***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: We investigated the clinical response of 10 patients with plaque psoriasis to multiple treatments with photodynamic therapy , using topical application of 5-aminolaevulinic acid followed by exposure to broad-b and visible radiation . Treatment was performed up to 3 times per week , with a maximum of 12 treatments , using a light dose of 8 Jcm(-2 ) delivered at a dose-rate of 15 mW cm(-2 ) . Eight patients showed a clinical response .  Out of 19 treated sites , 4 cleared , 10 responded but did not clear and 5 showed no improvement . Of the 4 sites that cleared only 1 did so fully , after 7 treatments , 45 days after the start of therapy . Of the 10 sites that responded partially , the greatest reduction in scale , erythema and in duration index occurred after a minimum of 3 and a maximum of 8 treatments . The intensity of 5-aminolaevulinic acid-induced protoporphyrin IX fluorescence , recorded prior to the first treatment , varied between sites on the same patient as well as between patients . There was also a variation in fluorescence intensity recorded from the same site immediately prior to subsequent treatments , although the pretreatment levels generally decreased as the study progressed and then increased as psoriasis relapsed . Biopsies confirmed that fluorescence was localized throughout the epidermis and stratum corneum , but the level was not consistent between sections taken within the same biopsy . We also observed fluorescence at sites distant from the ones that received 5-aminolaevulinic acid , which was not present prior to the start of the treatment programme , but found no evidence of elevated levels of plasma porphyrins . The level of discomfort associated with this therapy increased with increasing values of the calculated photodynamic dose , defined as the product of the initial photosensitizer concentration and the percentage reduction in fluorescence following irradiation . Therefore , although clinical efficacy improved with multiple treatments , unpredictable response and patient discomfort make ALA-PDT unsuitable for the treatment of psoriasis 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 OBJECTIVE Our purpose was to demonstrate the efficacy of the 308-nm excimer laser for treatment of psoriasis . METHODS This study was a multicenter open trial from 5 dermatology practice s ( one university-based and 4 private practice s ) . Up to 30 patients per center with stable mild to moderate plaque-type psoriasis constituted the study population . Patients received 308-nm ultraviolet B doses to affected areas . The initial dose was based on multiples of a predetermined minimal erythema dose . Subsequent doses were based on the response to treatment . Treatments were scheduled twice weekly for a total of 10 treatments . The main outcome measure was 75 % clearing of the target plaque . Time to clearing was analyzed by Kaplan-Meier methods , accounting for truncated observations . RESULTS One hundred twenty-four patients were enrolled in the study , and 80 completed the entire protocol . The most common reason for exiting from the study was noncompliance . Of the patients who met the protocol requirements of 10 treatments or clearing , 72 % ( 66/92 ) achieved at least 75 % clearing in an average of 6.2 treatments . Eighty-four percent of patients ( 95 % confidence interval [ CI ] , 79%-87 % ) reached improvement of 75 % or better after 10 or fewer treatments . Fifty percent of patients ( 95 % CI , 35%-61 % ) reached improvement of 90 % or better after 10 or fewer treatments . Common side effects included erythema , blisters , hyperpigmentation , and erosions , but they were well tolerated . CONCLUSIONS Monochromatic 308-nm excimer laser treatment appears to be effective and safe for psoriasis . It requires fewer patient visits than conventional phototherapy , and , unlike those treatments , the laser targets only the affected areas of the skin , sparing the surrounding uninvolved skin Targeted broadb and ultraviolet B ( UVB ) phototherapy as well as 308-nm excimer laser have been reported to significantly improve or clear localized psoriatic plaques within 5 to 10 treatments when medium fluences [ i.e. 4 - 6 