title: Phototherapy and photochemotherapy for psoriasis.
abstract: Phototherapy is a first-line option for the treatment of moderate to severe psoriasis. Systematic reviews indicate near comparable efficacy of the different forms of phototherapy. Localized phototherapy can be an adjunctive treatment of recalcitrant plaques during systemic treatment of psoriasis. More than 200 psoralen-UV-A therapy treatment sessions is associated with an increased risk of keratinocytic cancers, whereas no increased risk has been demonstrated for narrow-band UV-B therapy. The mechanism of action of phototherapy in psoriasis is via inhibition of keratinocyte proliferation; induction of apoptosis in keratinocytes, dendritic, and T cells; and inhibition of Th1 and Th17 pathways, but activation of Th2.
authors.affiliation: Department of Dermatology, Erasmus University Medical Center Rotterdam, PO Box 2040, Rotterdam 3000 CA, The Netherlands.
authors.forename: Emoke
authors.initials: E
authors.lastname: Racz
authors.affiliation: Department of Dermatology, Erasmus University Medical Center Rotterdam, PO Box 2040, Rotterdam 3000 CA, The Netherlands. Electronic address: e.prens@erasmusmc.nl.
authors.forename: Errol P
authors.initials: EP
authors.lastname: Prens
mesh_terms: D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D017209:Apoptosis / Q000528:radiation effects; D003131:Combined Modality Therapy; D004249:DNA Damage / Q000528:radiation effects; D003879:Dermatologic Agents / Q000627:therapeutic use; D006801:Humans; D015603:Keratinocytes / Q000528:radiation effects; D011701:PUVA Therapy / Q000009:adverse effects; D010778:Photochemotherapy / Q000009:adverse effects; D017319:Photosensitizing Agents / Q000627:therapeutic use*; D011565:Psoriasis / Q000188:drug therapy* / Q000532:radiotherapy*; D017382:Reactive Oxygen Species; D012176:Retinoids / Q000627:therapeutic use; D013601:T-Lymphocytes / Q000528:radiation effects; D014467:Ultraviolet Therapy / Q000009:adverse effects / Q000191:economics; D014560:Urocanic Acid / Q000378:metabolism
chemical_list: D000911:Antibodies, Monoclonal; D003879:Dermatologic Agents; D017319:Photosensitizing Agents; D017382:Reactive Oxygen Species; D012176:Retinoids; D014560:Urocanic Acid
keywords: Broad band; Narrow band; PUVA; UV mode of action; UV-B