Phototherapy in Pediatric Patients

Abstract

The treatment of children with psoriasis, atopic dermatitis (AD), pityriasis lichenoides, and scleroderma poses a therapeutic problem because all therapeutic options are associated with numerous side effects. Therefore ultraviolet A and B (UVA and UVB) phototherapy is presented as a possible alternative to some of these therapies, primarily topical and systemic corticosteroids, in children. Our results in treating children with phototherapy and psoralen plus UVA (PUVA) bath phototherapy over the past 5 years are reported. UVB therapy (TL01) was used in 20 psoriatic children (6 boys, 14 girls; ages 6-14 years) during the stage of disease exacerbation and in 9 children (3 boys, 6 girls; ages 8-16 years) with pityriasis lichenoides. Combined UVA/UVB phototherapy was applied in 21 AD children (7 boys, 14 girls; ages 4-15 years). Photochemotherapy with local application of a PUVA bath was used in six children (2 boys, 4 girls; ages 9-16 years) with circumscribed scleroderma and in one girl with systemic scleroderma. All children received short courses of phototherapy with either no maintenance or short maintenance. All three therapeutic protocols resulted in a certain degree of improvement in most of the study patients. None of the patients exhibited any early phototherapy side effects. We conclude that phototherapy and PUVA bath are valuable and safe therapeutic options for selected children who do not respond to other treatments.

Pityriasis lichenoides and its subtypes

“…[123][124][125] Ultraviolet B therapy and ultraviolet A without psoralen have also been used with varying degrees of success. [126][127][128] Recommended therapies. From the evidence listed above, the ease of administration, and the authors' experience, first-line therapies could include oral antibiotics and topical corticosteroids or topical immunomodulators.…”

A series of critically challenging case scenarios in moderate to severe psoriasis: A Delphi consensus approach

“…295,296 UV phototherapy remains a safe option for the committed patient (and parent), as long as precautions are taken to avoid the exposure of the UV radiation to the eyes (Grade C evidence). 297 No systemic therapy-biologic or conventionalis approved for pediatric psoriasis. Methotrexate has extensive on-label use in pediatric rheumatologic conditions, such as juvenile idiopathic arthritis (JIA).…”

Esclerodermia localizada na criança: aspectos clínicos, diagnósticos e terapêuticos

“…Os resultados foram alcançados com um pequeno número de sessões (média de 25, variando de 14 a 39). 71 Após a radiação UVA, pode-se detectar um aumento na expressão da colagenase nos fibroblastos da derme. Especula-se que a radiação UVA pode suprimir a síntese de colágeno e induzir a atividade da colagenase, resultando na melhora clínica das placas escleróticas.…”