Search

Importance Targeted phototherapy for treatment of localized psoriasis has advantages over non-targeted phototherapy. It delivers high ultraviolet doses to only the diseased skin, sparing irradiation to normal skin. Objective This study aims to review the devices that are available for targeted treatment of psoriasis. Evidence Review A PubMed literature review was conducted to identify devices for localized psoriasis phototherapy. Device manufacturer websites were searched for specific information. Findings Eighty-four papers were identified that met the inclusion criteria. We identified and described seven laser/light therapies and 22 devices for localized psoriasis treatment. Limitations There is potential bias for each device since the products’ information was provided by their manufacturer. Some devices were excluded due to lack of relevant information. Conclusions and Relevance Excimer laser and narrow band ultraviolet B devices are valuable treatment modalities for localized psoriasis. Handheld, narrow band ultraviolet B devices are efficacious and available for home treatment.

Ultraviolet B (UVB 290–320 nm) radiation has been used in the treatment of different skin diseases. Light sources with narrowband UVB output spectrum have been developed with the aim of increasing the rates of “beneficial to side effect” profile of the treatment. Narrowband UVB phototherapy using fluorescent lamps (TL01, 311±2nm) has been widely adopted over the past 10 years. Monochromatic Excimer Light (MEL) represents a new source of narrow-band UVB emitting at 308 nm and guarantees a safe and effective approach to different chronic and recurrent skin diseases thanks to its potent and selective immunosuppressant action.

Background Phototherapy has been used for many years as a treatment for psoriasis. It has progressed from simple heliotherapy, to the utilization of specific wavelengths including ultraviolet light A (UVA), psoralen plus UVA (PUVA photochemotherapy), broad-band ultraviolet light B (BB-UVB), and narrow-band UVB (NB-UVB). NB-UVB in particular has become a much utilized treatment for psoriasis due to its efficacy and safety profile. Objective This paper reviews the published literature regarding the question of increased carcinogenesis with the use of NB-UVB in psoriasis. Methods Studies published between 1980 and 2008 with English abstracts identified in PubMed, with the key words psoriasis, phototherapy, carcinogenesis, and NB-UVB, were reviewed. Results Rates of carcinogenesis with the use of NB-UVB are lower than or equal to other current phototherapy modalities. Conclusion NB-UVB is an effective and overall safe treatment option in the therapy of psoriasis.

Narrow-band UVB is effective for the treatment of psoriasis. 3,8,10 The numerous protocols available in the literature may make it challenging for a practitioner, wishing to initiate narrow-band therapy, to choose the appropriate protocol. This article is a review of the literature on narrow-band UVB protocols and a guide to initiate therapy. To commence therapy, a protocol that best suits the practi- tioner's expertise level and the type of staff the practitioner has is chosen. The two main types of narrow-band protocols presented in this review are the Skin Type and MED (minimal erythema dose) protocols. MED and skin type testing to determine the dose of narrow-band UVB to begin treatment are detailed in a step-by-step process. Subsequent treatment doses are based on the skin's response to the previous treatment. 11 Further adjustments in light dose can accommodate missed treatments. Narrow-band light treatments are continued until psoriasis clears or almost clears, followed by tapering maintenance treatments. The goals of therapy are to establish and maintain control over psoriatic flares, and to balance the risks and benefits of narrow-band treatment. Narrow-band ultraviolet B (NB-UVB) was introduced in 1976 and has been widely used for psoriasis, especially in Europe and Australia. It became available in the United States in 1996. NB- UVB emits a wavelength between 311-313 nm, which is most phototherapeutic for the clearance of psoriasis. NB-UVB has been shown to be more effective than broad-band ultraviolet B (BB-UVB) 1,2,3 and almost as effective as PUVA for the treatment of psoriasis, but with a shorter remission time, and possibly with a lower risk of skin cancer. 4,5,6 No standardized protocol has yet