Phototherapy: experience from a reference service^*

Dear Editor,

Phototherapy is a treatment method that uses ultraviolet radiation (UVR).^1,2 The extensive use of phototherapy in dermatology, the growing number of dermatoses that benefit from this therapeutic modality, and the scarcity of data in the literature regarding the profile of a phototherapy sector in a reference dermatology center, motivated this study.

This is an observational and descriptive study carried out at the phototherapy sector of the Dermatology Service at the Hospital Universitário de Taubaté, in the state of São Paulo, Brazil, from January to December 2014.

We included both male and female patients, with no age restrictions, attended in the study period, by any dermatosis and who agreed to participate in the study by signing an informed consent form. Exclusion criteria were incomplete forms and individuals with less than 10 phototherapy sessions.

Data were collected using a standard form and complemented with an interview. Our dependent variable was phototherapy, and the independent variables included demographic parameters and parameters related to dermatosis and phototherapy.

This study was approved by the Research Ethics Committee of the institution (No. 109816).

A total of 166 individuals were included, out of which more than 65% were females.

The mean age of the sample (at the time of the interview) was 43.1 years (SD = 20.5), ranging from 6 to 86 years, with a predominance of individuals over 40 years of age.

Skin phototype III was prevalent in the sample.

Vitiligo and psoriasis were among the most prevalent dermatoses treated in this sector (Graph 1).

Graph 1
Distribution of the most prevalent dermatoses treated in the phototherapy sector

Regarding phototherapy, most patients underwent narrowband ultraviolet B radiation (UVB) (Graph 2). Cabin was the most used phototherapy equipment.

Graph 2
Sample distribution according to the type of ultraviolet radiation used

Regarding the number of sessions per week, most patients (138 or 83.1%) reported having two sessions.

The average number of sessions at the time of the interview was 78 (SD = 62.8), ranging from 10 to 254. The sessions were performed without interruption in 90 individuals (54.2%).

Only 27 subjects (16.3%) reported adverse events. First-degree burn was the most prevalent adverse event (63%) and was caused by UVB in 81.3% of the cases.

The association of phototherapy with other treatments (topical, systemic drugs or both) was reported by 100% of the sample.

In relation to the degree of satisfaction with the treatment, more than 90% (150 individuals) of the sample were satisfied, and about 40% were very satisfied.

This is an original study designed to fill a gap in the literature by describing the profile of a phototherapy sector in a reference dermatology center. Comparative analysis of the data from this study is difficult given the paucity of similar studies.

The predominance of older individuals in our study may be justified by the presence of comorbidities or contraindications to conventional treatments, making phototherapy an excellent isolated or adjuvant therapeutic option. Powell and Gach³ reported phototherapy as well tolerated, safe, and effective in their study, suggesting a likely future increase in the indication/adherence to this treatment.

The prevalence of females and low phototypes was in agreement with the findings of Casara et al.⁴ and are possibly justified by a greater female concern with health and aesthetics and by the predominant ethnic profile in the region.

The prevalence of vitiligo and psoriasis as the dermatoses most treated with phototherapy was also in agreement with the literature.^4,5

Our phototherapy-specific data are original, serving as the basis for future studies. The most prevalent adverse effect revealed by our study and the combined use of phototherapy with other medications are also in agreement with the literature.⁴

Although the accessibility to the phototherapy unit constitutes an important limiting factor to this type of treatment, the degree of satisfaction reported by patients motivates its use.

This study allowed to describe the profile of a phototherapy sector from a reference dermatology center, corroborating the literature and providing original data that could be used in future studies.

• *
  Work performed at Hospital Universitário de Taubaté - Universidade de Taubaté (HUT-UNITAU) - Taubaté (SP), Brazil
• Financial support: None.

REFERENCES

• ¹
  Cestari TF, Pessato S, Corrêa GP. Fototerapia - aplicações clínicas. An Bras Dermatol. 2007; 82:7-21.
• ²
  Duarte I, Buense R, Kobata C. Fototerapia. An Bras Dermatol. 2006; 81:74-82.
• ³
  Powell JB, Gach JE. Phototherapy in the elderly. Clin Exp Dermatol. 2015;40:605-10.
• ⁴
  Casara C, Eidt L, Cunha V. Estudo de prevalência das dermatoses encaminhadas ao setor de fototerapia do ambulatório de dermatologia do Hospital de Clínicas de Porto Alegre, RS, Brasil. An Bras Dermatol. 2013;88:211-5.
• ⁵
  Duarte I, Cunha JAJ, Bedrikow RB, Lazzarini RR. Qual é o tipo de fototerapia mais comumente indicada no tratamento da psoríase? UVB banda estreita e PUVA: comportamento da prescrição. An Bras Dermatol. 2009;84:244-48.

Publication Dates

• Publication in this collection
  Sep-Oct 2017

History

• Received
  06 Nov 2016
• Accepted
  26 Feb 2017