“Of the wide range of treatment modalities available to dermatologists, few possess the history, efficacy, and safety of phototherapy,” said Henry Lim, MD, former chair of the Department of Dermatology at Henry Ford Hospital and current President of the American Academy of Dermatology (AAD), the world’s largest dermatologic society. “It should be emphasized that dermatologists are the only group of physicians optimally trained and qualified to understand the medical indications of phototherapy.” *
Phototherapy is an efficient, effective and time tested means of treating some very intractable and debilitating skins disorders including psoriasis, vitiligo, eczema and others. It is an important tool in the field of dermatology and its importance continues to grow. Yearly, new reports point to phototherapy as a potential treatment for such far ranging problems as urticaria and the pain associated with herpes zoster. The list continues to grow.
Education is the key to both maintaining and enhancing phototherapy in its rightful place in the medical armamentarium.
Phototherapy using the sun has been around since ancient times. Phototherapy, using artificial sources of light, dates back to the 1920’s with the development of the Goekerman Regimen at Mayo Clinic. The Modern era in phototherapy began in the 1970’s when psoralens (used in conjunction with UVA light) were extensively studied and commercialized as PUVA therapy. In the 1990’s Narrowband UVB was introduced.
Phototherapy, both as a monotherapy and in combination with systemic medications, can produce impressive results for psoriasis patients. With published efficacy rates rivaling those of the best systemic therapies, it should be considered first-line treatment for many patients as well as adjunctive therapy for those who fail to respond to other treatment modalities.
In psoriasis patients, phototherapy has 80% clearance rates for 80% of patients treated.
Phototherapy is a cost-effective treatment for the management of a wide range of dermatoses. It is an integral part of the specialty of dermatology. Many biologic and newer medications can cost from $10,000 to $40,000 annually to treat one psoriasis patient. On the other hand, the most significant cost for a home phototherapy device is the one-time purchase of $900 -$7,000, depending on the model.
Phototherapy remains the only treatment option for patients who cannot tolerate systemic medications because of comorbidities, drug interactions, previous drug toxicity, or inefficacy of systemic medications. *
The side effects of Narrowband UVB are typically rare, mild, and most importantly external. It is safe to use for children, the elderly, and patients who are pregnant, or nursing. It can also be used for patients who are HIV+, or who have other conditions such as diabetes.
In an article in the Journal of American Academy of Dermatology, Dr. Lim says that Phototherapy needs to continue to be taught and trained in residency. His call to action is that payers and insurance companies need to be educated to ensure the coverage of phototherapy for patients.
If you have questions about phototherapy and whether it is right for your patients, contact a Daavlin representative. Email [email protected] or call 1-419-636-6304.
*Lim, Henry, MD. Phototherapy in dermatology: A call for action. J Am Acad Dermatol 2015;72:1078-80.