Phototherapy and photochemotherapy in dermatology. Recommendations of the Polish Dermatological Society

Abstract

Light is a component of the electromagnetic waves. The electromagnetic wave consists of mutually inducible electrical and magnetic components that generate variable electric field. This then turns into magnetic field, causing alternating current to flow. Electromagnetic waves include radio waves, microwaves, infrared light, visible light, ultraviolet light, X-rays and gamma radiation. The length of these waves determines their properties. An increase in wavelength is accompanied by a decrease in its radiation energy. Dermatological phototherapy uses the following types of light: broadband UVB, narrow-band monochromatic UVB, laser UVB, UVA in combination with psoralens-PUVA, UVA1, visible light, monochromatic light within the visible spectrum: violet, yellow, red, deep red and infrared. Phototherapy and photochemotherapy nowadays uses equipment emitting radiation at the following lengths: UVB 311, UVB 313, UVB 308, UVA 320-400 nm with a peek at 365 nm and 340-400 nm UVA1. In Poland, the most commonly used radiation is UVB 311 and UVA 320-400 mm (mainly with psoralens). Photochemotherapy is a form of treatment by light, in which the effect of ultraviolet in combination with chemical substances acting as photosensitizers (psoralens) is utilized. The term PUVA was introduced in 1974 by Parrish et al. in a publication assessing the results of psoriasis treatment with orally administered 8-methoxypsoralen and wholebody exposure to long-wave UVA radiation. This article contains the recommendations of the Polish Dermatological Society for photoherapy and photochemoterapy in dermatology.

Psoriasis in children. Diagnostic and therapeutic recommendations of the Polish Dermatological Society. Part 2

“…W terapii łuszczycy u dzieci wykorzystuje się obecnie naświetlania promieniami o długości 311-313 nm (tzw. narrow-band UVB -NB-UVB) oraz UVA (315-400 nm) w połączeniu z miejscową lub doustną aplikacją psoralenów (PUVA) [1,2]. W większości przypadków fototerapia stosowana jest w skojarzeniu z leczeniem miejscowym.…”

“…Choć u chorych dorosłych przed rozpoczęciem fototerapii rekomenduje się ustalenie minimalnej dawki rumieniowej, to u dzieci proponuje się, aby dawkę początkową ustalać przede wszystkim na podstawie fototypu skóry [1]. W dniach naświetlań pacjent nie powinien dodatkowo eksponować skóry na światło słoneczne.…”

“…Phototherapy is a common therapeutic method used for the treatment of psoriasis in both the pediatric and adult population. In children, irradiation with a length of 311-313 nm (the so-called narrow-band UVB, NB-UVB) and UVA (315-400 nm) are currently used in combination with topical or oral application of psoralens (PUVA) [1,2]. In most cases, phototherapy is used in combination with a local treatment.…”

“…Although in adult patients it is recommended to establish the minimum erythema-inducing dose before starting phototherapy, in children it is recommended that the initial dose should be determined primarily on the basis of the skin phototype [1]. On the days of irradiation, the patient should not expose the skin to sunlight.…”

Phototherapy in Atopic Dermatitis

“…Jury et al in their retrospective trial on 25 children with AD showed almost total reduction of lesions in 17 patients [23]. NB-UVB is a recommended therapeutic option in pregnancy [24].…”