Abstract
Psoriasis is a chronic and common disease mediated by resident memory T cells that
negatively affects a broad range of people worldwide. One of the oldest and most commonly
used treatments is phototherapy. We reviewed the existing literature on the four main
ultraviolet B (UVB) modalities of phototherapy in the management of psoriasis: heliotherapy,
broadband UVB, narrowband UVB, and excimer laser and lamp. Despite the many studies
done on these therapies, there is significant variation in their prescription and
use. Phototherapy remains one of the most effective and safest treatments for psoriasis.
We provide an updated comprehensive overview of UVB phototherapy for psoriasis to
help physicians optimize their choice of modality and dosing regimen to ensure optimal
outcomes for psoriasis patients. © 2016 Elsevier Inc. All rights reserved.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Clinics in DermatologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- The impact of psoriasis on health care costs and patient work loss.J Am Acad Dermatol. 2008; 59: 772-780
- Cause-specific mortality in patients with severe psoriasis: a population-based cohort study in the U.K.Br J Dermatol. 2010; 163: 586-592
- European S3-guidelines on the systemic treatment of psoriasis vulgaris.J Eur Acad Dermatol Venereol. 2009; 23: 1-70
- Patients with psoriasis and their compliance with medication.J Am Acad Dermatol. 1999; 41: 581-583
- Dermatologist preferences for first-line therapy of moderate to severe psoriasis in healthy adult patients.J Am Acad Dermatol. 2012; 66: 376-386
- Narrowband UV-B (TL-01) phototherapy vs oral 8-methoxypsoralen psoralen-UV-A for the treatment of chronic plaque psoriasis.Arch Dermatol. 2003; 139: 325-328
- Definition of treatment goals for moderate to severe psoriasis: a European consensus.Arch Dermatol Res. 2011; 303: 1-10
- Guidelines of care for the management of psoriasis and psoriatic arthritis: section 1. Overview of psoriasis and guidelines of care for the treatment of psoriasis with biologics.J Am Acad Dermatol. 2008; 58: 826-850
- Assessment and management of psoriasis: summary of NICE guidance.BMJ. 2012; 345: e6712
- Guidelines of care for the management of psoriasis and psoriatic arthritis: section 5. Guidelines of care for the treatment of psoriasis with phototherapy and photochemotherapy.J Am Acad Dermatol. 2010; 62: 114-135
- Guidelines for dosimetry and calibration in ultraviolet radiation therapy: a report of a British Photodermatology Group workshop.Br J Dermatol. 2002; 146: 755-763
- Bolognia J.L. Jorrizo J.L. Rapini R.P. Dermatology. 2nd ed. Mosby Elsevier, 2008
- Feasibility and accuracy of a newly developed hand-held device with a flat-type fluorescent lamp for measuring the minimal erythema dose for narrow-band UVB therapy.Photodermatol Photoimmunol Photomed. 2009; 25: 41-44
- Effect of heliotherapy on the cost of psoriasis.Br J Dermatol. 1998; 138: 288-292
- Effectiveness of heliotherapy for psoriasis clearance in low and mid-latitudinal regions: a theoretical approach.J Photochem Photobiol B. 2012; 115: 35-41
- Quantitative assessment of heliotherapy in psoriasis vulgaris in high altitude climate.Z Hautkr. 1989; 64: 466-472
- Effect of heliotherapy on skin and joint symptoms in psoriasis: a 6-month follow-up study.Br J Dermatol. 1993; 128: 172-177
- Outcome of "short-term" Dead Sea climatotherapy for psoriasis.Acta Derm Venereol. 2008; 88: 90-91
- Space-based estimation of the solar UV-B doses for psoriasis heliotherapy in Poland using OMI data for the period 2005–2011.J Photochem Photobiol B. 2012; 117: 240-246
- Climate therapy for Swedish psoriatics on Hvar, Yugoslavia.Acta Derm Venereol. 1972; 52: 155-160
- Ultraviolet radiation properties as applied to photoclimatherapy at the Dead Sea.Int J Dermatol. 2003; 42: 359-365
- Determination of solar ultraviolet dose in the Dead Sea treatment of psoriasis.Isr Med Assoc J. 2003; 5: 87-88
