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The pathogenesis is complex and remains poorly understood. Treatment is based on organ involvement and requires a multidisciplinary approach. Skin sclerosis can cause disability, leading to decreasing quality of life. Various systemic antifibrotic therapies have been used; however, most have unsatisfactory results. Recently, phototherapy and in particular ultraviolet A (<jats:styled-content style=\"fixed-case\">UVA<\/jats:styled-content>) has been used to treat skin sclerosis in <jats:styled-content style=\"fixed-case\">SS<\/jats:styled-content>c patients with satisfactory results. The main mechanisms include lymphocyte apoptosis, cytokine alteration, inhibition of collagen synthesis and increased collagenase production, and neovascularization, leading to the breakdown of collagen fibrils resulting in skin softening or even healing digital ulcers. Most studies reported that psoralen plus <jats:styled-content style=\"fixed-case\">UVA<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">PUVA<\/jats:styled-content>) and <jats:styled-content style=\"fixed-case\">UVA<\/jats:styled-content>1 phototherapy improved clinical outcomes vis\u2010\u00e0\u2010vis skin sclerosis, joint mobility, ulcers, and histopathology. <jats:styled-content style=\"fixed-case\">PUVA<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">UVA<\/jats:styled-content>1 phototherapy therefore have potential as an alternative or adjunctive therapy for patients with <jats:styled-content style=\"fixed-case\">SS<\/jats:styled-content>c.<\/jats:p>","DOI":"10.1111\/phpp.12331","type":"journal-article","created":{"date-parts":[[2017,7,13]],"date-time":"2017-07-13T10:54:45Z","timestamp":1499943285000},"page":"296-305","source":"Crossref","is-referenced-by-count":21,"title":["Phototherapy in systemic sclerosis: Review"],"prefix":"10.1111","volume":"33","author":[{"given":"Suteeraporn","family":"Chaowattanapanit","sequence":"first","affiliation":[{"name":"Division of Dermatology Department of Medicine Faculty of Medicine Khon Kaen University  Khon Kaen Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3417-6210","authenticated-orcid":false,"given":"Charoen","family":"Choonhakarn","sequence":"additional","affiliation":[{"name":"Division of Dermatology Department of Medicine Faculty of Medicine Khon Kaen University  Khon Kaen Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chingching","family":"Foocharoen","sequence":"additional","affiliation":[{"name":"Division of Allergy\u2010Immunology\u2010Rheumatology Department of Medicine Faculty of Medicine Khon Kaen University  Khon Kaen Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Narachai","family":"Julanon","sequence":"additional","affiliation":[{"name":"Division of Dermatology Department of Medicine Faculty of Medicine Khon Kaen University  Khon Kaen Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,8,6]]},"reference":[{"key":"e_1_2_9_2_1","first-page":"166","article-title":"Treatment of early diffuse systemic sclerosis skin disease","volume":"31","author":"Frech TM","year":"2013","journal-title":"Clin Exp Rheumatol"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rdc.2007.11.005"},{"key":"e_1_2_9_4_1","first-page":"2361","article-title":"Successful treatment of systemic sclerosis with topical PUVA","volume":"22","author":"Morita A","year":"1995","journal-title":"J Rheumatol"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1346-8138.1996.tb04054.x"},{"key":"e_1_2_9_6_1","doi-asserted-by":"crossref","first-page":"1597","DOI":"10.1001\/archderm.1997.03890480123023","article-title":"Psoralen bath plus UV\u2010A therapy. 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