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While phototoxic reactions usually occur during the initial phase of treatment, the appearance of PUVA-induced blisters is predominantly associated with the dose administered during the last 30 days of treatment, not with the last dose administered nor the total dose.4,5 Heidbreder and Henseler reported a negative correlation between patient age and blistering time.5 The main histopathological findings described in psoriatic patients7,9 are subepidermal blisters with variable epidermal involvement, ranging from complete necrosis of the Malpighian layer to the presence of isolated necrotic keratinocytes
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