Phototesting prior to narrowband (TL‐01) ultraviolet B phototherapy

Abstract

A device for phototesting patients prior to narrowband phototherapy is described. One hundred and fifty patients (130 with psoriasis and 20 with eczema) of skin types I-IV were phototested on the forearm and 22 on both forearm and back. The minimal erythema dose (MED) was judged visually 24 h after irradiation, and in those patients who were tested at two body sites, objective measurement of the erythema was made using a reflectance instrument. The MED values on the arm showed a fivefold range. There was no significant association between skin type and MED. The MED values on the arm were significantly higher than those measured on the back, although the differences were small in the majority of cases. No significant difference was found between the slopes of the dose-response curves measured on the arm and on the back.

Narrowband UVB phototherapy in skin conditions beyond psoriasis

“…Because NB UVB is also effective when applied in suberythemogenic doses and MED-NB UVB is not predictable by skin type, phototesting with TL-01 lamps is generally recommended before starting therapy. 7 Devices for phototesting fitted with TL-01 lamps are commercially available to assess rapidly and conveniently at different body sites MED-NB UVB (eg, Durham [Dr P. J. Saunders, Dryburn Hospital, Durham, UK] or Dermalight [Dr A. G. Hönle, Gräfelfing, Germany] erythema testers). 7,60 The most common starting and incremental doses used for treatment with NB UVB, respectively, are 70% of the MED and 20% to 10% incremental doses depending on the patients individual tolerability.…”

“…[5][6][7][8] During the last decade, however, NB UVB has increasingly been used in a variety of skin conditions beyond psoriasis. In this systematic review we aimed to give an update on studies of nonpsoriatic skin conditions treated with NB UVB, and to establish its current position within the spectrum of competing photo(chemo)therapeutic options.…”

Narrowband ultraviolet B phototherapy to clear and maintain clearance in patients with mycosis fungoides

“…MED was accepted as the lowest dose to produce just perceptible erythema that covers the entire irradiated area with 4 distinct borders at 24 h. Therapy was initiated with a dose of 70% MED if the test area was the upper back and 60% MED if it was the forearm. 11 Therapy was held 3 days a week on Monday, Wednesday, and Friday. Dose increments at each visit were made according to the previous erythema response.…”

In search of an optimum dose escalation for narrowband UVB phototherapy: Is it time to quit 20% increments?

“…5 Therapy was initiated with a dose of 70% MED if the test area was the upper back, and 60% MED if it was an area other than the upper back. 6 Therapy was performed every other day, 3 days a week. Dose increments with 20% incremental regimen at each visit were made according to the previous erythema response at 48 hours as reported by Green et al, 7 and a similar approach was applied both for 10% and 5% incremental regimens.…”