PUVA therapy in localized scleroderma.

To the Editor: We report the case of an 80-yearold man with localized scleroderma, treated successfully with PUVA therapy. The patient came to our office with progressive hardening of his abdominal skin. Clinical examination (Fig. 1) showed a large (25 cm in diameter) slightly erythematous plaque that could not be pinched and made it difficult for the patient to bend down. The lesion margins were rough, showing no lilac ring. Histological examination confirmed morphoea. The patient was classified as skin phototype IV. PUVA therapy began with 0.6 mgk, 42 mglday 8-methoxypsoralen and an initial UVA dose of 4 J/ cm2, which was gradually increased, weekly, to a maximal single dose of 18 J/cm2. Photochemotherapy was given once daily, three times a week from March to November 1996. Two months after the patient started treatment he felt better; in fact, soft areas could be seen inside the plaque. In November he was able to move around well, and photochemother-