Comparison of psoralen plus ultraviolet A therapy and biologics in moderate to severe chronic plaque psoriasis

Conflicts of interest While I have no conflict of interest, I may be slightly biased as I used to be a so‐called ‘photobiology fellow’ for some while in the 1970s at the late Tom Fitzpatrick’s Department in Boston. In this issue Inzinger et al.1 present a retrospective data analysis on the efficacy of psoralen plus ultraviolet (UV) A (PUVA) vs. biologics in moderate to severe chronic plaque psoriasis. Although being a retrospective study it is important because it represents the first comparison of PUVA and biologics. So far no direct comparison studies of PUVA or narrowband UVB (NB‐UVB) vs. biologics have been reported and for obvious reasons comparative blinded studies may be impossible to perform as PUVA therapy induces erythema and pigmentation. I think the paper has a definite impact on treatment recommendations. Biologics are currently quite aggressively advertised as the non plus ultra in psoriasis therapy. Phototherapy (PUVA and NB‐UVB) should be presented in the proper light when compared with other treatment options.