Phototherapy in the perspective of the chronicity of psoriasis
SourceJEADV : Journal of the European Academy of Dermatology and Venereology, 34, 5, (2020), pp. 926-931
Article / Letter to editor
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JEADV : Journal of the European Academy of Dermatology and Venereology
SubjectRadboudumc 5: Inflammatory diseases RIHS: Radboud Institute for Health Sciences
According to the guidelines for the treatment of psoriasis, phototherapy is given in courses of UVB exposure starting at 50-70% of the minimal erythema dose, MED, with subsequently incremental dosages, but keeping erythemal skin reactions to a minimum by restraining the dosages when necessary. In this review, this classical principle of short-term near erythematogenic UVB therapy without further UVB maintenance therapy is challenged as it is evidently not optimal for psoriasis as a chronic condition. There is old experimental evidence supplemented with growing knowledge on the mode of action of phototherapy and more recent data on low-level UVB regimens as maintenance therapy that should urge us to revisit our guidelines on phototherapy to address psoriasis for what it is: a chronic condition.
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