BACKGROUND: Both oral and bath PUVA with 8-methoxypsoralen (8-MOP) have been 
shown to be effective in the treatment of chronic palmoplantar eczema. However, 
most studies were retrospective and did not include longer follow-up periods.
AIM: To compare the therapeutic efficacy, tolerability and duration of remission 
after oral vs. bath PUVA using 8-MOP in patients with chronic palmoplantar 
eczema.
METHODS: Twenty-nine patients were randomly allocated to treatment with oral or 
bath PUVA. Treatment was given thrice weekly for a maximum of 20 weeks. The 
primary outcome measure was the improvement in eczema score at the end of 
treatment. After clearing patients were followed up until relapse or up to 40 
months.
RESULTS: Overall, both PUVA modalities appeared comparably effective. However, 
after stratifying according to eczema type, significant differences in 
therapeutic outcome in general as well as in response to the two regimes were 
found. Dyshidrotic eczema responded better to both treatments (P=0.048) and 
remained longer in remission than hyperkeratotic eczema. Hyperkeratotic eczema 
cleared significantly better with oral than with bath PUVA (P=0.03).
CONCLUSION: Oral PUVA is preferable for patients with hyperkeratotic eczema and 
bath PUVA for patients with dyshidrotic eczema.