multiples of minimal erythema doses ( MED ) ] were used . Our study was conducted to determine the effects of different concentrations of topical 8-methoxypsoralen ( 8-MOP ) cream when used in combination with targeted UV phototherapy with regard to number of treatments and cumulative UV doses to clear localized psoriasis . Ten evaluable patients with stable plaque-type psoriasis completed the study . Three different concentrations of 8-MOP creams ( 0.001 % , 0.01 % and 0.1 % ) were applied prior to irradiation with 4 MEDs of targeted narrowb and UVB ( NB-UVB ) , whereas 0.001 % 8-MOP cream was used in conjunction with 5 J/cm(2 ) UVA . All irradiations took place once weekly for 12 weeks . Psoriasis severity index ( PSI ) score was used to evaluate the efficacy of the treatment . With area-under-the-curve analysis , 0.1 % 8-MOP/NB-UVB was superior to other modalities in reducing the PSI scores . The number of treatments and cumulative NB-UVB doses necessary to achieve PSI-95 , a 95 % reduction in the scores , was also lower in the 0.1 % 8-MOP/NB-UVB group , although the differences were not statistically significant . We conclude that topical 8-MOP cream enhances the therapeutic effects of targeted NB-UVB phototherapy without significantly increasing the short-term adverse effects BACKGROUND Ultraviolet radiation has been used for curative purpose s in dermatologic conditions , especially in the last 30 years . OBJECTIVES We analyzed the efficacy of monochromatic excimer light in psoriasis , palmoplantar pustulosis , vitiligo , mycosis fungoides and alopecia areata , and to examine potential new indications . METHODS Two hundred seventy-nine patients with common and persistent skin diseases were enrolled in an open prospect i ve study : 152 patients with stable and localized plaque psoriasis , 47 with palmoplantar psoriasis , 7 with palmoplantar pustulosis , 32 with vitiligo , 11 with prurigo nodularis , 9 with mycosis fungoides stage Ia , 8 with alopecia , 5 with localized scleroderma , 5 with genital lichen sclerosus , and 3 with granuloma annulare . The 308 nm excimer light was used at a power density of 48 mW/cm(2 ) . An average of 12 sessions ( range , 6 - 18 ) , one session per week , was performed and yielded a total dose range of 4 - 12.5 J/cm(2 ) . Clinical response was assessed using photos , biopsies , and specific clinical scores . Patients were monitorized for 6 and 12 months for psoriasis , 12 months for mycosis fungoides , and 4 months for the remaining conditions . RESULTS We observed complete remission in more than 50 % of patients with plaque psoriasis and palmoplantar dermatoses , respectively , complete remission in all patients affected by mycosis fungoides , excellent repigmentation in one third of vitiligo patients , hair regrowth in three patients with alopecia areata , an overall improvement in prurigo nodularis , a partial remission in patients affected by localized scleroderma , and a complete remission in most of the patients with genital lichen sclerosus and granuloma annulare . CONCLUSIONS Our study confirms the use of monochromatic excimer light as a valid choice for the treatment of psoriasis , vitiligo , and mycosis fungoides ; we also observed and report for the first time that monochromatic excimer light produces a therapeutic response in prurigo nodularis , localized scleroderma , genital lichen sclerosus , and granuloma annulare BACKGROUND Psoralen-UVA ( PUVA ) and narrowb and UVB ( 311-nm ) therapy are considered to be first-line phototherapies for patients with moderate to severe psoriasis . To reduce side effects as a result of systemic resorption of psoralens , topical PUVA therapies have been developed and proven to be effective in the treatment of psoriasis . OBJECTIVE We sought to evaluate the combination therapy of narrowb and UVB plus cream PUVA on selected psoriatic plaques compared with narrowb and UVB or cream PUVA alone . METHODS A total of 30 patients ( Psoriasis Area and Severity Index score of 8 - 15 ) were included in the r and omized study . The combination therapy consisting of narrowb and UVB whole-body irradiation followed by cream PUVA therapy for selected psoriatic plaques was evaluated in 10 patients with chronic plaque-stage psoriasis . For comparison , the therapeutic efficacy , number of treatments , and cumulative UV doses until remission ( Psoriasis Area and Severity Index score < 4 ) of cream PUVA therapy or narrowb and UVB alone was determined in 10 patients , respectively . RESULTS Both monotherapies induced clearance of psoriatic lesions in all patients within 5 to 7 weeks . Mean number of treatments for cream PUVA was 24 + /- 5 ; for narrowb and UVB was 21 + /- 3 . The mean cumulative UVA dose was 45.0 + /- 16.3 J/cm(2 ) and the mean cumulative UVB dose was 17.1 + /- 4.1 J/cm(2 ) . Combination therapy result ed in complete clearance of lesions in all patients after 3 to 4 weeks . Mean number of treatment was 14 + /- 2 , mean cumulative UVA dose was 18.7 + /- 4.7 J/cm(2 ) , and mean cumulative UVB dose was 8.2 + /- 3.3 J/cm(2 ) . The number of treatments ( P < .001 , analysis of variance ) , UVA dose ( P < .001 , t test ) , and UVB dose ( P < .001 , t test ) were significantly reduced compared with both monotherapies . CONCLUSIONS Our results indicate that a combination therapy of narrowb and UVB plus cream PUVA appears to have a significantly higher efficacy compared with either monotherapy . The cumulative UV doses were significantly lower in the combination therapy . We conclude that cream PUVA can be used in addition to narrowb and UVB for areas that tend to clear less quickly than the rest of the body Background : Phototherapy is an effective treatment for generalized plaque psoriasis , but is inconvenient and dosimetry is limited by the minimal erythema dose ( MED ) . Objective : This pilot study evaluated the efficacy , safety , and feasibility of excimer laser utilizing a supra-erythemogenic phototherapy strategy ( phototherapy well beyond the MED dose ) to treat generalized psoriasis . Methods : In this 9-month study , 13 patients with psoriasis involving > 10 % but < 30 % body surface area received laser treatment twice weekly for 12 weeks , with 6 months of post-treatment follow-up . The primary endpoint was percentage of patients achieving Psoriasis Area and Severity Index ( PASI ) 75 . Results : Of the 12 patients who completed the treatment phase , 54 % achieved PASI 75 . During the 6-month follow-up period 83 % maintained PASI 50 with no treatment . Limitations : This pilot study had a small sample size . Conclusion : The laser is an effective treatment with a favorable remission rate . With enhanced power in the near future , laser is likely to become more promising for generalized psoriasis Summary Topical photochemotherapy with psoralen and its derivatives 4.5′,8‐trimethylpsoralen ( TMP ) and 8‐methoxypsoralen ( 8‐MOP ) , with UVA irradiation , was evaluated with regard to minimum phototoxic dose , concentration , timing of UVA irradiation and systemic and local side‐effects , in healthy volunteers .  Psoralen ( 0.005 % ) in aqueous gel was found to be superior to TMP and 8‐MOP in aqueous gel . No hyperpigmentation was seen after topical PUVA treatment with psoralen in aqueous gel . Patients with plaque‐type psoriasis ( n = 7 ) , palmoplantar psoriasis ( n = 7 ) and hyperkeratotic eczema ( n = 2 ) were treated . Topical PUVA therapy was effective in most psoriasis patients , without the occurrence of local or systemic side‐effects . Moreover , hyperkeratotic eczema patients who did not respond to conventional therapy showed partial remission . These results indicate that topical PUVA therapy with psoralen in aqueous gel is a useful therapeutic modality for treatment of psoriasis patients , and patients with recalcitrant dermatoses such as palmoplantar psoriasis and hyperkeratotic eczema PUVA-bath therapy has proven to avoid many side effects associated with oral 8-methoxypsoralen ( 8-MOP ) treatment . In order to investigate the effectiveness of topical PUVA-bath therapy ( PUVA-soak therapy ) on chronic palmoplantar dermatoses , 30 patients with plaque-type psoriasis , pustular psoriasis 
    Output:
    
Topical PUVA and targeted UVB phototherapy are very effective in the treatment of localized psoriasis .
Topical PUVA seems more effective than non-laser targeted UVB phototherapy .
On the other h and , PDT has low efficacy and high percentage of side effects in treating localized psoriasis