***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The synthetic compound MC 903 ( calcipotriol ) is a structural analogue of the naturally occurring , biologically active 1,25-dihydroxyvitamin D3 [ 1,25-(OH)2-D3 ] . MC 903 and 1,25-(OH)2-D3 show similar receptor binding and comparable effects on cell differentiation . However , MC 903 appears to be at least 100 times less potent in its effects on calcium metabolism . In previous double-blind placebo-controlled studies , topical MC 903 has been shown to have a therapeutic effect in psoriasis . The present open study involving 20 patients with psoriasis vulgaris was a right/left comparison of the efficacy and tolerability of MC 903 ointment ( 50 micrograms/g ) alone or with UVB radiation . After treatment for 8 weeks , topical MC 903 alone result ed in marked improvement in 66 % of the patients and in clearance in 17 % . Combination of topical MC 903 with UVB result ed in marked improvement in 50 % of the patients and in clearance in 39 % . These differences were not statistically significant . No significant change in serum calcium levels was detected . Two patients developed a facial dermatitis which disappeared spontaneously during continued treatment . These results show that the combination of topical MC 903 and UVB radiation is well tolerated . Larger-scale studies are warranted to answer the question whether UVB radiation induces a significant improvement of the antipsoriatic effect of topical MC 903 BACKGROUND Psoralen plus ultraviolet A ( PUVA ) for the treatment of psoriasis has never been evaluated using the Psoriasis Area Severity Index ( PASI ) in a r and omized , double-blind , placebo-controlled trial . The lack of such data limits our capacity to estimate PUVA 's efficacy relative to other treatment options that are available today . OBJECTIVES The purpose of this study was to evaluate the efficacy of  PUVA  therapy for patients with plaque-type psoriasis . METHODS This study involved 40 patients with psoriasis ; 30 received PUVA  and 10 received UVA with placebo .  PASI scores were assessed at baseline and every 4 weeks thereafter for 12 weeks . RESULTS By nonresponder imputation , 60 % ( 18 of 30 ) in the PUVA group achieved 75 % or more improvement in PASI score after 12 weeks of treatment compared with 0 % ( 0 of 10 ) in the UVA plus placebo group ( P < .0001 ) . Using intent to treat with last observation carried forward analysis , 63 % ( 19 of 30 ) in the PUVA group achieved 75 % or more improvement in PASI score compared with 0 % ( 0 of 10 ) in the UVA plus placebo group ( P < .0001 ) . By per protocol analysis , 86 % ( 18 of 21 ) in the PUVA group as compared with 0 % ( 0 of 7 ) in the UVA plus placebo group reached 75 % or more improvement in PASI score after 12 weeks ( P < .0001 ) . LIMITATIONS The study was relatively small with only 40 patients enrolled and 28 patients who completed the protocol . Further studies that involve head-to-head comparison of PUVA with other treatment modalities are needed . Nonresponder imputation , last observation carried forward with intent to treat , and per protocol analyses each have separate advantages and limitations when determining clinical significance . CONCLUSIONS This study supports the observation that PUVA is a highly efficacious treatment for chronic plaque psoriasis BACKGROUND Psoralen-UVA ( PUVA ) photochemotherapy is widely used for the treatment of psoriasis despite concerns of skin carcinogenesis from high cumulative UVA doses and number of treatments . OBJECTIVE We attempted to determine whether combined bath-PUVA with narrow-b and ( 311 nm ) phototherapy improves efficacy and reduces long-term toxicity . METHODS Twelve psoriatic patients underwent phototesting with 311 nm lamps and , after topical bath-water psoralen sensitization , with 311 nm , UVA , or both radiations . Patients were treated with bath-PUVA on one side of the body and with bath-PUVA plus 311 nm exposures ( bath-PUVA-311 nm ) on the other side . On both sides , four weekly treatments were delivered and