About
Psoralen, typically methoxsalen or trioxsalen, is a photosensitizing agent used in conjunction with ultraviolet A (UVA) radiation in a therapeutic modality known as PUVA (Psoralen plus UVA). This treatment is primarily indicated for severe, recalcitrant skin conditions such as psoriasis, vitiligo, and cutaneous T-cell lymphoma. Psoralens are furocoumarin derivatives that, upon oral administration and subsequent absorption, intercalate into the DNA of epidermal cells. When exposed to UVA light, these psoralen molecules undergo photoactivation, forming covalent bonds with pyrimidine bases in the DNA. This photo-adduct formation inhibits DNA synthesis and cell proliferation, leading to a reduction in the rapid cell turnover characteristic of psoriasis and repigmentation in vitiligo. The treatment requires careful dosing and controlled UVA exposure to maximize therapeutic benefits while minimizing risks of phototoxicity.
Uses
- Treatment of severe psoriasis.
- Repigmentation in vitiligo.
- Management of cutaneous T-cell lymphoma.
- Used in conjunction with UVA light therapy (PUVA).
Directions For Use
Take this medication orally 1-2 hours before scheduled UVA light exposure, exactly as directed by your dermatologist. Follow specific instructions for light exposure duration.
Benefits
- Effective in clearing severe psoriatic plaques.
- Promotes repigmentation in vitiligo.
- Helps manage symptoms of cutaneous T-cell lymphoma.
- Can induce long-lasting remissions in some conditions.
- A well-established treatment for specific dermatological disorders.
- Offers an alternative for patients unresponsive to topical therapies.
Side Effects
- Nausea
- Vomiting
- Dizziness
- Headache
- Pruritus (itching)
- Erythema (redness)
- Blistering
- Increased skin photosensitivity
- Hyperpigmentation
- Increased risk of skin cancer (long-term)
- Cataract formation (long-term)
- Edema
Safety Measures
- Alcohol - Avoid or limit alcohol consumption as it may increase the risk of liver toxicity and can exacerbate photosensitivity reactions.
- Pregnancy - Psoralen is generally not recommended during pregnancy due to potential risks to the fetus, including teratogenicity. Use only if clearly indicated and under strict medical supervision, with careful consideration of risks versus benefits.
- Breastfeeding - It is unknown if psoralen is excreted into breast milk. Due to potential risks to the infant, breastfeeding is generally not recommended. Consult your doctor.
- Liver - Use with caution in patients with liver impairment. Liver function should be monitored, as psoralens are metabolized by the liver.
- Kidney - Use with caution in patients with severe kidney impairment. Dose adjustments may be necessary, and renal function should be monitored.
- Lung - No specific direct lung toxicity is commonly associated with psoralen. However, general health status, including lung function, should be considered in patients undergoing PUVA therapy.
Disclaimer
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Always consult your doctor for any medical concerns, and discuss your questions about health conditions or medications with a qualified healthcare professional. Do not ignore or delay seeking professional medical advice based on information found on Med E Hub.
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