title: Ultraviolet B Phototherapy for Psoriasis: Review of Practical Guidelines.
abstract: Psoriasis is an inflammatory skin condition that affects approximately 2 % of people worldwide. Topical treatments, systemic treatments, biologic agents, and phototherapy are all treatment options for psoriasis. Ultraviolet (UV) B phototherapy is most appropriate for patients with >10 % affected body surface area who have not responded to topical treatments. This review outlines the use, dosage, safety, and efficacy of narrowband UVB (NB-UVB) and targeted phototherapy. NB-UVB and excimer laser are effective treatment options for psoriasis; they are administered two to three times weekly until clearance followed by maintenance treatment before discontinuation. Long-term data on NB-UVB indicate that it has a good safety profile. NB-UVB is commonly used with adjunctive topical treatments such as emollients, calcipotriene, cortico-steroids, retinoids, and tar. NB-UVB can be used in selected patients with traditional systemic agents such as methotrexate, mycophenolate mofetil, and cyclosporine, although the duration of the combined treatment should be kept to a minimum and patients need to be closely monitored. Acitretin can be safely used with phototherapy, but robust data on the combination use of biologic agents or phosphodiesterase inhibitors with phototherapy are lacking.
authors.affiliation: Department of Dermatology, Henry Ford Hospital, Henry Ford Medical Center-New Center One, 3031 West Grand Blvd, Suite 800, Detroit, MI, 48202, USA.
authors.forename: Dhwani
authors.initials: D
authors.lastname: Mehta
authors.affiliation: Department of Dermatology, Henry Ford Hospital, Henry Ford Medical Center-New Center One, 3031 West Grand Blvd, Suite 800, Detroit, MI, 48202, USA. hlim1@hfhs.org.
authors.forename: Henry W
authors.initials: HW
authors.lastname: Lim
mesh_terms: D017255:Acitretin / Q000627:therapeutic use; D000287:Administration, Topical; D003131:Combined Modality Therapy / Q000009:adverse effects / Q000379:methods; D000075202:Contraindications; D003879:Dermatologic Agents / Q000627:therapeutic use; D004307:Dose-Response Relationship, Radiation; D006801:Humans; D020381:Interleukin-17 / Q000037:antagonists & inhibitors / Q000276:immunology; D007641:Keratolytic Agents / Q000627:therapeutic use; D054018:Lasers, Excimer / Q000009:adverse effects / Q000592:standards / Q000627:therapeutic use; D028022:Low-Level Light Therapy / Q000009:adverse effects / Q000379:methods; D008727:Methotrexate / Q000627:therapeutic use; D011701:PUVA Therapy; D010726:Phosphodiesterase Inhibitors / Q000627:therapeutic use; D017410:Practice Guidelines as Topic; D011565:Psoriasis / Q000188:drug therapy / Q000532:radiotherapy*; D012867:Skin / Q000528:radiation effects*; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors / Q000276:immunology; D014467:Ultraviolet Therapy / Q000009:adverse effects / Q000379:methods*
chemical_list: D003879:Dermatologic Agents; C508717:IL17A protein, human; D020381:Interleukin-17; D007641:Keratolytic Agents; D010726:Phosphodiesterase Inhibitors; C439524:TNF protein, human; D014409:Tumor Necrosis Factor-alpha; D017255:Acitretin; D008727:Methotrexate