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The review paper provides brief analysis of phototherapy methods used in various dermatoses. Phototherapy can be prescribed in combination with drugs or used solo. Phototherapy methods based on using the medium-wavelength (UVB) and long-wavelength (UVA) ultraviolet radiation are most commonly used in clinical practice: PUVA therapy and narrow-band UVB (311 nm) therapy, as well as treatment with excimer light with the wavelength of 308 nm. Photodynamic therapy combining photosensitizer, oxygen and visible light also gradually takes leading positions in aesthetic medicine and dermatology.

Introduction: UVA therapy is used in treatment of wide range of skin diseases, which proceed with hardening of the skin or inflammation. First use of ultraviolet radiation can be tracked down to 1896. Wavelength vary among diseases against which it is used. In literature as results of therapy are mentioned improvement of skin elasticity, reduction of inflammation, and protection from relapse. In terms of sclerotic skin diseases most promising effect is seen in reducing skin hardness in the mechanism of stimulating collagen breakdown. The therapy itself has a good safety profile, but is time-consuming due to the high frequency of irradiation. Effectiveness of treatment are determined by factors such as advancement of skin lesions, pigmentation and the intensity of the therapy itself. Aim of study: The aim of the study is to summarize the available knowledge about the UVA therapy in skin diseases. The way of work, effectiveness of treatment, side effects and potential new methods of use were summarized and described. Materials and methods: The literature available in PubMed database was reviewed using following keywords: "UVA therapy", "UVA", "Scleroderma", "Buschke's Scleredema", "Systemic sclerosis", "Morphea" Conclusion: UVA1 therapy is one of the most effective therapeutic options in subtypes of morphea which affect only superficial tissues. Phototherapy accelerate healing of ulcerations on fingertips in patients with Systemic sclerosis. Patient suffering from Buschke Scleredema had good response to therapy. Observed side effects consist of hyperpigmentation, erythema, xerosis and pruritus in range from mild to severe. Carcinogenic effect has not yet been proven. [ABSTRACT FROM AUTHOR]

Introduction: UVA therapy is used in treatment of wide range of skin diseases, which proceed with hardening of the skin or inflammation. First use of ultraviolet radiation can be tracked down to 1896. Wavelength vary among diseases against which it is used. In literature as results of therapy are mentioned improvement of skin elasticity, reduction of inflammation, and protection from relapse. In terms of sclerotic skin diseases most promising effect is seen in reducing skin hardness in the mechanism of stimulating collagen breakdown. The therapy itself has a good safety profile, but is time-consuming due to the high frequency of irradiation. Effectiveness of treatment are determined by factors such as advancement of skin lesions, pigmentation and the intensity of the therapy itself. Aim of study: The aim of the study is to summarize the available knowledge about the UVA therapy in skin diseases. The way of work, effectiveness of treatment, side effects and potential new methods of use were summarized and described. Materials and methods: The literature available in PubMed database was reviewed using following keywords: “UVA therapy”, “UVA”, “Scleroderma”, “Buschke’s Scleredema”, “Systemic sclerosis”, “Morphea” Conclusion: UVA1 therapy is one of the most effective therapeutic options in subtypes of morphea which affect only superficial tissues. Phototherapy accelerate healing of ulcerations on fingertips in patients with Systemic sclerosis. Patient suffering from Buschke Sclerederma had good response to therapy. Observed side effects consist of hyperpigmentation, erythema, xerosis and pruritus in range from mild to severe. Carcinogenic effect has not yet been proven.

