ABSTRACT
This chapter presents classification & mode of action, indications & dermatological uses, formulations/presentation, dosages & suggested regimens, baseline investigations, considerations & monitoring, contraindications, cautions, important drug interactions, adverse effects & their management, use in special situations, and essential patient information of Psoralens. Psoralens are naturally occurring furocoumarins that are found in several plant species. Psoralens intercalate between DNA strands, favouring thymidine rich portions of genome. As oral psoralens are metabolized in the liver, it is sensible to avoid their use in severe liver disease, although they may be used in mild impairment. Synthetic psoralens have been used therapeutically in dermatology since the 1970s in conjunction with ultraviolet A (UVA) in psoralen-UVA (PUVA) photochemotherapy. Renal excretion is the main route of elimination of psoralen metabolites; thus oral PUVA can be used in patients with stable renal impairment in a reduced dose, but preferably combined with minimal phototoxic dose measurement prior to treatment, to reduce the risk of burning.
