History of phototherapy in dermatology

Abstract

Over many centuries, treatment with sunlight or "heliotherapy" was used in the treatment of skin diseases. More than 3500 years ago, ancient Egyptian and Indian healers used the ingestion of plant extracts or seeds in addition to sunlight for treating "leucoderma". Modern phototherapy began with Nobel Prize winner Niels Finsen who developed a "chemical rays" lamp with which he treated patients with skin tuberculosis. However, it took several decades until phototherapy was introduced anew into the dermatological armamentarium. It was the development of photochemotherapy (PUVA) in 1974 that marked the beginning of a huge upsurge in photodermatology. The subsequent development of high intensity UV sources with defined spectra facilitated an optimized therapy for psoriasis and led to an expansion of indications for photo(chemo)therapy also in combination with topical and systemic agents. The introduction of extracorporeal photopheresis in 1987 for cutaneous T-cell lymphoma and of topical photodynamic therapy widely expanded the therapeutic possibilities in dermato-oncology.

Trends in Type of Original Psoriasis Publications by Decade, 1960 to 2010

“…8 Attention shifted to phototherapy in 1980, which corresponded with the discovery of photochemotherapy (psoralen-ultraviolet A) in the mid-1970s. 9 In 1990, research in phototherapy had dissipated, instead replaced by renewed interest in topical and oral therapy. In particular, studies evaluating cyclosporine and systemic retinoids were frequent.…”

New Approaches to Photodynamic Therapy from Types I, II and III to Type IV Using One or More Photons

“…Nonetheless it took until the late 18 th century before an early form of phototherapy for the treatment of smallpox and cutaneous tuberculosis using an artificial red light source was developed by Niels Finsen. For his work using a "Finsen" lamp the Danish scientist was awarded the Nobel Prize in 1903 [31]. Around the same time in 1900 Oscar Raab, a student of Professor Herman von Tappeiner, observed cell death in paramecia cultures when treating them with a combination of acridine red and light irradiation.…”

“…Exciting results were obtained in the treatment of cutaneous and subcutaneous malignant tumours with tumour regression being observed in 111 cases. However, photosensitization of the skin for up to 6 weeks following administration of the PS was found to be a major side-effect of this treatment [4,7,31,32,38,39]. Despite the promising results achieved by Dougherty and his co-workers, the first controlled clinical trials using HpD as PDT PS were only started in the mid-1980's -mid-1990's by Quadra Logic Technologies (QLT) Photo Therapeutics (Canada) and American Cyanamid (NY).…”

“…The use of sunlight ("heliotherapy") to treat conditions such as vitiligo, rickets, psoriasis, psychosis, and even skin cancer was recognized by ancient civilisations including the Egyptians, Indians, Chinese and Greek [7,31]. Nonetheless it took until the late 18 th century before an early form of phototherapy for the treatment of smallpox and cutaneous tuberculosis using an artificial red light source was developed by Niels Finsen.…”

Progress in dermatology

“…Due to the skin's easy accessibility it was the target for the earliest attempts of photon-based therapies in humans. Examples include the application of ultraviolet phototherapy for the treatment of cutaneous tuberculosis by Niels Finsen [1][2][3], as well as the first trial using photodynamic therapy (PDT) of basal cell cancer of the skin by Hermann Tappeiner [4,5]; both of these pivotal innovations happened over a century ago.…”