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A combination therapy consisting of the photosensitizing agent 8-methoxypsoralen (methoxsalen) and the systemic retinoid acitretin. This combination, often termed Re-PUVA, is primarily used for the treatment of severe or refractory psoriasis, including palmoplantar and plaque variants. Acitretin acts by regulating keratinocyte differentiation and proliferation through the activation of retinoic acid receptors. 8-methoxypsoralen, when activated by ultraviolet A (UVA) light, forms covalent interstrand DNA cross-links that inhibit DNA synthesis and cell division. The addition of acitretin to PUVA therapy often enhances clinical response, reduces the total UVA dose required, and decreases the number of treatment sessions needed.
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