UVA doses were increased once weekly whereas 311 nm doses were adjusted at each exposure . RESULTS Psoralen sensitization did not modify the erythematous threshold to 311 nm radiation . However , 311 nm exposures enhanced the phototoxic activity of bath-PUVA . Bath-PUVA-311 nm cleared psoriasis with fewer exposures and lower cumulative UVA doses under the same minimally erythemogenic conditions . CONCLUSION Combination with 311 nm exposures enhanced the phototoxic and therapeutic activities of bath-PUVA OBJECTIVE To determine whether the addition of 311-nm narrowb and UV-B ( NB UV-B ) phototherapy accelerates and improves the therapeutic efficacy of alefacept , a biological antipsoriatic drug approved for the treatment of moderate to severe psoriasis . DESIGN R and omized half-body comparison study . SETTING Ambulatory section of a university hospital photodermatology unit . PATIENTS Fourteen patients with moderate to severe psoriasis . INTERVENTIONS All patients were treated with 7.5 mg of intravenous alefacept once weekly for 12 weeks . Three times each week , a r and omly selected body half ( left or right ) was treated with NB UV-B light until complete remission , defined as a reduction in the Psoriasis Area Severity Index ( PASI ) to 3 or lower , was achieved on the irradiated body half . MAIN OUTCOME MEASURES Modified PASI , self-assessed visual analogue scale rating of skin lesions , and self-assessed therapeutic efficacy . RESULTS After 12 weeks of treatment , the mean PASIs on UV-irradiated and nonirradiated body halves were significantly reduced by 81 % and 62 % , respectively ( P < .001 ) . From week 3 to week 12 , the mean PASI was significantly lower on UV-irradiated body halves than on nonirradiated body halves ( P < .001 ) . At week 12 , PASI reductions of greater than 75 % had been achieved significantly more often on UV-irradiated body halves ( 86 % , 12 of 14 ) than on nonirradiated body halves ( 43 % , 6 of 14 ) , and complete remission had been achieved significantly more often on UV-irradiated body halves ( 43 % , 6 of 14 ) than on nonirradiated body halves ( 0 of 14 ) ( McNemar test P = .03 ) . CONCLUSIONS In this r and omized half-side comparison of alefacept with and without phototherapy for psoriasis , alefacept with NB UV-B phototherapy accelerated and improved the clearance of psoriasis . This suggests a promising future for this combination as antipsoriatic therapy Summary Background The optimum treatment frequency for narrowb and ( TL‐01 ) ultraviolet B ( NB‐UVB ) in psoriasis is not yet known . We have previously found three times weekly to be preferable to five times weekly treatment in our population A prospect i ve , r and omized , double-blind , placebo-controlled trial was performed to assess the effect of a potent topical corticosteroid cream used in conjunction with ultraviolet B ( UVB ) phototherapy on psoriasis with respect to time to clearing and duration of remission after clearing . Of the 53 out patients who received suberythemogenic UVB phototherapy three times per week , 24 applied the topical corticosteroid and 29 applied the placebo cream twice daily until clearing was achieved . Nine patients in each group failed to comply with the protocol . Although there was a trend toward a slightly more rapid response in the topical corticosteroid-treated group , there was no significant difference in patients ' early response to therapy , number of treatments , and UVB dose required to achieve clearing . Patients in the topical corticosteroid-treated group remained in remission longer than did patients in the control group ( 183 vs 116 days ) . Life-table analysis predicts that 62 % of emollient-treated patients flare within 6 months of clearing compared with only 42 % of topical corticosteroid-treated patients ( p less than 0.1 ) . For most patients with psoriasis who receive UVB therapy in an outpatient setting , the use of potent topical corticosteroids appears to produce , at most , a modest beneficial effect The efficacy of trimethylpsoralen bath PUVA and UVB TL01 