Treatment of Psoriasis : Phototherapy

Phototherapy ncludes Ultraviolet Radiation A and B given to the sites affected by Psoriasis

Mechanism of Action:

Phototherapy acts by the following mechanisms:

1.Inhibition of production and releaes of  pro-inflammatory cytokines.

2.Induction of apoptosis of immune cells.

3.Reduction of Antigen presentin capacity of dendritic cells.

Usually phototherapy is given to patients with extensive disease and in those in which topical treatment has failed.

Duration lasts for approximately 6 to 8 weeks and  sessions are conducted 2 – 3 times / week.

A layer of emollient is usually applied on the skin and the therapy is given in special cubicles.

The dose and time of exposure is increased gradually as the treatment progresses.

Side Effects of Phototherapy:

1.Can cause increase susceptibility to skin cancers

2.Excessive dose can cause premature aging of skin

Contraindications:

1.Increased Photosensitivity

2.Albinism

3.History of skin cancer

4.Lupus erythematosus

5.Porphyrias.

Ultraviolet B is short wavelength therapy.

It canbe used in children and during pregnancy.

Ultraviolet A

This is long wavelength light.

It is given with oral or topical psoralen  as Psoralen + UV A called as PUVA.

It cannot be used during pregnancy.

Is used in thick plaque and wide spread psoriatic disease.