Ultraviolet phototherapy for treatment of various dermatoses
Irwan Saputra Batubara(1*), Larisa Paramitha Wibawa(2), Erdina Pusponegoro(3), Windy Keumala Budianti(4), Githa Rahmayunita(5), Shannaz Nadia Yusharyahya(6)
(1) Department of Dermatology and Venereology, Faculty of Medicine, Universitas Indonesia/Dr. Cipto Mangunkusumo General Hospital, Jakarta
(2) Department of Dermatology and Venereology, Faculty of Medicine, Universitas Indonesia/Dr. Cipto Mangunkusumo General Hospital, Jakarta
(3) Department of Dermatology and Venereology, Faculty of Medicine, Universitas Indonesia/Dr. Cipto Mangunkusumo General Hospital, Jakarta
(4) Department of Dermatology and Venereology, Faculty of Medicine, Universitas Indonesia/Dr. Cipto Mangunkusumo General Hospital, Jakarta
(5) Department of Dermatology and Venereology, Faculty of Medicine, Universitas Indonesia/Dr. Cipto Mangunkusumo General Hospital, Jakarta
(6) Department of Dermatology and Venereology, Faculty of Medicine, Universitas Indonesia/Dr. Cipto Mangunkusumo General Hospital, Jakarta
(*) Corresponding Author
Abstract
Ultraviolet (UV) radiation has been applied to treat many chronic skin diseases. Based on the wavelength, UV radiation consists of three types, namely ultraviolet C (UVC), ultraviolet B (UVB), and ultraviolet A (UVA). The types of UV that are widely used in dermatology are narrowband ultraviolet B (NB-UVB), broadband ultraviolet B (BB-UVB), UVA1, and psoralen combined with UVA (PUVA). The interaction between UV and the skin determines the effectiveness of phototherapy. The biological effects of UV are used in the management of inflammatory skin diseases, malignancies, and various rare dermatoses. Apart from these benefits, UV increases the risk of photoaging and skin cancer. Therefore, further researches are necessary to enhance the effectiveness and safety of phototherapy. This literature review discusses the role of phototherapy in various dermatoses other than psoriasis and vitiligo.
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- Grimes DR. Dose quantification in UV phototherapy. Adv Exp Med Biol 2017; 996:349-60. https://doi.org/10.1007/978-3-319-56017-5_29
- Krenitsky A, Ghamrawi RI, Feldman SR. Phototherapy: a review and update of treatment options in dermatology. Curr Dermatol Rep 2020; 9(1):10-21. https://doi.org/ 10.1007/s13671-020-00290-6
- Darné S, Leech SN, Taylor AEM. Narrowband ultraviolet B phototherapy in children with moderate-to-severe eczema: a comparative cohort study. Br J Dermatol 2014; 170(1):150-6. https://doi.org/10.1111/bjd.12580
- Legiawati L, Astriningrum R, Yusharyahya SN, Chandrakesuma V. Sociodemographic and clinical characteristics of geriatric patients with psoriasis receiving narrowband ultraviolet B phototherapy. Ann Geriatr Med Res 2020; 24(4):290-6. https://doi.org/10.4235/agmr.20.0048
- Vieyra-Garcia PA, Wolf P. From early immunomodulatory triggers to immunosuppressive outcome: therapeutic implications of the complex interplay between the wavebands of sunlight and the skin. Front Med 2018; 5:232. https://doi.org/10.3389/fmed.2018.00232
- Yu Z, Wolf P. How it works: the immunology underlying phototherapy. Dermatol Clin 2020; 38(1):37-53. https://doi.org/10.1016/j.det.2019.08.004
- Walterscheid JP, Nghiem DX, Kazimi N, Nutt LK, Mcconkey DJ, Norval M, et al. Cis-urocanic acid, a sunlight-induced immunosuppressive factor, activates immune suppression via the 5-HT2A receptor. Proc Natl Acad Sci USA 2006; 103(46):17420-5. https://doi.org/10.1073/pnas.0603119103
- Yamazaki S, Nishioka A, Kasuya S, Ohkura N, Hemmi H, Kaisho T, et al. Homeostasis of thymus-derived Foxp3+ regulatory T cells is controlled by ultraviolet B exposure in the skin. J Immunol 2014; 193(11):5488-97. https://doi.org/10.4049/jimmunol.1400985
- Jaleel T, Pollack BP, Elmets CA. Phototherapy. In: Kang S, Amagai M, Bruckner AL, Enk AH, Margolis DJ, Mcmichael AJ, et al. Editor. Fitzpatrick’s dermatology. Ninth edition. New York: McGraw Hill Companies; 2019. h.3635–63.
