Abstract
To the Editor:
In their review article on alopecia areata, Gilhar et al. (April 19 issue)
1
do not mention psoralen–ultraviolet A (PUVA) photochemotherapy. This was probably because there have been no published controlled studies of this local immunosuppressive treatment for extensive alopecia areata.
2
However, reported response rates are typically as good as those for contact immunotherapy, which is supported by only slightly better evidence, with half-scalp comparative studies confirming an effect.
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Contact immunotherapy involves the discomfort of a medically induced dermatitis every week; PUVA only rarely causes localized phototoxic responses. In terms of long-term risks, whole-body PUVA treatment increases the . . .
