title: Skin hardening effect in patients with polymorphic light eruption: comparison of UVB hardening in hospital with a novel home UV-hardening device.
abstract: BACKGROUND
  An effective prophylactic treatment of patients with polymorphic light eruption (PLE) consists of repeated low, gradually increasing exposures to UVB radiation. This so-called UV(B) hardening induces better tolerance of the skin to sunlight.
  
  
  OBJECTIVE
  SunshowerMedical company (Amsterdam) has developed an UV (B) source that can be used during taking shower. The low UV fluence of this apparatus makes it an interesting device for UV hardening. In a group of PLE patients, we compared the effectiveness of the irradiation with SunshowerMedical at home with that of the UVB treatment in the hospital.
  
  
  METHODS
  The PLE patients were randomized for one of the treatments. The hospital treatment consisted of irradiations with broad-band UVB (Waldmann 85/UV21 lamps) twice a week during 6 weeks. The home UV-device was used each day with the maximal irradiation time of 6 min. The outcome assessment was based on the information obtained from patients' dermatological quality of life (DLQI) questionnaires, the ability of both phototherapies to reduce the provocation reaction and from the patients' evaluation of the long-term benefits of their phototherapies.
  
  
  RESULTS
  Sixteen patients completed treatment with SunshowerMedical and thirteen completed treatment in hospital. Both types of phototherapy were effective. There was a highly significant improvement in DLQI with either treatment. In most cases, the hardening reduced or even completely suppressed clinical UV provocation of PLE. The patients using SunshowerMedical at home were, however, much more content with the treatment procedure than the patients visiting the dermatological units.
  
  
  CONCLUSIONS
  Both treatments were equally effective in the induction of skin tolerance to sunlight in PLE patients. However, the home treatment was much better accepted than the treatment in the hospital.
authors.affiliation: Department of Dermatology, Free University Medical Centre, Amsterdam, The Netherlands. s.franken@vumc.nl
authors.forename: S M
authors.initials: SM
authors.lastname: Franken
authors.forename: R E
authors.initials: RE
authors.lastname: Genders
authors.forename: F R
authors.initials: FR
authors.lastname: de Gruijl
authors.forename: T
authors.initials: T
authors.lastname: Rustemeyer
authors.forename: S
authors.initials: S
authors.lastname: Pavel
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016001:Confidence Intervals; D017454:Dermatitis, Photoallergic / Q000175:diagnosis / Q000532:radiotherapy*; D004867:Equipment Design; D004869:Equipment Safety; D005260:Female; D005500:Follow-Up Studies; D006699:Home Care Services / Q000706:statistics & numerical data; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D010787:Photosensitivity Disorders / Q000175:diagnosis / Q000532:radiotherapy; D011829:Radiation Dosage; D012720:Severity of Illness Index; D012867:Skin / Q000473:pathology / Q000528:radiation effects*; D016896:Treatment Outcome; D014467:Ultraviolet Therapy / Q000295:instrumentation* / Q000379:methods*; D055815:Young Adult