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September 1978

Trioxsalen vs Methoxsalen in the Treatment of Psoriasis

Arch Dermatol. 1978;114(9):1399. doi:10.1001/archderm.1978.01640210078028

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To the Editor.—  Fischer and Juhlin described their use of a trioxsalen bath in the photochemotherapy of psoriasis in the June 1977 issue of the Archives (113:852).I have tried their method and can vouch for its efficacy. Admittedly, it has some drawbacks, and could, like methoxsalen, conceivably also be risky. However, I cannot see that the Editor's fear of potentially dangerous effects is based on fact or sound reasoning.Arora and Willis (Archives 112:327-332, 1976) used a substance with entirely different properties, viz, methoxsalen, and in a concentration more than 1,000 times that of the trioxsalen of Fischer and Juhlin. The methoxsalen was applied for much longer periods, six times longer than trioxsalen, yet methoxsalen at the lowest concentration was never associated with a phototoxic reaction after three hours had elapsed.After a trioxsalen bath, the phototoxic effect actually remains for about six hours. Accidental reactions can easily be

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