A patient receiving oral methoxsalen plus UVA (PUVA) asks about long-term risks. The principal cutaneous malignancy associated with high cumulative PUVA exposure is squamous cell carcinoma. An essential protective measure during every PUVA session is:

• A Application of a broad-spectrum sunscreen to the entire body
• B Avoidance of all sunlight for 72 hours after each session
• C Wearing occlusive plastic dressings over treated plaques
• D Shielding of the genital area in males ✓

Explanation

High cumulative PUVA exposure produces a dose-dependent rise in squamous cell carcinoma risk, with genitalia particularly vulnerable because this site is normally sun protected. Shielding the male genitalia during every exposure session is therefore standard practice. Patients should also wear UVA-blocking sunglasses for 24 hours after oral psoralen to prevent cataract formation, but complete avoidance of ambient daylight is unnecessary, and sunscreen is not a substitute for physical shielding.

Reference: Rook's Textbook of Dermatology, 9th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.