Interesting day, I received two phone calls from people with Pruritus (extreme itching) associated Polycythaemia Vera, sometimes spelled Polycythemia Vera. I did some searching in my local library database and found a couple of useful articles.
TITLE: Narrowband (TL-01) ultraviolet B phototherapy for pruritus in polycythaemia vera.
SOURCE: MEDLINE
BACKGROUND: There are several reports of the efficacy of broadband ultraviolet (UV) phototherapy in the treatment of pruritus associated with polycythaemia vera.
OBJECTIVES: To evaluate whether narrowband (TL-01) UVB phototherapy is also effective in treating this condition.
METHODS: Ten patients with pruritus associated with polycythaemia vera were treated with narrowband (TL-01) UVB phototherapy. The first irradiation dose was 2/3 of the minimal erythema dose; the treatment schedule consisted of three irradiation sessions per week, with dose increments of 10% each session for skin types I and II, and 15% for skin types III and IV.
RESULTS: Patients reported a marked relief of symptoms after an average of six treatments (median cumulative dose 1851.52 mJ cm-2, range 1180.4-2468.4). A complete remission of the pruritus occurred within 2-10 weeks of treatment (median cumulative dose 5371.46 mJ cm-2, range 3271.2-7336.3) in eight of 10 patients. Two patients had only a partial and temporary relief of pruritus after two cycles of treatment and a cumulative dose of 3271.2 mJ cm-2.
CONCLUSIONS: Narrowband UVB phototherapy is effective for treatment of pruritus associated with polycythaemia vera, and has the advantage of being less erythemogenic than broadband UVB.
1.
TITLE: Water-induced pruritus in haematologically controlled polycythaemia vera: response to phototherapy. (Citation Only)
Source: MEDLINE
BACKGROUND: Water-induced pruritus is characterized by the development of intense and widespread itching after contact with water at any temperature and without observable skin lesions. Around 40-52% of patients with polycythaemia vera (PV) have water-induced pruritus, and more than 20% of the patients continue with symptoms despite an adequate control of the underlying disease. The aetiology is unknown and treatment is often unsuccessful. We report a patient with a haematologically controlled polycythaemia vera and water-induced pruritus that responded to phototherapy.
METHODS: An 83-year-old woman with haematologically controlled PV referred with intense water-induced pruritus without cutaneous lesions. Topical emollients and oral antihistamines were unsatisfactory and so phototherapy treatment (90% UVA/10% UVB) three times a week was commenced.
RESULTS: Improvement was visible after 1 month and at the end of 3 months the pruritus had disappeared and treatment was stopped.
CONCLUSION: It is considered that the successful treatment in this patient is due to the UVB radiation
2.
TITLE: Resolution of pruritus secondary to polycythemia vera in a patient treated with narrow-band ultraviolet B phototherapy. (Citation Only)
Source: MEDLINE
About: Narrow-band ultraviolet B (UVB) is a newer treatment modality for photoresponsive skin diseases. Since its introduction, dermatologists continue to use it for a myriad of dermatoses. Polycythemia vera is one cause of intractable pruritus that has recently been treated successfully with narrow-band UVB. We describe the case of a 77-year-old Caucasian male with a 4-year history of polycythemia vera complicated by intractable pruritus. Narrow-band UVB was successfully used to treat his pruritus. The patient noted an improvement in pruritus within the first four treatments and almost complete resolution after 18 treatments
3.
TITLE: Water-induced pruritus in haematologically controlled polycythaemia vera: response to phototherapy
Source: Academic Search Premier
BACKGROUND: Water-induced pruritus is characterized by the development of intense and widespread itching after contact with water at any temperature and without observable skin lesions. Around 40-52% of patients with polycythaemia vera (PV) have water-induced pruritus, and more than 20% of the patients continue with symptoms despite an adequate control of the underlying disease. The aetiology is unknown and treatment is often unsuccessful. We report a patient with a haematologically controlled polycythaemia vera and water-induced pruritus that responded to phototherapy.
METHODS: An 83-year-old woman with haematologically controlled PV referred with intense water-induced pruritus without cutaneous lesions. Topical emollients and oral antihistamines were unsatisfactory and so phototherapy treatment (90% UVA/10% UVB) three times a week was commenced.
RESULTS: Improvement was visible after 1 month and at the end of 3 months the pruritus had disappeared and treatment was stopped.
CONCLUSION: It is considered that the successful treatment in this patient is due to the UVB radiation.
I have PV with awful puritus. Do you know if regular medicare will cover buying the narrow band UVB box? If so, could you give me info. as to how to code up the script so I could have my dermatologist do it?
Medicare only approve UVB NB for Psoriasis, we have had patients whose doctors complete the prescription with the ICD-9 Disease Code 696.1 as quite often PV is accompanied by Psoriasis. You can call me 513-942-2770 or email me at chris@cane.com