- Phototherapy arsenal in the treatment of psoriasis.Dermatol Clin. 2004; 22 ([viii]): 397-406
- Phototherapy for psoriasis.Clin Exp Dermatol. 2001; 26: 343-350
- Narrow-band UVB (311 nm) versus conventional broad-band UVB with and without dithranol in phototherapy for psoriasis.J Am Acad Dermatol. 1993; 28: 227-231
- Treatment of psoriasis with a 311-nm UVB lamp.Br J Dermatol. 1992; 127: 509-512
- Action spectrum for phototherapy of psoriasis.J Invest Dermatol. 1981; 76: 359-362
- Narrowband ultraviolet B therapy in psoriasis: randomized double-blind comparison of high-dose and low-dose irradiation regimens.Br J Dermatol. 2009; 161: 1351-1356
- A review of phototherapy protocols for psoriasis treatment.J Am Acad Dermatol. 2011; 64: 936-949
- An update and guidance on narrowband ultraviolet B phototherapy: a British Photodermatology Group Workshop Report.Br J Dermatol. 2004; 151: 283-297
- Narrowband ultraviolet B (UVB) phototherapy in children.Clin Exp Dermatol. 2006; 31: 196-199
- A randomized comparison of narrow-band TL-01 phototherapy and PUVA photochemotherapy for psoriasis.J Am Acad Dermatol. 1999; 41: 728-732
- Different narrowband UVB dosage regimens in dark skinned psoriatics: a preliminary study.Photodermatol Photoimmunol Photomed. 2008; 24: 256-259
- Narrow-band (TL-01) ultraviolet B phototherapy for chronic plaque psoriasis: three times or five times weekly treatment?.Br J Dermatol. 1998; 138: 833-839
- A randomized, observer-blinded trial of twice vs. three times weekly narrowband ultraviolet B phototherapy for chronic plaque psoriasis.Br J Dermatol. 2002; 147: 973-978
- 308-nm excimer laser therapy for psoriasis.Arch Dermatol. 2001; 137: 95-96
- Targeted phototherapy.Indian J Dermatol Venereol Leprol. 2009; 75: 119-125
- Treatment of palmoplantar psoriasis with monochromatic excimer light (308-nm) versus cream PUVA.Acta Derm Venereol. 2006; 86: 22-24
- Efficacy of the 308-nm excimer laser for treatment of psoriasis: results of a multicenter study.J Am Acad Dermatol. 2002; 46: 900-906
- Ultraviolet B 308-nm excimer laser treatment of psoriasis: a new phototherapeutic approach.Br J Dermatol. 2003; 149: 1250-1258
- The effectiveness of PUVA treatment in severe psoriasis is significantly increased by additional UV 308-nm excimer laser sessions.Eur J Dermatol. 2008; 18: 55-60
- Comparison of the 308-nm excimer laser and a 308-nm excimer lamp with 311-nm narrowband ultraviolet B in the treatment of psoriasis.Br J Dermatol. 2005; 152: 750-754
- Medium-dose 308-nm excimer laser for the treatment of psoriasis.J Am Acad Dermatol. 2002; 47: 701-708
- Vitiligo following narrow-band TL-01 phototherapy for psoriasis.Br J Dermatol. 2001; 144: 1264-1266
- Formation of cyclobutane pyrimidine dimers and 8-oxo-7,8-dihydro-2'-deoxyguanosine in mouse and organ-cultured human skin by irradiation with broadband or with narrowband UVB.Photochem Photobiol. 2002; 76: 397-400
- Differences in narrow-band ultraviolet B and broad-spectrum ultraviolet photocarcinogenesis in lightly pigmented hairless mice.Photodermatol Photoimmunol Photomed. 1994; 10: 192-197
- The phototumorigenic potential of broad-band (270–350 nm) and narrow-band (311–313 nm) phototherapy sources cannot be predicted by their edematogenic potential in hairless mouse skin.J Invest Dermatol. 1995; 104: 359-363
- 308-nm excimer laser for the treatment of psoriasis: a dose–response study.Arch Dermatol. 2000; 136: 619-624
- Assessment of DNA damage induced by broadband and narrowband UVB in cultured lymphoblasts and keratinocytes using the comet assay.Photochem Photobiol. 1998; 67: 647-650
Article info
Footnotes
☆Funding Sources: This work was supported by the Medical Dermatology Research Fellowship from the National Psoriasis Foundation and American Skin Association Research Grant.
Identification
Copyright
© 2016 Elsevier Inc. All rights reserved.
