 

Problems. risks. and side effects of hand and foot topical PUVA

 

You should be aware of the possible problems, risks, and side effects of PUVA therapy.  These are minimal, however, for the patients receiving hand and foot PUVA because of the relatively small areas being treated.

 

Long term risks of PUVA therapy include:

 

1. Premature skin aging may result from prolonged PUV A therapy, especially in those individuals who have light skin. This problem is similar to excessive exposure to sunlight.

 

2. There is an increased risk of developing skin cancer for individuals who fall into .the following categories:
1. Fair skin that burns rather than tans.
2. Have had prior treatment with radiation, grenz rays, or arsenic.
3. Have had coal tar and Ultraviolet (UVB) treatment.

 

Even though your doctor will be examining you, you should routinely examine yourself for small growths on your skin or skin sores that will not heal. Immediately report such observations to your doctor.

 

The possible immediate side effects include:

 

1. The most common side effects of topical PUVA therapy are itching and redness of the skin.  The use of moisturizers and mild skin cleansers may be helpful.
2. Tenderness or blistering of the skin can occur.  These symptoms can be: helped by the use of skin products recommended by your doctor or phototherapy staff.
3. Pigmentary changes such as tanning, freckling, or darkening of the skin may occur.  These changes usually diminish or fade over time, once treatment is discontinued.
4. Side effects that may occur with systemic PUVA (when the psoralen is taken by mouth), include nausea, and rarely depression, dizziness, headache, swelling, rash, or leg cramps.  However, these side effects do not generally occur with topical PUVA.

 

What are the problems associated with pregnancy or breast-feeding?

 

1. Birth control methods or abstinence should be employed since the effects of PUVA therapy on the unborn child are not known.  If you become pregnant inform your doctor so that he/she can determine whether it is necessary for you to temporarily stop therapy.

 

2. Since it is not known whether Oxsoralen passes into mother's milk it is safer not to breast feed while using this drug.