Background: Cutaneous and mucocutaneous histiocytosis (group C) comprise a wide variety of entities affecting skin and/or mucosae. Although they are considered as reactive proliferations, their exact pathophysiology remains unknown and, therefore, they lack a specific treatment. Aims: The aim of this study is to review the evidence on cases of histiocytosis treated with UVB and/or UVA and to report a new case of relapsing group C histiocytosis that has been successfully treated with PUVA therapy. Materials & Methods: We have conducted a review of the literature published over the last 40 years on the treatment of histiocytosis with phototherapy in the online PubMed database. We also describe a new case of successful treatment of histiocytosis with PUVA therapy. Results: Our patient was a 27‐year‐old man with persistent outbreaks of cutaneous histiocytosis over the previous 8 years. He responded successfully to PUVA therapy, and no relapse has been detected after one year of follow‐up. Discussion: Self‐involution is usual in group C histiocytosis, so conservative management is usually the first approach. Relapsing cases pose a therapeutic challenge. Reported treatment options for these patients include isotretinoin, cryotherapy, immunosuppressants, low‐dose chemotherapy, CO2 laser, radiotherapy, and surgery. Phototherapy and photochemotherapy have been used in a small number of patients with considerable success. The main limitation to provide firm recommendations on histiocytosis therapy is the absence of solid evidence, as the articles published are mainly case reports with a short follow‐up. In our patient, despite the short follow‐up we have considered photochemotherapy to be effective since no spontaneous remission had been achieved in the previous 8 years. Conclusion: PUVA therapy could be a safe and effective option to treat persistent cutaneous manifestations in patients with histiocytosis, although more evidence is required to support this statement. [ABSTRACT FROM AUTHOR]

Mycosis fungoides (MF) is a subtype of cutaneous T‐cell lymphoma (CTCL). Topical or systemic treatment with psoralen, such as 8‐methoxypsoralen (8‐MOP), followed by ultraviolet A (UVA) irradiation (PUVA therapy) is an effective phototherapy for early‐stage MF. However, the efficacy of PUVA therapy for advanced‐stage MF is not satisfactory, and the ideal combination partner for PUVA therapy has not yet been found. In this study, we developed a new mouse model of CTCL in which efficacy of PUVA was detected and further evaluated the efficacy of combination treatment of PUVA and mogamulizumab, an anti‐CCR4 monoclonal antibody. Cytotoxicity of PUVA therapy against HH cells, a CTCL cell line, was observed in vitro. The cytotoxicity was dependent on both 8‐MOP and UVA. Using HH cells, we developed a mouse model in which HH cells were subcutaneously inoculated in the ear. In this model, PUVA therapy suppressed tumour growth with statistical significance, while 8‐MOP or UVA alone did not. Combination therapy of PUVA and mogamulizumab showed greater antitumor activity than either monotherapy with statistical significance. In the histological analysis of the tumour tissue, PUVA accelerated tumour necrosis and then induced the infiltration inflammatory cells in the necrotic area, suggesting that these cells served as effector cells for mogamulizumab. This combination therapy is expected to be a beneficial option for CTCL therapy. [ABSTRACT FROM AUTHOR]

Abstract Of all the therapeutic options available in Dermatology, few of them have the history, effectiveness, and safety of phototherapy. Heliotherapy, NB-UVB, PUVA, and UVA1 are currently the most common types of phototherapy used. Although psoriasis is the most frequent indication, it is used for atopic dermatitis, vitiligo, cutaneous T-cell lymphoma, and cutaneous sclerosis, among others. Before indicating phototherapy, a complete patient assessment should be performed. Possible contraindications should be actively searched for and it is essential to assess whether the patient can come to the treatment center at least twice a week. One of the main method limitations is the difficulty that patients have to attend the sessions. This therapy usually occurs in association with other treatments: topical or systemic medications. Maintaining the regular monitoring of the patient is essential to identify and treat possible adverse effects. Phototherapy is recognized for its benefits and should be considered whenever possible.

