Tuscan consensus on the use of UVBnb phototherapy in the treatment of psoriasis

Russo, Filomena; Vispi, Martina; Sirna, Riccardo; Mancini, Virginia; Bagnoni, Giovanni; Bartoli, Laura; Bellini, M.; Brandini, Luca; Caproni, Marzia; Castelli, Antonio; Cecchi, Roberto; Cuccia, Aldo; Fimiani, Michele; Grazzini, Marta; Marsili, Franco; Mazzatenta, Carlo; Niccoli, Maria Chiara; Panduri, Salvatore; Peccianti, C.; Pecenco, Silvia; Pimpinelli, Nicola; Prignano, Francesca; Ricceri, Federica; Romanelli, Marco; Rossari, Susanna; Taviti, Franca; Volpi, Walter; Pellegrino, Michele

doi:10.23736/s0392-0488.18.06223-5

Cited by 8 publications

(11 citation statements)

References 29 publications

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“…In particular, clinicians treating psoriatic patients with phototherapy should include diet information in medical history. Vegans and vegetarians with psoriasis displayed higher photosensitivity than omnivores, and deserve ad hoc phototherapy management [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, we used a solar simulator since the monochromator, the most precise instrument to measure MED on the market, was not present in the involved centers [ 45 , 46 ]. As current Italian guidelines did not suggest a specific instrument to measure MED [ 28 ], we used a solar simulator that, together with the monochromator, is internationally regarded as the gold standard [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

“…MED testing was performed on normal dorsal skin of each enrolled patient before starting phototherapy using a Multiport UV Solar Simulator 601 (Solar Light CO.INC: Philadelphia, PA, USA) [ 28 ]. MED testing was repeated after 8 weeks of phototherapy treatment to evaluate photoadaptation.…”

Section: Methodsmentioning

confidence: 99%

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Diet-Related Phototoxic Reactions in Psoriatic Patients Undergoing Phototherapy: Results from a Multicenter Prospective Study

et al. 2021

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Vegans and vegetarians often consume foods containing photosensitizers capable of triggering phytophotodermatitis. The potential effect of vegan and vegetarian diets on the response of psoriatic patients undergoing phototherapy is not well characterized. We assessed clinical outcomes of vegan, vegetarian and omnivore adult psoriatic patients undergoing band ultraviolet B phototherapy (NB-UVB). In this multicenter prospective observational study, we enrolled 119 adult, psoriatic patients, of whom 40 were omnivores, 41 were vegetarians and 38 were vegans, with phototherapy indication. After determining the minimum erythemal dose (MED), we performed NB-UVB sessions for 8 weeks. The first irradiation dosage was 70.00% of the MED, then increased by 20.00% (no erythema) or by 10.00% (presence of erythema) until a maximum single dose of 3 J/cm2 was reached and constantly maintained. All the enrolled patients completed the 8 weeks of therapy. Severe erythema was present in 16 (42.11%) vegans, 7 (17.07%) vegetarians and 4 (10.00%) omnivores (p < 0.01). MED was lowest among vegans (21.18 ± 4.85 J/m2), followed by vegetarians (28.90 ± 6.66 J/m2) and omnivores (33.63 ± 4.53 J/m2, p < 0.01). Patients with severe erythema were more likely to have a high furocumarin intake (OR 5.67, 95% CI 3.74–8.61, p < 0.01). Vegans consumed the highest amount of furocumarin-rich foods. A model examining erythema, adjusted for gender, age, skin type, MED, phototherapy type, number of phototherapies and furocumarin intake, confirmed that vegans had a lower number of treatments. Vegans had more frequent severe erythema from NB-UVB, even after adjustment of the phototherapy protocol for their lower MED. Assessing diet information and adapting the protocol for vegan patients may be prudent.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Diet-Related Phototoxic Reactions in Psoriatic Patients Undergoing Phototherapy: Results from a Multicenter Prospective Study

et al. 2021

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“…Combination therapies with the systemic drug were prescribed in line with the "Italian guidelines on the systemic treatments of moderate-to-severe plaque psoriasis" in terms of dosage and frequency [78], whilst the NB-UVB was used following the "Tuscan consensus on the use of UVBnb phototherapy" [79] and the principles of diet changes in minimal erythema dose [80] and photoadaptation [81].…”

