Phototherapy and photochemotherapy in childhood dermatoses

Abstract

The concept of phototherapy and photochemotherapy is not new, and sophisticated ultraviolet (UV) treatment modalities are available for almost three decades. However, phototherapy has not been used in children as extensively as in adults, probably due to long-term safety concerns. Photochemotherapy (psoralen plus UVA) is not considered to be safe in the younger age group. UV therapies can be useful treatment options for children with selected dermatological conditions provided they are used under carefully controlled conditions. Presently there is insufficient data available to provide recommendations regarding the safe maximum dose and duration of phototherapy in children. Developments of new UV delivery systems and devices are aimed at improving the safety and efficacy of phototherapy. In this review, we discuss the published literature on phototherapy and photochemotherapy in children, drawbacks of their use in pediatric population and future prospects.

Narrow-band ultraviolet B in childhood vitiligo: An open prospective uncontrolled study in 28 children of South India

“…[1,2] NBUVB may be a safe and preferred treatment option for children with vitiligo because it is generally well-tolerated with minimal side effects. Though, psoralen and ultraviolet A (PUVA) is also a treatment option for vitiligo but may be considered second line to NBUVB because of the associated higher side effects.…”

“…NBUVB also has been increasingly tested in the pediatric population as a therapy for diseases, including vitiligo and atopic dermatitis. [1][2][3][4][5] In 1997, Westerhof and Nieuweboer-Krobotova [6] were the first to study the effect of NBUVB in vitiligo. In 2000, Njoo et al [7] and 2005, Kanwar and Dogra [8] ABSTRACT Background: Management of vitiligo in children is difficult as therapeutic options are restricted when compared to that in adult patients.…”

Treatment of Childhood Psoriasis with Phototherapy and Photochemotherapy

“…They also need to have their genitals protected during therapy 19,37. This is usually done by having patients wear their underwear or other protective garments.…”

“…Phototherapy may be inconvenient and difficult to use in the pediatric population. Accessibility is often an issue 37. These concerns may preclude the use of phototherapy in this population.…”

Phototherapy in Pediatric Dermatology

“…Ayrıca sistemik PUVA tedavisi sonrasındaki 24 saat süresince güneş gözlüğü kullanılması gerekliliği başka bir kısıtlayıcı nedendir. Erişkinlerde fototerapi ile melanom dışı deri kanserleri arasındaki ilişki açıkça ortaya konmuş olmasına rağmen, fototerapinin çocuklardaki uzun dönem risklerini ortaya koyan çalışmalar yoktur 2,3 . Yine de artmış karsinogenez ve erken yaşlanma riskleri çocuk hastalarda asıl kısıtlayıcı neden olarak görünmektedir.…”