Typical UVB Narrowband Cabinet

We’ve seen a few reports out of New Zealand with respect to the use of ultraviolet light. Here’s one I added to our blog in July: < click here > 

Recently (12 October) another article was posted about the use of UVB and kids. The study involed  116 children. Here’s the essence of the article.

Background:  Phototherapy is effective for many dermatoses in adults, but there is a paucity of data for its use in children. 

Objectives:  To review the efficacy and tolerability of narrowband UVB phototherapy in children at a tertiary centre in New Zealand, and determine if there were any factors that differentiated responders from non-responders. 

Methods:  A prospective analysis of children (<16 years old) who had undergone phototherapy over a 15-year period. 

Results:  116 children received phototherapy with a total of 144 courses. Mean age was 11.0 years with the majority being European and having skin phototype II. Atopic dermatitis was the most common indication for treatment followed by psoriasis, pityriasis lichenoides, nodular prurigo, morphea, vitiligo, urticaria pigmentosa and erythropoietic porphyria. Treatment was effective in the majority of children (72%). Most received only one course. For responders, the mean number of treatments was 32.4. The mean dose per treatment to achieve clearance was 886 mJ/cm2 and the mean maximum treatment dose per treatment was 1328 mJ/cm2. All children tolerated treatment well with 36% developing brief, minimally symptomatic, erythema. Only two children experienced exacerbations of their underlying dermatoses. 

Conclusions:  This study shows that phototherapy is an effective and well-tolerated treatment modality in children. 

UVB Narrowband products for home and clicical use can be found at www.homephototherapy.com

The new Dermalume 2X uses the National Biological Corp CPT or Controlled Prescription Timer to help the doctor and the patient work together for optimal treatment.

It’s interesting to see the sales of our Dermalight 80 drop slightly as our sales of the Dermalume ramp up.

The Dermalume 2X arrives ready for use in a handy briefcase type case allowing the user to easily pack it away between treatments and carry it with them while traveling.

The unit allows the user to treat only affected areas – and use comb to maintain consistent distance from skin or separate hairs for scalp psoriasis treatment.

The clever hinge allows multiple wand positions can be held where you want while the two lamps with the large output window allow for faster treatment. The DermaLume is shipped fully assembled with an optional comb attachment (includes) , goggles, and carrying case.

You can learn more about the Dermalume 2X at our website. Please visit http://www.homephototherapy.com/dermalume2X.htm for more information.

The original work was completed by Dawe RS. at the: Photobiology Unit, Department of Dermatology, University of Dundee, Ninewells Hospital and Medical School, Dundee DD1 9SY, UK. r.s.dawe@dundee.ac.uk

Long-wavelength ultraviolet A (340-400 nm; UVA1) therapy is currently available in only a few dermatology departments. Equipment capable of delivering this waveband has been available since 1981, but it is only over the past decade that increasing numbers of studies assessing the potential of this as a therapy have been published. High-dose UVA1, which requires expensive and space-occupying apparatus, is effective as a monotherapy for acute flares of atopic dermatitis, but it has not yet been formally assessed as an adjunct, rather than as an alternative to conventional therapies including potent and very potent topical corticosteroids. Low-dose (which can be administered using a standard phototherapy cubicle fitted with appropriate lamps) and medium-dose UVA1 may be less effective for this indication. Another condition for which UVA1 is effective, and is particularly promising because we have no reliably effective treatment already, is localized scleroderma. It also appears to be effective in systemic lupus erythematosus (although it is not yet clear when it is indicated, and its safety needs to be assessed in more patients) and in polymorphic light eruption (although there have been no studies suggesting that UVA1 will have any advantages over standard prophylactic phototherapies). Open studies and case series suggest that UVA1 may prove beneficial for various other diseases, including cutaneous T-cell lymphoma, lichen sclerosus, keloids, systemic sclerosis and hand dermatitis. In the centres where it is available, UVA1 has already proved a useful addition to the range of phototherapies previously available. However, much more research is needed to confirm its efficacy for many of its potential indications, and to determine when and how it should be used.

Original Article << Click Here >>

Abstract:  Twenty children age 14 months to 12 years with photoresponsive dermatoses were treated with ultraviolet B (UVB) phototherapy over four years. Ten children had psoriasis, five had pityriasis lichenoides, and five had atopic dermatitis. All received short courses (average 34 treatments) of phototherapy with either no maintenance or short maintenance. Treatment was effective and well tolerated in most patients, and no serious side effects were seen. Patients with psoriasis and pityriasis lichenoides cleared completely. No patient with atopic dermatitis cleared completely, but all were moderately improved, with reduction of the extent of eczema and decreased pruritus. It appears that UVB phototherapy is a valuable and safe therapeutic option for selected children who do not respond to other treatments.

Alopecia
Atopic Dermatitis
CTCL (Cutaneous T-Cell Lymphoma)
Dermatitis
Eczema
Graft vs Host Disease (GVHD)
Lichen Planus
Mycosis Fungoides
Parapsoriasis
Pityriasis Lichenoides (PLEVA)
Pityriasis rosea
Pityriasis Rubra Pilaris
Prurigo Nodularis
Pruritus associated with Polycythaemia Vera
Psoriasis
Scleroderma
Sebhorrheic dermatitis
Vitiligo

The first report of the use of ‘phototherapy’ in the treatment of skin disorders dates from 1400 BC from India when patients with vitiligo were given certain plant extracts (whose active ingredients included psoralens) and then exposed to the sun. The real interest in the use of ultraviolet (UV) irradiation in the treatment of various skin diseases started in the 19th century when Niels Finsen received the Nobel Prize (1903) for his therapeutic results with UV irradiation in lupus vulgaris, the only dermatologist ever to be awarded one. This marked the start of modern phototherapy. It was used in thermal stations for the treatment of tuberculosis, in the treatment of leg ulcers in wartime, and various other skin diseases. It was a very long journey from the use of plant extracts and sun exposure to treat vitiligo to the use of oral psoralens and total body UVA-irradiation cabins (PUVA) to treat various skin diseases. In a landmark development, in 1974 Parrish et al reported the useful role of high intensity UVA tubes in combination with oral psoralens in the treatment of psoriasis leading to what is now known as PUVA therapy.

The history of UVB phototherapy is not as old as the history of photochemotherapy. Wiskemann introduced irradiation cabin with broad band UVB tubes in 1978 for the treatment of psoriasis and uremic pruritus. However, broad band UVB phototherapy was less efficient for treating psoriasis than PUVA and so never achieved popularity. The breakthrough came after 1988 when narrow-band UVB (NB-UVB) phototherapy was introduced for the treatment of psoriasis by van Weelden et al and Green et al.

Link to entire article << Click Here >>

Excerpted from an article by: Sunil Dogra, Amrinder Jit Kanwar, Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education & Research, Chandigarh, India

Correspondence Address:
Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education & Research, Chandigarh – 160102, India
ajkanwar@sify.com