BACKGROUND: Vesicular dyshidrotic palmoplantar eczema is a common disorder but 
treatment is difficult. Localized photochemotherapy (cream psoralen-UVA [PUVA]) 
has widely been used for therapy. Although the efficacy of cream PUVA therapy is 
well known, potential side effects may occur. Therefore, a more standardized 
safe and effective UV therapy should be carried out.
OBJECTIVE: This study compared the effects of localized high-dose UVA1 
irradiation versus topical cream PUVA for treatment of chronic vesicular 
dyshidrotic eczema.
METHODS: On the basis of the assessment of the Dyshidrotic Area and Severity 
Index, the decrease of score points on the UVA1-treated side was compared with 
the decrease on the cream PUVA-treated side in 27 patients. In addition, 
analysis of serum markers was performed.
RESULTS: Of 27 patients, 24 showed a good response to localized UVA1 irradiation 
or cream PUVA. Dyshidrotic Area and Severity Index scores significantly 
decreased on both sides and were reduced to half of the pretreatment values. No 
statistically significant differences between localized UVA1 irradiation or 
cream PUVA could be detected.
CONCLUSION: This study demonstrates that localized UVA1 phototherapy is easy to 
perform and appears to be an effective and safe treatment for vesicular 
dyshidrotic eczema.