Phototherapy and photochemotherapy in skin diseases

Abstract

The authors describe the usefulness of the phototherapy in the treatment of skin diseases on the basis of the literature and their own experience. Various mechanisms of action of ultraviolet radiation (UVB, UVA) and their usefulness in skin diseases therapy are discussed. For many years, phototherapy UVA1, UVB, narrow-band UVB (311 nm) and photochemotherapy (PUVA) based on the combined action of psoralens (8-methoxypsoralen, 8-MOP, 5-methoxypsoralen, 5-MOP and trimethylpsoralen, TMP) and long ultraviolet waves (UVA) were used in treatment of over thirty skin diseases. The photochemotherapy follow-up study demonstrated a significant dose-related increase in the risk of adverse effects. They include chronic degenerative and pigmentary skin changes and increased risk of squamos cell carcinoma (SCC) and malignat melanoma. The incidence of SCC and malignat melanoma was higer in patients who received high-dose PUVA (>250 treatments or >2000J/cm2). To reduce these side effects, a combination of PUVA, UVB with other topical therapies and especially balneophotherapy (salt, sulfur water baths and artificial UVB), PUVA-bath (with the use of TMP solution and UVA) should be used. © Medsportpress, 2006.