BACKGROUND: Numerous studies have confirmed the short-term effectiveness of 
8-methoxypsoralen bath PUVA therapy in patients with chronic palmoplantar 
dermatoses; however, little is known about long-term results.
PATIENTS AND METHODS: In this retrospective study we examined the long-term 
results in 79 patients (mean age: 48 years) with chronic palmoplantar dermatoses 
who were treated with bath PUVA three times a week over an 8-year period. A good 
clinical response (a reduction of more than 50% of the skin lesions) occurred 
after a mean of 23 treatments and a mean cumulative UVA dose of 39 J/cm(2) in 51 
patients (65%). In 2007 a questionnaire was sent to these 51 patients to assess 
the long-term outcome.
RESULTS: With bath PUVA treatment, the best results were found in patients with 
hyperkeratotic eczema (17/22; 77% good clinical response) followed by patients 
with palmoplantar psoriasis (26/41; 63%) and patients with dyshidrotic eczema 
(8/16; 50%). Thirty-four patients (67%) answered the questionnaire after a mean 
follow-up interval of 4.3 years (10-87 months). Among these patients, 36% 
reported an improved course of disease after PUVA therapy with reduced frequency 
and/or intensity of the skin rash, and 29% of patients reported continued 
complete clearance. 79% of our patients reported a long-term reduction in the 
use of topical corticosteroids during the follow-up period (mean: 4.3 years). In 
addition, 67% of patients reported a lasting improvement in quality of life.
CONCLUSIONS: These data show that bath PUVA may have a long-term, beneficial 
influence on the course of disease in a majority of patients with recalcitrant 
chronic palmoplantar dermatoses.