Clinical reasoning. There is a need to optimize the use of UV-B-311 nm and PUVA-therapy in patients with mycosis fungoides to determine the duration of the treatment regimen, the number of sessions per week, and ultraviolet irradiation regimen. Goal of research. Evaluation of the effect of the type and duration phototherapy on efficacy in patients with mycosis fungoides. Principle. A comparative, non-randomized study of the effectiveness of phototherapy in patients with mycosis fungoides in the early stages. Evaluation of the effectiveness of UV-B-311 nm and PUVA therapy was performed using the BSA index (area of skin lesions) and Modified Severity-Weighted Assessment Tool (mSWAT), as well as according to the criteria proposed by the International Society for Skin Lymphomas (ISCL), the European Organization for the Study and Cancer Treatment (EORTC) and United States Cutaneous Lymphoma Consortium (USCLC). Results. The study included 14 patients with mycosis fungoides, 5 of whom received treatment with UV-B-311 nm, 9 PUVA therapy. A strong correlation was found between the duration of UV-B-311 nm therapy with mSWAT delta (R = 0.90; p = 0.038) and BSA delta (R = 0.90; p = 0.038), while similar correlation was not found in the PUVA-therapy group (mSWAT (R = 0.24; p = 0.527); BSA (R = 0.09; p = 0.823)). When comparing the effectiveness of therapy between the treatment group UV-B-311 nm and PUVA therapy, delta mSWAT and BSA at the 20th procedure, delta mSWAT and BSA after the end of therapy did not have a statistically significant difference between the UVB-311 nm and PUVA groups. Conclusion. Statistically significant correlation was found between the number of procedures and the effectiveness of therapy In the UV-B-311 nm group. An increase in the number of PUVA therapy procedures (after 20) does not lead to a statistically significant increase in the effectiveness of treatment. Additional research is needed to increase the level of evidence of the results and develop optimal phototherapy regimens.

Background: Cutaneous graft-versus-host disease (GVHD) is a common complication of allogeneic hematopoietic stem cell transplantation. Phototherapy has been used to treat cutaneous GVHD, but data on its safety and efficacy are sparse., Aim: Review the current medical literature regarding the efficacy, dosing, and safety of various types of phototherapies for the treatment of cutaneous GVHD., Methods: A systematic review of PubMed, Embase, Cochrane, and ClinicalTrials databases was performed. Publications were screened according to the PRISMA guidelines. Exclusion criteria comprised case reports and case series reporting less than five patients, review articles, and articles not published in English., Results: A total of 28/1304 (2.5%) studies were included. Fifteen studies (n = 267 patients) focused on psoralen and ultraviolet (UV) A (PUVA), in which 65.5% of patients received concomitantly other systemic treatments. The response rate was 89.9%, with a mean of 33.2 treatments. Adverse events were recorded in 54% but were mainly mild. Eight studies, encompassing 95 patients, focused on narrow-band (NB) UVB. A response was observed in 94%, with a mean number of 26 treatments and 8.6% adverse effects. UVA1 was reported in six studies (n = 132 patients). A response was recorded in 89.3% with a mean of 26.2 treatments. Adverse events were noted in 70.1%, with a discontinuation rate of 10.9%. It should be noted that adverse events were recorded during the follow-up period of the studies, which varied significantly, ranging from no follow-up to 31 months., Conclusions: Current data regarding the use of phototherapy for the treatment of cutaneous GVHD are based on retrospective studies and case series. The present report advocates the use of one of the three modalities of phototherapy as an effective and safe adjunctive treatment for cutaneous GVHD, especially NB UVB phototherapy., (© 2024 The Author(s). Photodermatology, Photoimmunology & Photomedicine published by John Wiley & Sons Ltd.)

Background/purpose: Interferon (IFN)-a is often used in combination with psoralen plus ultraviolet A (PUVA) in patients with mycosis fungoides (MF) refractory to skin-targeted therapies in early or advanced stages. The main objective is to evaluate the effectiveness of combined PUVA and low-dose IFN-α-2a therapy in patients with early- and advanced-stage MF., Methods: Sixty-eight patients who received a combination of PUVA twice or thrice a week and INF-a 3 MU thrice a week for at least 3 months were reviewed retrospectively. The treatment response was evaluated as complete remission (CR), partial remission, stable disease, or progression., Results: At the initiation, the majority of patients (66.2%) had early-stage disease. In 27.9% of cases, this was the initial treatment administered following the diagnosis of MF. The median duration of combination therapy was 11 months. Complete remission was achieved in 45.6% of the patients with an overall response rate of 60.3%. The mean duration of response was 5 months. Complete remission was statistically significantly higher in early-stage patients (p < .05). No statistically significant correlation was observed between CR and gender, histopathological features, or laboratory parameters. In patients with CR, 80% experienced relapse, significantly higher in early-stage patients (p < .05). However, there was no significant difference in disease-free survival between early and advanced stages (p > .05)., Conclusions: The study results indicated that PUVA + low-dose INF-a combination therapy was more effective in the early stage than in the advanced stage. Additionally, there was a high relapse rate after the cessation of treatment in patients who achieved CR., (© 2024 The Author(s). Photodermatology, Photoimmunology & Photomedicine published by John Wiley & Sons Ltd.)

