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Journal of the American Academy of Dermatology
Volume 3, n° 3
pages 248-250 (septembre 1980)
Doi : 10.1016/S0190-9622(80)80187-3
Clinical and laboratory studies

Toxic hepatitis from oral methoxsalen photochemotherapy (PUVA)

David M. Pariser, M.D. , Ronald J. Wyles, M.D.
 From the Department of Medicine (Dermatology), Eastern Virginia Medical School, USA 

1Reprint requests to: Dr. David M. Pariser, Eastern Virginia Medical School, Department of Internal Medicine, 600 Gresham Dr., Norfolk, VA 23507.

A 59-year-old white woman with long-standing psoriasis, who had a damaged liver from methotrexate, developed a toxic hepatitis while on oral methoxsalen photochemotherapy (PUVA). Fever and marked elevation of liver enzymes occurred after the fifteenth PUVA treatment and spontaneously returned to normal within 5 days. One week later, following the next PUVA treatment, the same toxic hepatitis developed and again spontaneously resolved. Topical methoxsalen photochemotherapy with ultraviolet A (UVA) did not produce the toxic hepatitis and provided a suppression of the psoriasis on a maintenance basis.

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