Differences in phototherapy among skin diseases and genders in real‐life conditions—A retrospective analysis of the cumulative doses, numbers of sessions, side effects and costs in 561 patients

Abstract

Background: Phototherapy has been a mainstay therapy for dermatological diseases since more than a century. Although phototherapy is still extensively used and some recommendations exist, only scarce data are available addressing disease-specific differences in cumulative doses, treatment durations and costs. Knowledge of such differences could help to avoid over-/undertreatment, predict treatment duration and costs. Therefore, we sought to determine differences in cumulative doses, numbers of sessions, side effects and costs among different skin diseases and genders in real-life conditions. Methods:In this single-centre, retrospective study, patients treated with phototherapy between March 2014 and April 2019 were classified into seven diagnostic groups and analysed according to the study goals.Results: Out of 561 patients (age 53.9 ± 20.3 yrs; 52.9% females), 83.7% percent were treated with cabin NB-UVB (mean cumulative dose 17.79 ± 17.11 J/cm 2 ). Patients with vitiligo and psoriasis were treated with significantly higher cumulative NB-UVB doses (cabin, local) in comparison with the five other diagnostic groups as were males in comparison with females. Consequently, significantly higher UV-related costs resulted in patients with vitiligo, psoriasis and males.Patients with atopic dermatitis and pruritus were treated with significantly higher cumulative UVA1 doses compared to patients with non-atopic eczema.The complication rate (pooled from all UV modalities) in our population was 3.8% (erythema 3.4%, aggravated itch 0.4% and worsening of symptoms 0.2%). Conclusions:Our results demonstrate that cumulative doses and phototherapyrelated costs vary strongly among skin diseases-a fact not adequately considered in recommendations. A more disease-specific stratification of phototherapy could not | 465 ALESSIA MERKEL Et AL.

The impact of phototherapy on itch intensity and itch‐related quality of life amongst different skin diseases, skin phototypes and genders – A prospective study with 102 patients

“…However, it is worth mentioning that some pruritic conditions commonly treated with phototherapy, such as uremic CP or chronic nodular prurigo, were not present in our population. As in other studies, NB‐UVB was the most commonly used modality of phototherapy 18,36 …”

“…In the current “era of biologics and small molecules,” the role of phototherapy was repeatedly questioned 36,55 . Yet, our data and plenty of previous studies have demonstrated that phototherapy is undoubtedly still an important and effective treatment option for various itchy skin diseases 44,56–58 .…”

“…As in other studies, NB-UVB was the most commonly used modality of phototherapy. 18,36 In consideration of previous studies, the definition by Note: All numbers ± standard deviation.…”

Dermatologische Klinik des Universitätsspitals Basel

“…Bei der Behandlung des Pruritus spielt die Phototherapie in unserer Abteilung nach wie vor eine wichtige Rolle, wobei primär UVBnb, bei entsprechender Indikation auch UVA1 eingesetzt wird. Basierend auf einer Dissertation von Dr. Tamara Merkel aus unserem Team versuchen wir hier, möglichst diagnosespezi-fische, effektive und zugleich kostengünstige Dosierungsschemata anzuwenden [11]. Die Margarethenklinik zeichnet sich durch ihren Ruf als Referenzzentrum für die Behandlung von Komplikationen nach ästhetischen Eingriffen sowie durch ihre Pionierstellung im Bereich der ultraschallgesteuerten ästhetischen Injektionen in der Schweiz aus [17,18].…”