were compared in chronic plaque psoriasis . Patients were r and omly assigned to receive UVB TL01 on one side and bath PUVA on the contra-lateral side . Altogether 17 patients received treatments and 15 completed the trial . The decrease in the PASI score was greater with UVB TL01 than PUVA . At the end of the treatment period , the difference was highly significant ( p < 0.001 ) . The difference was already significant at week 3 ( p = 0.014 ) . The relative median decrease in the PASI score was 77 % ( 24 - 100 % ) with UVB and 45 % ( 8 - 100 % ) with PUVA . The median cumulative UVB dose was 39.92 ( range 13.95 - 81.56 ) J/cm2 and the corresponding UVA dose was 8.06 ( range 3.31 - 12.51 ) J/cm2 . All patients relapsed within 4 months . Narrowb and UVB  improved psoriasis clinical ly and statistically more efficiently than trimethylpsoralen bath PUVA , and UVB was better tolerated BACKGROUND Combination UVB phototherapeutic regimens were introduced to improve therapeutic results and reduce cumulative UVB doses . OBJECTIVE Broadb and UVB and UVB + bergamot oil ( UVBB ) therapies in the treatment of psoriasis were compared with regard to : efficacy , side effects , mean number of procedures , mean UVB dose , and duration of remissions . PATIENTS / METHODS One hundred and ninety three ( 193 ) patients r and omly divided into two groups were treated : Group I with UVB monotherapy and Group II with UVB and bergamot oil ( UVBB ) . RESULTS Overall assessment of the efficacy of the two treatment regimens demonstrated no statistically significant differences in either the post-therapy PASI values ( t = 0.27 , p = 0.786 ) or the duration of remissions ( t = 0.22 , p = 0.904 ) . However , significant differences in the number of procedures ( t = 2.3 , p = 0.04 ) and the cumulative UVB doses were established ( t = 3.4 , p = 0.004 ) . CONCLUSION UVBB phototherapy significantly reduces the UVB doses and the duration of treatment for psoriatic patients Thirty‐four patients with extensive psoriasis were treated in a double‐blind parallel fashion with either acitretin plus bath PUVA ( trimethylpsoralen bath + UVA ) or etretinate plus bath PUVA .  Each group consisted of 17 patients . The dose of retinoid was 40 mg/day during the 2‐week monotherapy phase and subsequently 20 mg/day during the combination treatment . Bath PUVA was given three times a week starting with a UVA dose of 0.06 J/cm2 . Remission ( > 90 % improvement ) was achieved in all patients in 6–10 weeks . There were no significant differences in clinical response between the two groups ; the mean ±SD PASI score ( psoriasis area and severity index ) before treatment was 22.6±7.1 in the acitretin‐PUVA group and 19.4±7.8 in the etretinate‐PUVA group . The corresponding figures after treatment were 0.6±0.6 and 1.0±0.5 , respectively . Side‐effects related to retinoid treatment were frequent in both groups but they were usually mild and well‐tolerated . There was only one case of diffuse alopecia after 8 weeks in the etretinate‐PUVA  group . Scaling of the palms and soles was seen in six patients in the acitretin‐group but only in two patients in the etretinate‐group . Triglycerides were elevated in about half of the patients in both groups . The present study shows that acitretin is as effective as  etretinate in the combination with bath PUVA Ro 10 - 9359 is a retinoic acid derivative , selected for study because of a better tolerance than retinoic acid , shown in animal experiments . Doses of 25 mg b.i.d . , 25 mg t.i.d . and 50 mg b.i.d . were administered orally to 27 patients suffering from severe chronic generalized psoriasis . The clinical efficacy was evaluated by means of a new index , psoriasis area and severity index ( PASI ) based on severity and area of psoriatic lesions . At doses of 25 mg t.i.d . or 50 mg b.i.d . Ro 10 - -9359 proved to be an extremely potent antipsoriatic drug . A more than 90 % reduction of psoriatic lesions 
    Output:
    
The short-term adverse effects were mild as shown by the low rate of withdrawal due to adverse effects