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UV Phototherapy is used by a large number of dermatologists for all types of vitiligo
Type:Uv phototherapy Time:2015-05-22 9:52:29To the best of our knowledge, none of the published studies has demonstrated an increase in skin cancer risk with UVB phototherapy for psoriasis. Based on the data that are currently available, even for fair-skinned Caucasians, no precise limit to the number of allowable UVB treatments can be defined. However, it is recommended that dermatologists continue the current practice of shielding the patients' genitals during UVB phototherapy. Exposure should be even less of a concern for darker-skinned non-Caucasians whose skin is less prone to UV damage. The relative carcinogenicity of NB-UVB vs BB-UVB phototherapy remains to be determined.
Eye protection is always used during phototherapy. The appropriate sunglasses must filter out more than 99% of the UV light that penetrates the cornea. Ninety-seven percent of the present respondents adhered to this guideline. Only 6.5% of our respondents said that they did not protect the male genitalia during phototherapy. The strongly dose-dependent increase in the risk for genital tumors associated with PUVA and UVB radiation exposure is well reported, making it prudent for men to use genital protection whenever they are exposed to PUVA or NB-UVB.
The most common side effects reported by our dermatologists were mild erythema, burning, and pruritus. The approaches used for the management of severe accidental UVB exposure are markedly variable. The majority of dermatologists treat overexposure with topical steroids, emollients, and cool or wet compresses. This treatment strategy is supported by recent management recommendations, which are largely supportive and include the use of emollients, cool compresses, and ample pain control. Nearly half of our dermatologists (45%) suggested the use of NSAIDs within 24 hours of side effect. NSAIDs have been shown to partially prevent UVB-induced erythema, but they are not effective when given in the late phase of an injury.
Phototherapy is used by a large number of dermatologists for all types of vitiligo. The present survey has identified variations in phototherapy practices for vitiligo in Saudi Arabia. To the best of our knowledge, this is the first detailed report concerning phototherapy practices in vitiligo treatment among dermatologists worldwide. We demonstrate some clear differences in vitiligo management in dark skin compared to European skin. A limitation of this study is the use of a convenience sample, as dermatologists attending a scientific conference might not be very representative of all dermatologists in the country. However, due to the lack of postal addresses or a database for dermatologists in this country, the distribution of questionnaires at a national conference was probably the best available option.
The good sample size is a strength of this study. However, it is true that it is a spot survey and more or less individual dependent. But we are not looking for therapeutic comparison, rather to see the dermatologists' perception about them. The respondents of survey are relatively representatives of our dermatologist community, because they belong to different age groups, different practicing groups, for example, residents, specialists, and consultants and have different levels of experience.
More studies are needed to compare phototherapy practices for vitiligo in other countries and worldwide.