Acitretin in combination with UVB or PUVA

Combination therapy of psoriasis with acitretin and phototherapy (psoralen-ultraviolet A [PUVA] or ultraviolet B [UVB]) offers multiple advantages over use of either modality alone. As monotherapy, acitretin in doses of 50 mg/day is moderately effective, but is associated with numerous side effects. Single modality treatment with UVB or PUVA involves multiple visits over a period of months and is also associated with dose-limiting side effects. When used in combination, lower doses of both modalities can be used more effectively, helping to reduce side effects. In addition, clearing occurs much more quickly, reducing treatment time and number of phototherapy visits. Moreover, patients whose psoriasis does not clear with monotherapy will often achieve significant clearing with the combination of acitretin and phototherapy.