Currently, phototherapy has been widely used in the treatment of various skin diseases, including mycosis fungoides. The article provides a literature review on the use of various spectra ultraviolet therapy in the treatment of patients with early stages of mycosis fungoides. The mechanisms of action of medium-wave ultraviolet therapy (UVB-311 nm) and PUVA therapy, causing the immunosuppressive, anti-inflammatory and anti-proliferative effect, are described. The results of retrospective studies of PUVA therapy and UVB-311 nm efficacy in patients with cutaneous T-cell lymphoma are presented, as well as modern literature evidence of the need for standardization of phototherapy methods for patients with mycosis fungoides.

The analysis of the literature data conducted incorporating modern views on psoriasis and the effectiveness of its complex therapy with the use of existing methods of physiotherapeutic treatment. The questions of the urgency of the problem of psoriasis, its etiology, and pathogenesis, the clinical picture of the disease, drug treatment are reflected. The review of physiotherapeutic methods in the complex treatment of psoriasis is presented. The modern scientific view of psoriasis is described as a systemic disease that manifests as a form of immune-dependence dermatosis. The question of application of physical factors considered in the complex therapy of psoriasis, the mechanism of their action, and describes the methods of physiotherapy due to the therapeutic treatment of psoriasis, in particular, ultraviolet radiation

Copyright of Der Hautarzt is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Der Hautarzt is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Mycosis fungoides is the most frequent form of cutaneous T-cell lymphoma. It is characterized by a chronic, slow, and progressive course, and is associated with mortality rates that depend on several factors, such as clinical staging. A median survival time of up to 13 months is found in patients with advanced stages that require more aggressive treatments, with greater toxicity and higher costs. In Latin America, few prognostic studies of the disease are available., Objective: To determine the rate of progression from early stages (IA, IB, IIA) to more advanced stages (> IIB) in patients older than 18 years with mycosis fungoides treated at two medical centers in Colombia between January 1, 2010, and December 31, 2019., Methods: Retrospective cohort study with a longitudinal design., Results: 112 patients diagnosed with early mycosis fungoides were included. 56.2% were male (n = 63), with a median age of 53 years (IQR 43‒67). The most frequent clinical variant was classic (67.9%; n = 76), followed by folliculotropic (16%; n = 18), and hypopigmented (10.7%; n = 12). The most common first-line treatment was NB-UVB phototherapy (27.7%; n = 31), followed by PUVA phototherapy (25.8%; n = 29%), and topical corticosteroids (25%; n = 28). The global rate of disease progression was 8% (n = 9), with an overall mortality of 12.5% (n = 14)., Study Limitations: Its retrospective design and the lack of molecular studies for case characterization., Conclusions: Early mycosis fungoides is a disease with a good prognosis in most patients, with a progression rate of 8% (n = 9)., (Copyright © 2024 Sociedade Brasileira de Dermatologia. Published by Elsevier España, S.L.U. All rights reserved.)