- Christensen L, Suggs A, Baron E. Ultraviolet photobiology in dermatology. Adv Exp Med Biol 2017; 996:89-104. https://10.1007/978-3-319-56017-5_8
- Zubair R, Hamzavi IH. Phototherapy for vitiligo. Dermatol Clin 2020; 38(1):55-62. https://doi.org/ 10.1016/j.det.2019.08.005
- haowattanapanit S, Choonhakarn C, Foocharoen C, Julanon N. Phototherapy in systemic sclerosis: review. Photodermatol Photoimmunol Photomed 2017; 33(6):296-305. https://doi.org/10.1111/phpp.12331
- Tobin DJ. Introduction to skin aging. J Tissue Viability 2017; 26(1):37-46. https://doi.org/10.1016/j.jtv.2016.03.002
- Poon F, Kang S, Chien AL. Mechanisms and treatments of photoaging. Photodermatol Photoimmunol Photomed 2015; 31(2):65-74. https://doi.org/10.1111/phpp.12145
- Seebode C, Lehmann J, Emmert S. Photocarcinogenesis and skin cancer prevention strategies. Anticancer Res 2016; 36(3):1371-8.
- Valejo Coelho MM, Matos TR, Apetato M. The dark side of the light: mechanisms of photocarcinogenesis. Clin Dermatol 2016; 34(5):563-70. https://doi.org/10.1016/j.clindermatol.2016.05.022
- Bae JM, Ju HJ, Lee RW, Oh SH, Shin JH, Kang HY, et al. Evaluation for skin cancer and precancer in patients with vitiligo treated with long-term narrowband UV-B phototherapy. JAMA Dermatology 2020; 156(5):529-37. https://doi.org/10.1001/jamadermatol.2020.0218
- Ortiz-Salvador JM, Ferrer DS, Saneleuterio-Temporal M, Victoria Martínez AM, Ferriols AP, Vilata Corell JJ, et al. Photocarcinogenic risk associated with narrowband UV-B phototherapy: an epidemiologic study in a tertiary care hospital. Actas Dermosifiliogr 2018; 109(4):340-5. https://10.1016/j.ad.2018.01.001
- Stern RS. The risk of melanoma in association with long-term exposure to PUVA. J Am Acad Dermatol 2001; 44(5):755-61. htpps://doi.org/10.1067/mjd.2001.114576
- Stern RS. The risk of squamous cell and basal cell cancer associated with psoralen and ultraviolet A therapy: a 30-year prospective study. J Am Acad Dermatol 2012; 66(4):553-62. https://doi.org/10.1016/j.jaad.2011.04.004
- Thompson KG, Kim N. Distinguishing myth from fact: photocarcinogenesis and phototherapy. Dermatol Clin 2020; 38(1):25-35. https://doi.org/10.1016/j.det.2019.08.003
- Elmets CA, Lim HW, Stoff B, Connor C, Cordoro KM, Lebwohl M, et al. Joint American Academy of Dermatology-National Psoriasis Foundation guidelines of care for the management and treatment of psoriasis with phototherapy. J Am Acad Dermatol 2019; 81(3):775-804. https://doi.org/10.1016/j.jaad.2019.04.042
- Jeremy Howick, Iain Chalmers, Paul Glasziou, Trish Greenhalgh, Carl Heneghan, Alessandro Liberati, et al. Oxford centre for evidence-based medicine, levels of evidence working group. The Oxford 2011 levels of evidence. cite: https://www.cebm.net/index.aspx?o=5653
- Ortiz-Salvador JM, Pérez-Ferriols A. Phototherapy in atopic dermatitis. Adv Exp Med Biol 2017; 996:279-86. https://doi.org/10.1007/978-3-319-56017-5_23
- Patrizi A, Raone B, Ravaioli GM. Safety and efficacy of phototherapy in the management of eczema. Adv Exp Med Biol 2017; 996:319-31. https://doi.org/10.1007/978-3-319-56017-5_27
- Patrizi A, Raone B, Ravaioli GM. Management of atopic dermatitis: safety and efficacy of phototherapy. Clin Cosmet Investig Dermatol 2015; 8:511-20. https://doi.org/10.2147/CCID.S87987
- Gambichler T, Skrygan M, Tomi NS, Altmeyer P, Kreuter A. Changes of antimicrobial peptide mRNA expression in atopic eczema following phototherapy. Br J Dermatol 2006; 155(6):1275-8. https://doi.org/10.1111/j.1365-2133.2006.07481.x
