In psoriasis patients treated with PUVA there is an increased risk of skin cancer especially squamous cell carcinoma, particularly in individuals with certain risk factors. These include a history of exposure to x-ray therapy, a personal or family history of previous skin cancer, and a history of sunburning easily and tanning poorly. The increased risk of squamous cell carcinoma following PUVA therapy is related to the cumulative dose and duration of therapy. In addition to the acute toxic effect of a sunburn-like reaction and long term increased risk of skin cancer and cataracts, other side effects of PUVA have occurred. Itching during the course of UVA therapy is quite a common symptom, is usually related to dryness of the skin and is relieved by the frequent application of moisturizing creams or lotions.
Nausea is an occasional complication that is minimized by taking the psoralen pills with food.
Marked tanning of the skin following PUVA therapy is usual, even in persons who do not ordinarily tan well following sun exposure. Increased freckling can also occur. If any skin lesions are suspicious for skin cancer, you will be advised to have a skin biopsy, with further treatment pending the biopsy report. Since the effects of psoralen on a fetus are unknown, we recommend that women use birth control measures while being treated. This should be discussed with your physician before beginning treatment.