PHOTOTHERAPY (UVB) AND PHOTOCHEMOTHERAPY (PUVA) FOR PSORIASIS

SUMMARYThe review covers the current practice of phototherapy with ultraviolet (UV) radia- tion without sensitizers and of psoralen photochemotherapy (PUVA) in the treatment of psoriasis. There are several types of UVB radiation in clinical use: traditional or broad band UVB (280 • 320 nm); selective UVB (305 • 325 nm); and narrow band UVB (311 nm). Forms of PUVA therapy are: systemic photochemotherapy (PUVA therapy with oral administration of psoralen); PUVA bath therapy; and PUVA therapy with topical psoralen application. PUVA therapy is more effective than UVB therapy in clearing psoriasis in most patients, but since UVB is easier to administer and does not involve an oral photosensitizing medication, it is often selected before PUVA. UVB and PUVA have been administered alone or in combination with topical corticosteroids, salicylic acid, anthralin, calcipotriol and tazarotene, and with systemic therapies such as retinoids. The most important po- tential long-term side effects of UVB and PUVA are accelerated skin aging and an increased risk of cutaneous cancer.