- Sidbury R, Davis DM, Cohen DE, Cordoro KM, Berger TG, Bergman JN, et al. Guidelines of care for the management of atopic dermatitis: section 3. Management and treatment with phototherapy and systemic agents. J Am Acad Dermatol 2014; 71(21):327-49. https://doi.org/10.1016/j.jaad.2014.03.030
- Dayal S, Pathak K, Sahu P, Jain VK. Narrowband UV-B phototherapy in childhood atopic dermatitis: efficacy and safety. An Bras Dermatol 2017; 92(6):801-6. https://doi.org/10.1590/abd1806-4841.20175958
- Garritsen FM, Brouwer MWD, Limpens J, Spuls PI. Photo(chemo)therapy in the management of atopic dermatitis: an updated systematic review with implications for practice and research. Br J Dermatol 2014; 170(3):501-13. https://doi.org/10.1111/bjd.12645
- Maul JT, Kretschmer L, Anzengruber F, Pink A, Murer C, French LE, et al. Impact of UVA on pruritus during UVA/B phototherapy of inflammatory skin diseases: a randomized double-blind study. J Eur Acad Dermatol Venereol 2017; 31(7):1208-13. https://doi.org/10.1111/jdv.13994
- Brass D, Fouweather T, Stocken DD, Macdonald C, Wilkinson J, Lloyd J, et al. An observer-blinded randomized controlled pilot trial comparing localized immersion psoralen-ultraviolet A with localized narrowband ultraviolet B for the treatment of palmar hand eczema. Br J Dermatol 2018; 179(1):63-71. https://doi.org/10.1111/bjd.16238
- Smith IL, Brown S, Nixon J, Cowdell FC, Ersser S, Fernandez C, et al. Treatment of severe, chronic hand eczema: results from a UK-wide survey. Clin Exp Dermatol 2017; 42(2):185-8. https://doi.org/10.1111/ced.13015
- Sezer E, Etikan I. Local narrowband UVB phototherapy vs. local PUVA in the treatment of chronic hand eczema. Photodermatol Photoimmunol Photomed 2007; 23(1):10-4. https://doi.org/10.1111/j.1600-0781.2007.00258.x
- Sharma VK, Sahni K, Wadhwani AR. Photodermatoses in pigmented skin. Photochem Photobiol Sci 2013; 12(1):65-77. https://doi.org/10.1039/c2pp25182e
- Jiang AJ, Lim HW. Phototherapy in the evaluation and management of photodermatoses. Dermatol Clin 2020; 38(1):71-7. https://doi.org/10.1016/j.det.2019.08.007
- Aslam A, Fullerton L, Ibbotson SH. Phototherapy and photochemotherapy for polymorphic light eruption desensitization: a five-year case series review from a university teaching hospital. Photodermatol Photoimmunology Photomedicine 2017; 33(4):225-7. https://doi.org/10.1111/phpp.12310
- Roelandts R. Phototherapy of photodermatoses. J Dermatolog Treat 2002; 13(4):157-60. https://doi.org/10.1080/09546630212345671
- Bilsland D, George SA, Gibbs NK, Aitchison T, Johnson BE, Ferguson J. A comparison of narrow band phototherapy (TL-01) and photochemotherapy (PUVA) in the management of polymorphic light eruption. Br J Dermatol 1993; 129(6):708-12. https://doi.org/10.1111/j.1365-2133.1993.tb03337.x
- Khafagy NH, Salem SAM, Ghaly EG. Comparative study of systemic psoralen and ultraviolet A and narrowband ultraviolet B in treatment of chronic urticaria. Photodermatol Photoimmunol Photomed 2013; 29(1):12-7. https://doi.org/10.1111/phpp.12008
- Sheikh G, Latif I, Lone KS, Hassan I, Jabeen Y, Keen A. Role of adjuvant narrow band ultraviolet B phototherapy in the treatment of chronic urticaria. Indian J Dermatol. 2019; 64(3):250. https://doi.org/10.4103/ijd.IJD_475_16
- Hong JY, Kim MH, Lee JH, Han HS, Seo SJ, Park KY, et al. Phototherapy may be a useful adjuvant therapy for retractable chronic spontaneous urticaria: a systematic review. Photochem Photobiol 2020; 96(4):738-40. https://doi.org/10.1111/php.13260
