Background：Local bath-PUVA(LB-PUVA) therapy has been recently tried for the treatment of palmoplantar pustular psoriasis and chronic eczema with successful results. However it has not been reported that the effectiveness of LB-PUVA was compared with that of steroid treatment which is the most available treatment. Objectives：The purpose of this study was to assess the effectiveness, symptom-free interval, recurrence rate and side effects of local bath-PUVA(LB-PUVA) therapy in palmoplantar pustular psoriasis and dyshidrotic eczema which had been resistant to conventional treatments and to compare these results with those of the steroid treatment. Methods：Twenty four patients with palmoplantar pustular psoriasis, dyshidrotic eczema and palmoplantar keratoderma were treated with local bath-PUVA and the control group of twenty patients with systemic and topical steroid. 1. Local bath-PUVA therapy After a 15-minute bath in 1mg/L of methoxsalen solution(0.0001%), the palms or soles or both were exposed immediately to UVA radiation by UV/PUVA200. The initial standard dose was 1.5 J/cm2, and the patients were treated three times a week. 2. Systemic and topical steroid therapy The patients treated with 10-15mg of oral prednisolone once a day and high-potency steroid(Dermovate ointment) to the lesion topically for 4-8 weeks. The efficacy, symptom-free interval and side effects were assessed for 6-12 months after termination of the treatments. Results：The following results were obtained from this study. 1. In the objective study, severity scores before and after treatment significantly differed in palmoplantar pustular psoriasis treated with local bath-PUVA (p<0.001). 2. In the subjective study, steroid treatment was more effective than LB-PUVA treatment for dyshidrotic eczema and palmoplantar pustular psoriasis. 3. Remission period was significantly longer (mean 9.1±2.8 months vs. 5.2±3.1 months) and recurrence rate, lower (26.7% vs. 68.9%) after LB-PUVA treatment than after steroid treatment in palmoplantar pustular psorisis and dyshidrotic eczema. 4. One patient with palmoplantar keratoderma was effectively treated by LB-PUVA. Conclusion：Local bath-PUVA therapy can be used as an effective and safe treatment method of palmoplantar pustular psoriasis and possibly palmoplantar keratoderma. (Korean J Dermatol 2000;38(6)：742~749)