[Clinical and immunological aspects of extracorporeal photochemotherapy for psoriasis and psoriatic arthritis].

To evaluate the clinical efficiency of extracorporeal photochemotherapy (EPCI) in the treatment of psoriasis (Ps) and Ps associated with psoriatic arthritis (PsA). Ninety-three patients with different forms of psoriasis were examined. A study group (SG) comprised 52 patients who were treated with EPCT; a control group (CG) included 41 patients. All the patients received pharmacotherapy generally accepted for these diseases. The SG patients were given additionally EPCT (the patient took 8-methoxypsoralen in a dose of 0.6 mg/kg 1.5-2 hours before the procedure). Mononuclear cells were isolated from the patients' blood in the intermittent-line mode on a Haemonetics MCS+ cell separator. The cell suspension was irradiated with ultraviolet light A (lambda = 320-400 nm) on a JULIA irradiator at 10-15 mI/mm for 30 mm and reinfused in the patient. The course of therapy consisted of 4 sessions performed on alternate days. A varying positive effect was obtained in 49 (94%) SG patients; the mean PASI scores fell from 19.7 +/- 3.4 to 6.7 +/- 2.1 (p < 0.05). The DAS reflecting the activity of PsA reduced on average from 3.35 +/- 0.7 to 2.16 +/- 0.5 (p < 0.05), which corresponded to the change of PsA activity from moderate to weak. In CG, the positive effect was less pronounced in 27 (66%) patients, the PASI scores dropped on average from 19.2 +/- 3.7 to 12.2 +/- 3.1 (p < 0.05), DAS in patients with PsA decreased from 3.24 +/- 0.8 to 2.95 +/- 0.7 (p < 0.05). EPCT showed a high efficiency in patients with psoriasis and Ps associated with PsA; the immunological studies demonstrated the pathogenetic direction of the technique.