- Weisshaar E, Szepietowski JC, Dalgard FJ, Garcovich S, Gieler U, Giménez-Arnau AM, et al. European S2k guideline on chronic pruritus. Acta Derm Venereol 2019; 99(5):469-506. https://doi.org/10.2340/00015555-3164
- Zhong CS, Elmariah SB. Phototherapy for Itch. Dermatol Clin 2020; 38(1):145-55. https://doi.org/10.1016/j.det.2019.08.008
- Sherjeena PB, Binitha MP, Rajan U, Sreelatha M, Sarita S, Nirmal C, et al. A controlled trial of narrowband ultraviolet B phototherapy for the treatment of uremic pruritus. Indian J Dermatol Venereol Leprol 2017; 83(2):247-9. https://doi.org/10.4103/0378-6323.198464
- Husein-ElAhmed H, Gieler U, Steinhoff M. Lichen planus: a comprehensive evidence-based analysis of medical treatment. J Eur Acad Dermatol Venereol 2019; 33(10):1847-62. https://doi.org/10.1111/jdv.15771
- Iraji F, Faghihi G, Asilian A, Siadat AH, Larijani FT, Akbari M. Comparison of the narrowband UVB versus systemic corticosteroids in the treatment of lichen planus: a randomized clinical trial. J Res Med Sci 2011; 16(12):1578-82.
- Fernández-Guarino M, Aboín S, Barchino L, Arsuaga C, Lázaro Ochaita P. Generalized lichen planus treated with narrowband UV-B phototherapy: results from 10 patients and a review of the literature. Actas Dermosifiliogr 2019; 110(6):490-3. https://doi.org/10.1016/j.ad.2018.01.015
- Dimova M, Damevska K, Nikolovska S, Karajovanov ID, Duma S, Kostovski M, et al. Pediatric case of lichen planus pigmentosus inversus successfully treated with narrow-band ultraviolet B phototherapy. Dermatol Ther 2020; 33(6):14073. https://doi.org/10.1111/dth.14073
- Keyal U, Bhatta AK, Wang XL. UVA1 a promising approach for scleroderma. Am J Transl Res 2017; 9(9):4280-7.
- Teske NM, Jacobe HT. Phototherapy for sclerosing skin conditions. Clin Dermatol 2016; 34(5):614–22. https://doi.org/10.1016/j.clindermatol.2016.05.012
- Breuckmann F, Freitag M, Rotterdam S, Stuecker M, Altmeyer P, Kreuter A. Immunohistochemical investigations and introduction of new therapeutic strategies in scleromyxoedema: case report. BMC Dermatol 2004; 4(1):12. https://doi.org/10.1186/1471-5945-4-12
- de Albuquerque JV, Andriolo BN, Vasconcellos MR, Civile VT, Lyddiatt A, Trevisani VF. Interventions for morphea. Cochrane Database Syst Rev 2019; 7(7):CD005027. https://doi.org/10.1002/14651858.CD005027.pub5
- Furuhashi T, Torii K, Ikumi K, Kato H, Nishida E, Morita A. Ultraviolet A1 phototherapy for the treatment of localized scleroderma. J Dermatol 2020; 47(7):792-5. https://doi.org/10.1111/1346-8138.15368
- Zulian F, Culpo R, Sperotto F, Anton J, Avcin T, Baildam EM, et al. Consensus-based recommendations for the management of juvenile localised scleroderma. Ann Rheum Dis 2019; 78(8):1019-24. https://doi.org/10.1136/annrheumdis-2018-214697
- Marka A, Carter JB. Phototherapy for cutaneous T-cell lymphoma. Dermatol Clin 2020; 38(1):127-35. https://doi.org/10.1016/j.det.2019.08.013
- Henn A, Michel L, Fite C, Deschamps L, Ortonne N, Ingen-Housz-Oro S, et al. Sézary syndrome without erythroderma. J Am Acad Dermatol 2015; 72(6):1003-9.e1. https://doi.org/10.1016/j.jaad.2014.11.015
- Grandi V, Fava P, Rupoli S, Alberti Violetti S, Canafoglia L, Quaglino P, et al. Standardization of regimens in narrowband UVB and PUVA in early stage mycosis fungoides: position paper from the Italian Task Force for Cutaneous Lymphomas. J Eur Acad Dermatol Venereol 2018; 32(5):683-91. https://doi.org/10.1111/jdv.14668
