{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:20:00Z","timestamp":1787016000424,"version":"build-2736575974"},"reference-count":16,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T00:00:00Z","timestamp":1755043200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Photoderm Photoimm Photomed"],"published-print":{"date-parts":[[2025,9]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background\/Purpose<\/jats:title>\n While biologics and small\u2010molecule inhibitors are first\u2010line systemic treatments for psoriasis, phototherapy remains an alternative for patients unable to access these treatments because of medical or financial constraints. Narrow\u2010band ultraviolet B (NB\u2010UVB) is effective for localized psoriasis but less so for extensive disease. To address this limitation, bathwater delivery of psoralen plus ultraviolet A (bath\u2010PUVA) was introduced in 2004. This study evaluates the efficacy, safety, and patient characteristics associated with bath\u2010PUVA therapy in a large cohort.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This retrospective analysis included 229 patients (180 males, 49 females) treated with bath\u2010PUVA from 2004 to September 2021. Baseline characteristics and treatment outcomes were assessed using the psoriasis area and severity index (PASI). Statistical analyses examined relationships between treatment outcomes and factors, including baseline PASI, body mass index (BMI), and smoking status.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The mean baseline PASI score was 24.9. Bath\u2010PUVA achieved PASI 75 in 80.4% of patients, PASI 90 in 44.1%, and PASI 100 in 2.6%, with efficacy comparable to biologics. Patients achieving PASI 90 had significantly higher baseline PASI scores (\n p<\/jats:italic>\n \u2009=\u20090.005), while the number of irradiations required did not differ (\n p<\/jats:italic>\n \u2009=\u20090.692). Higher baseline PASI scores correlated with elevated BMI (\n p<\/jats:italic>\n \u2009=\u20090.002), but BMI did not influence improvement rates (\n p<\/jats:italic>\n \u2009=\u20090.094). Smokers had significantly higher baseline PASI scores (\n p<\/jats:italic>\n \u2009=\u20090.004) compared with non\u2010smokers, yet smoking status did not affect improvement rates (\n p<\/jats:italic>\n \u2009=\u20090.862).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Bath\u2010PUVA demonstrates efficacy comparable with biologics for psoriasis, regardless of BMI or smoking status. This analysis supports its use as an effective and accessible treatment option for patients with extensive disease.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/phpp.70038","type":"journal-article","created":{"date-parts":[[2025,8,14]],"date-time":"2025-08-14T03:50:08Z","timestamp":1755143408000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["A Large\u2010Scale, Retrospective Analysis of Bath\u2010Psoralen Plus Ultraviolet A Therapy for Psoriasis: A Single\u2010Center Study"],"prefix":"10.1111","volume":"41","author":[{"given":"Mai","family":"Sakurai","sequence":"first","affiliation":[{"name":"Department of Geriatric and Environmental Dermatology Nagoya City University Graduate School of Medical Sciences Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuki","family":"Enomoto","sequence":"additional","affiliation":[{"name":"Department of Geriatric and Environmental Dermatology Nagoya City University Graduate School of Medical Sciences Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshifumi","family":"Kanayama","sequence":"additional","affiliation":[{"name":"Department of Geriatric and Environmental Dermatology Nagoya City University Graduate School of Medical Sciences Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Sakaida","sequence":"additional","affiliation":[{"name":"Department of Geriatric and Environmental Dermatology Nagoya City University Graduate School of Medical Sciences Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aya","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Department of Geriatric and Environmental Dermatology Nagoya City University Graduate School of Medical Sciences Nagoya 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Photoimmunology & Photomedicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/phpp.70038","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T05:23:49Z","timestamp":1763529829000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/phpp.70038"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,13]]},"references-count":16,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,9]]}},"alternative-id":["10.1111\/phpp.70038"],"URL":"https:\/\/doi.org\/10.1111\/phpp.70038","archive":["Portico"],"relation":{},"ISSN":["0905-4383","1600-0781"],"issn-type":[{"value":"0905-4383","type":"print"},{"value":"1600-0781","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,13]]},"assertion":[{"value":"2025-01-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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