UVB is light with a short wavelength that is absorbed in
the skin's epidermis. An artificial source can be used to treat mild and
moderate psoriasis. Some physicians will start treating patients with UVB
instead of topical agents. A UVB phototherapy, called broadband UVB, can be used
for a few small lesions, to treat widespread psoriasis, or for lesions that
resist topical treatment. This type of phototherapy is normally given in a
doctor's office or in the home by using a light panel or light box.
A newer type of UVB, called narrowband UVB, emits the part of
the ultraviolet light spectrum band that is most helpful for psoriasis.
Narrowband UVB treatment is superior to broadband UVB. It is gaining in
popularity because it does help and is more convenient than PUVA. At first,
patients may require several treatments of narrowband UVB spaced close together
to improve their skin. Once the skin has shown improvement, a maintenance
treatment once each week may be all that is necessary.
Ottawa Clinics Study
In 2006, after several years of prescribing Narrowband UVB home
phototherapy for patients that "had already responded favorably to phototherapy"
at one of the Ottawa clinics, this independent study was undertaken to assess
"the viability and safety of such treatment".
It was concluded: "NB-UVB home phototherapy was found to be
very effective in comparison with hospital therapy. It is safe and presents few
side effects when patients receive appropriate guidelines, teaching and
follow-ups. Not only is it convenient, it also provides effective savings for
the patients who are unable to attend the hospital owing to time, travel, and
interference with work schedule. All patients on home therapy were satisfied
with their treatment, plan to continue it, and recommend it to others in similar
situations."
Independent Study
Background: Phototherapy is a mainstay in the treatment of
psoriasis and other photoresponsive dermatoses and home phototherapy has
broadened therapeutic options.
Purpose: To describe the history of home phototherapy, the
technological advances in the safety and efficacy of the equipment available,
and the associated issues of cost, convenience, adherence, and quality of life.
Methods: We conducted a literature review of home
phototherapy, broad-band UVB, narrow-band UVB, and PUVA phototherapy using
PUBMED. A Google search of home phototherapy equipment and technology was also
undertaken.
Results: Technological advances in home phototherapy equipment
have allowed for more treatment options and improvements in safety and efficacy.
One randomized, controlled trial found results comparable to office-based
phototherapy. Home phototherapy is convenient, cost-effective, and associated
with better quality of life compared to outpatient phototherapy treatment. One
trial found that adherence to home phototherapy regimens was better than to oral
retinoids.
Conclusions: Home phototherapy is a well-tolerated,
efficacious, economical and patient friendly therapeutic option. Advantages of
home phototherapy include improved quality of life, greater convenience, lower
cost, and less time lost from work and social activities. Dermatologists should
strongly consider home phototherapy as a first-line treatment option for
appropriately selected psoriasis patients
References:
University of Ottawa Division of Dermatology; Phototherapy
Clinics, Ottawa Hospital Civic Campus; and Sisters of Charity Ottawa Health
Service, Elisabeth Bruyere Health Centre, Ottawa, Ontario, Canada.
Bridgit V Nolan1, Brad A Yentzer MD2, Steven R Feldman MD PhD2
, Dermatology Online Journal 16 (2)
