Should Phototherapy Be Used to Treat Stubborn Skin Conditions in Children?
Phototherapy has been shown to be effective in adults to treat stubborn skin conditions such as atopic dermatitis (AD), psoriasis, pityriasis lichenoides chronica (PLC), and nodular prurigo. It’s often used as a second-line treatment when those conditions fail to respond to topical steroid treatment.
A recent retrospective study looked at whether patients younger than 17 years of age showed a similar response to treatment and examined how effective phototherapy is at maintaining remission after 12 months of follow-up. Authors reviewed the medical records of 75 patients who had been receiving Narrowband Ultraviolet B (NBUVB) phototherapy or hand and foot psoralen plus ultraviolet A (PUVA) over a period of 18 months. Most of the patients received NBUVB and were being treated for a wide range of skin conditions including, AD, psoriasis, PLC, vitiligo, nodular prurigo, and granuloma annulare.
The data showed that phototherapy is an efficacious, safe, second-line therapy for children with AD and psoriasis. Of the patients with AD that completed their treatment, 76% had documented clear to almost clear skin, and at one year 52% remained clear. The patients with psoriasis that completed treatment saw a 90% improvement in the PASI, and at the 12-month follow-up, 43% of the patients with psoriasis remained clear.
Though the results were promising, the authors could not draw conclusions about PLC, vitiligo, nodular prurigo, and granuloma annulare because of the small numbers of patients. Overall, the authors conclude that phototherapy is well tolerated and can reduce disease burden in severe eczema and psoriasis, and therefore should be considered as second-line therapy. They caution that this small study does not provide enough data to assess long-term safety in this population.
Byline: Martha L. Sikes, MS, RPh, PA-C
Posted: May 1, 2017
Source: Wiley Online Library
Adapted from the original article.