Abstract: Background: Topical agents used in combination with phototherapy or photochemotherapy may have both blocking or enhancing effects in ultraviolet rays. Objective: In this in vivo study, the effects of topical petrolatum, basis cream, glycerine, and olive oil on the transmission of ultraviolet A radiation were investigated. Methods: A test was performed to determine the minimal phototoxic dose on 29 volunteers with only psoralen plus ultraviolet A (PUVA) and then the same test was repeated with white petrolatum, basis cream, glycerine, olive oil, and sunscreen (0.3cc/25cm2). The effects of each agent on the minimal phototoxic dose were determined after 72 h. Results: When compared to pure PUVA, there was a statistically significant increase in the mean minimal phototoxic dose values by the application of white petrolatum (P = 0.011), but there was no significant increase or decrease in the mean minimal phototoxic dose values after the application of basis cream (P = 0.326), glycerine (P = 0.611) or olive oil (P = 0.799). Study limitations: Low number of patients Conclusion: The application of white petrolatum, which has a blocking effect, and also of basis cream immediately before PUVA therapy should not be recommended. Although we specify that glycerine and maybe olive oil can be used before photochemotherapy, there is a need for further research in larger series.

Goal. To assess the therapeutic efficacy of the rotation of mid-wavelength ultraviolet therapy (311 nm) and PUVA therapy in patients with moderate to severe forms of psoriasis, and to assess the efficacy of mid-wavelength ultraviolet therapy (311 nm) in a multiple-course therapy. Materials and methods. The study involved 66 patients with moderate to severe forms of psoriasis who received multiple courses of treatment by methods of the PUVA therapy and narrowband mid-wavelength phototherapy (311 nm). The patients were divided into three groups: Group 1 (n = 20) - patients who received treatment in the form of mid-wavelength ultraviolet therapy (311 nm) after multiple courses of PUVA therapy; Group 2 (n = 26) - patients who received only multiple courses of PUVA therapy; Group 3 (n = 20) - patients who received only multiple courses of mid-wavelength ultraviolet therapy (311 nm). Results. The authors determined high efficacy (82.8%) of mid-wavelength ultraviolet therapy (311 nm) in patients with moderate to severe forms of psoriasis vulgaris who had previously received multiple courses of PUVA therapy. After multiple courses of long-term treatment by mid-wavelength ultraviolet therapy (311 nm), patients with moderate to severe forms of psoriasis had high efficacy of such multiple courses of treatment (85.78%). Conclusion. Patients with moderate to severe forms of psoriasis who had previously received multiple courses of PUVA therapy can be switched to mid-wavelength ultraviolet therapy (311 nm) with the maintenance of high efficacy of such treatment. The authors observed the absence of any adaptation to the spectral range of mid-wavelength ultraviolet therapy (311 nm) in case of multiple courses of treatment.

Monitoring of disseminated superficial actinic porokeratosis (DSAP) in patient suffering from plaque psoriasis treated by PUVA therapy was presented. DSAP is a rare skin disease developing in the result of keratosis disorder caused by solar radiation and appearing as clearly localized ringed or line plates. As patients with DSAP are sensitive to solar radiation, phototherapy is contraindicated for them. In this regard, subcutaneous injections of Methotrexate 10 mg once a week were prescribed to a patient suffering from psoriasis. Psoriatic rashes were regressed after the second injection, instead of them DSAP rashes remained.

The authors present a clinical case study of squamous cell carcinoma in a psoriasis patient after 24 courses of phototherapy (22 courses of PUVA therapy and two courses of mid-wavelength ultraviolet therapy (311 nm)). The malignant neoplasm developed against the background of signs of a chronic photodamage of the skin: lentigo, actinic elastosis, diffuse hyperpigmentation, spotty skin pigmentation.

Goal. To study the dynamics of expression rates of growth factor proteins in psoriatic patients receiving the PUVA therapy. Materials and methods. The authors conducted a study of 30 patients with psoriasis vulgaris treated with the PUVA therapy. The psoriasis severity and extent of itching were assessed prior to and after the treatment by the PASI index and visual analogue scale, respectively. The expression of semaphorin 3A, amphiregulin, nerve growth factor and PGP 9.5 protein (a nerve fiber marker) in the skin was assessed by the indirect immunofluorescence method. The expression of PGP 9.5 protein was used to assess the quantity and mean length as well as average and total fluorescence intensity of nerve fibers. Results. An increased expression of amphiregulin and nerve growth factor as well as increase in the quantity, mean length and average and total fluorescence intensity of nerve fibers were revealed in the epidermis of psoriatic patients. Following a course of the PUVA therapy, a decrease in the PASI index and extent of itching, reduced expression of amphiregulin and nerve growth factor as well as reduced quantity, mean length and average and total fluorescence intensity of nerve fibers in the epidermis were observed. Direct correlation dependence between the extent of itching, amphiregulin and nerve growth factor expression level and quantity and length of nerve fibers in the epidermis was discovered. Direct correlation dependence between the amphiregulin and nerve growth factor expression level, and average length of nerve fibers in the epidermis was discovered. Conclusion. The itching intensity in psoriatic patients receiving the PUVA therapy is reduced due to the decreased skin expression of the nerve growth factor and amphiregulin.

