Experience of phototherapy in dermatological praxis in complex therapy of psoriasis patients

Abstract

Psoriasis is a chronic relapsing skin disease presenting with erythematous and papulous lesions with infiltration and extensive desquamation on the skin surface. It is a genetically determined, multifactorial dermatosis where genetic, immune, and environmental factors play significant roles in its development. In Latvia in treatment of different forms of extensively spreading psoriasis, PUVA (psoralen and ultraviolet A light therapy), a combined method, is administered, applying long-wave UVA radiation with wavelength 320-400 nm in combination with photosensibilisator 8-metoxypsoralen and medium wave length UVB radiation narrow-band phototherapy - 311 nm using specialised TL-01 lamps. The aim of our clinical investigation was to determine the efficacy of narrow-band phototherapy (UVB 311 nm) in the complex treatment of patients with different severity of extensive psoriatic lesions treated in the Clinical Centre of Skin and Sexually Transmitted Diseases. Cases of clinical data of 260 patients with widely spread psoriasis were analysed. In the Group 1 (n = 102) receiving narrow-band UVB therapy, the mean and cumulative UVB dosage was 1.8 ± 0.6 and 21.5 ± 3.8 J/cm2, respectively, whereas in Group 2 (n = 91) it was 2.2 ± 0.1 and 27.7 ± 8.0 J/cm2. To obtain clinical recovery, 18 to 30 procedures were necessary (average 22 ± 4.1) with total irradiation dose received 110 ± 4.6 J/cm2. In 67 patients of the control group, PUVA therapy was administered, and positive therapeutic efficacy was observed in all patients. Clinical recovery was obtained in 86.2% in patients of the Group 1, in 82.4% - of Group 2, and in 80% - in 67 patients of the control group. Narrow-band (311 nm) UVB phototherapy is currently one of the leading pathogenetical methods of treatment of patients with widespread psoriasis. It has high efficacy, good tolerability, does not have severe side effects and restrictions in use, in comparison with traditional PUVA therapy.