Section: Clinical Evaluationmentioning

confidence: 99%

Secukinumab Loss of Efficacy Is Perfectly Counteracted by the Introduction of Combination Therapy (Rescue Therapy): Data from a Multicenter Real-Life Study in a Cohort of Italian Psoriatic Patients That Avoided Secukinumab Switching

et al. 2022

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Since psoriasis (PsO) is a chronic inflammatory disease, patients may experience a drug failure also with very effective drugs (i.e., secukinumab) and, consequently, dermatologists have two therapeutic options: switching or perform a combination therapy (rescue therapy) to save the drug that had decreased its efficacy. At the moment no studies focused on combination/rescue therapy of secukinumab, so we performed a 52-weeks multicenter retrospective observational study that involved 40 subjects with plaque psoriasis that experienced a secondary failure and were treated with combination therapy (ciclosporin (n = 11), MTX (n = 15), NB-UVB (n = 7) and apremilast (n = 7)). After 16 weeks of rescue/combination therapy, PASI and a DLQI varied respectively from 8 [7.0–9.0] and 13 [12.0–15.0], to 3 [2.8–4.0] and 3 [2.0–3.3]), suggesting a significant improvement of daily functionality and quality of life. Results were maintained at 52 weeks. No side effects were experienced during the study. Secukinumab remains a safety and effective drug for PsO patients also in the IL-23 and JAK inhibitors era. The rescue therapy is a valid therapeutic option in case of secukinumab secondary failure.

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“…P soriasis is traditionally defined as an immune-mediated, inflammatory dermatological disease characterized by a chronic-relapsing course and associated with multifactorial inheritance. Until recently psoriasis was considered to be a dermatological disease only, but is currently defined as a systemic one because of the involvement of multiple organs with important impact on social life and relationships (1). Social, psychological and economic impacts are comparable to other chronic diseases, such as chronic bronchitis, diabetes mellitus or depression (2).…”

mentioning

confidence: 99%

Efficacy and Safety of Oral Administration of a Mixture of Probiotic Strains in Patients with Psoriasis: a Randomized Clinical Trial

Navarro-López¹,

Martínez‐Andrés²,

Ramírez-Boscá³

et al. 2019

Acta Derm Venerol

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This clinical trial evaluated the effect of a probiotic mixture as coadjutant treatment together with topical steroids in 90 patients with plaque psoriasis. The results showed a larger reduction in the score of severity indexes in the probiotic group compared with the placebo group. Gut microbiota analysis demonstrated the efficacy of the probiotic in modulation of the composition of the microbiota. After the end of the probiotic or placebo intake, patients were followedup for 6 months. The results showed a lower risk of relapse in patients in the probiotic group. The aim of this 12-week randomized, double-blind, placebo-controlled trial was to determine the efficacy and safety of a probiotic mixture in the reduction of psoriasis severity. Ninety 18-70-year-old adults with plaque psoriasis were randomized into probiotic and placebo groups. At 12-week follow-up, 66.7% of patients in the probiotic group and 41.9% in the placebo group showed a reduction in Psoriasis Area and Severity Index of at least 75% (p < 0.05). A clinically relevant difference was observed in Physician Global Assessment index: 48.9% in the probiotic group achieved a score of 0 or 1, compared with 30.2% in the placebo group. The results of follow-up 6 months after the end of the study showed a lower risk of relapse after the intake of the probiotic mixture. Analysis of gut microbiota confirmed the efficacy of the probiotic in modulation of the microbiota composition.

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Tuscan consensus on the use of UVBnb phototherapy in the treatment of psoriasis

Cited by 8 publications

References 29 publications

Diet-Related Phototoxic Reactions in Psoriatic Patients Undergoing Phototherapy: Results from a Multicenter Prospective Study

Diet-Related Phototoxic Reactions in Psoriatic Patients Undergoing Phototherapy: Results from a Multicenter Prospective Study

Secukinumab Loss of Efficacy Is Perfectly Counteracted by the Introduction of Combination Therapy (Rescue Therapy): Data from a Multicenter Real-Life Study in a Cohort of Italian Psoriatic Patients That Avoided Secukinumab Switching

Efficacy and Safety of Oral Administration of a Mixture of Probiotic Strains in Patients with Psoriasis: a Randomized Clinical Trial

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