The article presents published data on the assessment of the risk of cancerogenicity of multiple courses of phototherapy methods such as PUVA therapy and UVB-311 in psoriatic patients. The authors analyzed the incidence of malignant skin neoplasms (squamous cell carcinoma, basal cell carcinoma, malignant skin melanoma) among psoriatic patients from different population groups taking into account the cumulative radiation doses and number of procedures.

Introduction: Phototherapy, particularly psoralen plus ultraviolet A (PUVA) and narrowband ultraviolet B (nbUVB), is a mainstay in the treatment of Mycosis Fungoides (MF). Methods: We analyzed outcomes of MF patients treated for the first time with either PUVA or nbUVB at the Photodermatology Unit, in the Department of Dermatology of Centro Hospitalar Universitário do Porto, from 2007 to 2017. The primary outcome was response to treatment. The secondary outcome was disease relapse free survival. Results: From a total number of 34 patients with MF identified, nine (26.5%) patients were diagnosed at stage IA and 25 (73.5%) patients were diagnosed at stage IB. Of these patients, 30 (88.2%) were treated with PUVA and four (11.8%) with nbUVB. Overall, 24 (80%) patients treated with PUVA and two (50%) patients treated with nbUVB had complete responses (CR). Relapse was observed in 17 (70.8%) PUVA treated patients and two (100%) nbUVB treated patients. Median disease relapse free survival was 12 months for PUVA and 6 months for nbUVB. Conclusion: PUVA is an effective therapy in early MF. Narrowband UVB could be a valid therapeutic alternative for these patients. However, the small size of nbUVB group in our study limits the conclusions about its efficacy.

Background: Psoriasis is a common, chronic, inflammatory disease. Although it mainly affects the skin, it has been associated with a large number of comorbidities. In addition to comorbidities such as depression and psoriatic arthritis, it is known that there is an increased prevalence of cancer in psoriasis patients. Skin cancers, particularly squamous cell carcinoma, have been associated with psoriasis. However, basal cell carcinoma data are limited., Methods: 346 psoriasis patients and 306 individuals were selected as the control group. There were no differences between the patient and control groups in terms of age and gender. The mean age of the psoriasis patients was 49.9 ± 15.8 years and the control group was 49.4 ± 13.4 years. Sociodemographic data of the patients were recorded. Pharmacological agents used in the treatment of psoriasis were included in the analysis. Disease severity was assessed by the psoriasis area severity index (PASI). In the physical examination of the patients, biopsies were taken from lesions suspicious for BCC. BCC diagnosis was made by histopathologically., Results: The frequency of BCC was higher in psoriasis patients than in the control group (6.6% vs. 2.9%, p < .001). Advanced age (p < .001), smoking (p = .003), and arthritis (p < .001) were associated with BCC in psoriasis patients. However, there was no relationship between PASI and BCC (p = .142). Among the psoriasis treatments, only UV therapy was associated with BCC (p = .038). The frequency of PUVA (p < .001) and number of PUVA session (p = .010) was higher in psoriasis patients with BCC rather than NB-UVB., Conclusion: The frequency of BCC is increased in psoriasis patients. Psoriasis is associated with an increased risk of BCC, especially when treated with PUVA therapy for a long time., (© 2024 The Authors. Photodermatology, Photoimmunology & Photomedicine published by John Wiley & Sons Ltd.)