UVA1 for diffuse cutaneous systemic sclerosis in a Fitzpatrick skin type VI patient: outcomes in the modified Rodnan skin score.

INTRODUCTION: Cutaneous sclerosis can lead to important mobility impairment. Ultraviolet (UV) A1 phototherapy may improve skin sclerosis, although most of the studies have been with Caucasian patients.

MATERIAL AND METHODS: A 44-year-old patient, Fitzpatrick skin type VI, was being followed up with the diagnosis of diffuse cutaneous systemic sclerosis. He had significant mobility impairment, especially of the right hand and arm. In 2015 he started UVA1 phototherapy daily, Monday until Friday (Waldmann® 7001 UVA cabin equipped with 40 Philips TL/10R lamps - spectral irradiation between 340 and 400 nm). The initial dose was 10 J/cm2, rapidly increased up to a steady dose of 35 J/cm2.

RESULTS: After 40 sessions of UVA1, active fingers flexion and abduction of the right arm significantly improved and the modified Rodnan skin score changed from 26 to 11.

CONCLUSION: The modified Rodnan skin score is a practical and useful tool during the follow-up of patients with systemic sclerosis. UVA1 phototherapy improves cutaneous sclerosis, and the related mobility impairment, and a dose of 35 J/cm2 is effective, even in higher phototypes, having a good safety profile.