Which patients with psoriasis can have phototherapy

Type:Uv phototherapy   Time:2018-09-15 11:39:31

1 Which patients with psoriasis can have phototherapy?

 

There are many treatments for psoriasis, and the treatment methods are different depending on the characteristics, types, and severity of the disease. For example, mild psoriasis is mainly treated with topical medications, topical glucocorticoids, calcipotriol ointment or non-hormonal tacrolimus ointment; moderate to severe psoriasis requires systemic treatment (internal and topical) ) and physical therapy (phototherapy). Phototherapy is a very important treatment for critically ill patients with a lesion area greater than 10% (10 palm areas)


¡ñ Why can phototherapy treat psoriasis?

 

Psoriasis is a chronic inflammation of the skin that is caused by an increase in the activity of T cells in the human body. After inflammation occurs, the skin will thicken and produce scales. The phototherapy can inhibit the proliferation of T cells in the skin, inhibit the epidermal hyperplasia, reduce inflammation, and thus reduce skin damage (referred to as skin lesions). The most commonly used phototherapy is narrow-spectrum UVB (narrow-spectrum UVB) and PUVA (referred to as UVA combined with photosensitizer), where narrow-spectrum UVB treatment is simple and rapid, and is more commonly used. PUVA must be applied with photosensitizer (psoralen) before it can be illuminated, and the irradiation time is long, and it is rarely used at present.

 

¡ñ Not all psoriasis is suitable for phototherapy

 

The different treatments for different types and severity of psoriasis are different. Therefore, phototherapy is not suitable for all patients with psoriasis. The fewer the scales and the thinner the skin, the better the phototherapy effect. The most suitable types of psoriasis for phototherapy are the following categories. The first type is drip psoriasis, whether it is a primary, generalized, or a large area of ​​psoriasis; the second type is plaque psoriasis, even if the patient's lesion area is very Large (greater than 10% or even greater than 20% or 30%) can also be used for a long time. Some psoriasis is not suitable for phototherapy, such as advanced erythrodermic type, pustular psoriasis, phototherapy will aggravate the condition; joint psoriasis after phototherapy can not improve the joint symptoms, so it is not suitable for phototherapy. In general, whether or not phototherapy is available requires an experienced doctor to judge.

 

¡ñ Phototherapy for pregnant women and children

 

Pregnant women and children with psoriasis are subject to many restrictions on the use of medication, so phototherapy is a good treatment for them. Due to the commonly used narrow-spectrum UVB, it only shines on the superficial layer of the skin, has no effect on the deep layers of the skin and the internal organs, and is as safe as the sun, so pregnant women and children who can stand in the phototherapy cabin can receive phototherapy. Important parts such as the eyes and external genitalia need to be protected during treatment. Many parents worry that phototherapy will not affect children's growth and development, then I have to ask, will the sun affect children's growth and development? of course not! Therefore, parents can safely give their children phototherapy. Because children's skin is thin, doctors will slowly increase the dose of phototherapy.

 

¡ñ What conditions are not available for phototherapy?

 

Here I want to emphasize the contraindications of phototherapy. The following conditions are absolutely not phototherapy, 1 patients with epilepsy or lupus erythematosus and other diseases can not, because phototherapy will induce diseases such as lupus erythematosus and epilepsy. 2 patients with photosensitive dermatitis or allergic to light, will increase the disease after the light. 3 During the administration of photosensitizing drugs, such as retinoids, antibiotics such as quinolones, griseofulvin, and tetracycline, phototherapy is not possible. 4 can not phototherapy with melanoma, cutaneous basal cell carcinoma and squamous cell carcinoma. In addition, light-sensitive foods such as mud snails, celery, gray vegetables, citron, and wild vegetables with heavy aromas should not be eaten during phototherapy.

 

In some cases, phototherapy is not possible as much as possible. 1 There is a malignant tumor. Although phototherapy has little effect on visceral tumors, phototherapy is not recommended. 2 patients can not cooperate with phototherapy, such as patients who can not stand in the phototherapy cabin, patients who are old and weak in the phototherapy cabin, children with claustrophobia and so on. For patients with special constitutions, doctors should analyze the specific situation.

 

¡ñ Other treatments are already effective, do you need phototherapy?

 

For external use, the condition can be controlled, and only patients who occasionally relapse can use phototherapy to enhance the efficacy and inhibit recurrence. When the efficacy of external use is poor, assisted local phototherapy can alleviate the condition and serve the purpose of treatment. When the area of ​​skin lesions is relatively large and the efficacy of topical drugs is limited, combined phototherapy can enhance the efficacy. Therefore, the purpose of using phototherapy for different psoriasis patients is different.

 

¡ñ What is the effect of phototherapy? How long can it last?

 

The therapeutic effect of phototherapy is certain. 70% to 80% of patients can achieve 70% to 80% remission after 2 to 3 months of regular treatment. How long it can last after phototherapy does not recur, depending on the specific circumstances of the patient. Patients with milder disease can maintain no recurrence for several months; patients with stubborn disease and difficult to remove have a higher risk of recurrence, and new skin lesions may occur 2 to 3 months after stopping phototherapy.