- Phan K, Ramachandran V, Fassihi H, Sebaratnam DF. Comparison of narrowband UV-B with psoralen-UV-A phototherapy for patients with early-stage mycosis fungoides: a systematic review and meta-analysis. JAMA Dermatology 2019; 155(3):335-41. https://doi.org/10.1001/jamadermatol.2018.5204
- Almohideb M, Walsh S, Walsh S, Shear N, Alhusayen R. Bath psoralen-ultraviolet A and narrowband ultraviolet B phototherapy as initial therapy for early-stage mycosis fungoides: a retrospective cohort of 267 cases at the University of Toronto. Clin Lymphoma Myeloma Leuk 2017; 17(9):604-12. https://doi.org/10.1016/j.clml.2017.06.015
- Hoot JW, Wang L, Kho T, Akilov OE. The effect of phototherapy on progression to tumors in patients with patch and plaque stage of mycosis fungoides. J Dermatolog Treat 2018; 29(3):272-6. https://doi.org/10.1080/09546634.2017.1365113
- Olsen EA, Hodak E, Anderson T, Carter JB, Henderson M, Cooper K, et al. Guidelines for phototherapy of mycosis fungoides and Sézary syndrome: a consensus statement of the United States Cutaneous Lymphoma Consortium. J Am Acad Dermatol 2016; 74(1):27-58. https://doi.org/10.1016/j.jaad.2015.09.033
- Bellinato F, Maurelli M, Gisondi P, Girolomoni G. A systematic review of treatments for pityriasis lichenoides. J Eur Acad Dermatol Venereol 2019; 33(11):2039-49.https://doi.org/10.1111/jdv.15813
- Maranda EL, Smith M, Nguyen AH, Patel VN, Schachner LA, Joaquin JJ. Phototherapy for pityriasis lichenoides in the pediatric population: a review of the published literature. Am J Clin Dermatol 2016; 17(6):583-91. https://doi.org/10.1007/s40257-016-0216-2
- Jung F, Sibbald C, Bohdanowicz M, Ingram JR, Piguet V. Systematic review of the efficacies and adverse effects of treatments for pityriasis lichenoides. Br J Dermatol 2020; 183(6):1026-32. https://doi.org/10.1111/bjd.18977
- Huu DL, Minh TN, Van TN, Minh PPT, Huu ND, Cam VT, et al. The Effectiveness of narrowband Uvb (Nb-Uvb) In the treatment of pityriasis lichenoides chronica (PLC) in Vietnam. Maced J Med Sci 2019; 7(2):221-3. https://doi.org/10.3889/oamjms.2019.055
- Feldreich N, Ringden O, Emtestam L, Omazic B. Photochemotherapy of cutaneous graft-versus-host disease may reduce concomitant visceral disease. Dermatol 2016; 232(4):453-63. https://doi.org/10.1159/000447058
- Gao L, Gu L, Chen Z, Cao S. Doxycycline combined with NB-UVB phototherapy for acquired reactive perforating collagenosis. Ther Clin Risk Manag 2020; 16:917-21. https://doi.org/10.2147/TCRM.S271058
- Lukács J, Schliemann S, Elsner P. Treatment of generalized granuloma annulare - a systematic review. J Eur Acad Dermatol Venereol 2015; 29(8):1467-80. https://doi.org/10.1111/jdv.12976
- Brazzelli V, Grassi S, Merante S, Grasso V, Ciccocioppo R, Bossi G, et al. Narrow-band UVB phototherapy and psoralen-ultraviolet A photochemotherapy in the treatment of cutaneous mastocytosis: a study in 20 patients. Photodermatol Photoimmunol Photomed 2016; 32(5-6):238-46. https://doi.org/10.1111/phpp.12248
- Fernández-de-Misa R, Hernández-Machín B, Servitje O, Valentí-Medina F, Maroñas-Jiménez L, Ortiz-Romero PL, et al. First-line treatment in lymphomatoid papulosis: a retrospective multicentre study. Clin Exp Dermatol 2018; 43(2):137-43. https://doi.org/10.1111/ced.13256
- Engelmann C, Elsner P, Miguel D. Treatment of pityriasis rubra pilaris type I: a systematic review. Eur J Dermatol. 2019; 29(5):524-37. https://doi.org/10.1684/ejd.2019.3641
DOI: https://doi.org/10.19106/JMedSci005304202107
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