Skip to main content
SpringerLink
Log in

Phototherapy in Atopic Dermatitis

  • Chapter
  • First Online:
Ultraviolet Light in Human Health, Diseases and Environment

Part of the book series: Advances in Experimental Medicine and Biology ((AEMB,volume 996))

Abstract

Atopic dermatitis (AD) is one of the most common chronic inflammatory skin diseases. Currently management of AD includes avoidance of triggering factors, skin care aiming to compensate the skin barrier defects, anti-inflammatory therapy (mostly topical corticosteroids and topical calcineurin inhibitors). When these first-line approaches are unsuccessful, systemic treatment or phototherapy ought to be carried out as next line of defence. Current phototherapy modalities for AD include broadband UVB (290–320 nm), narrowband UVB (311–313 nm), UVA-1 therapy (340–400 nm), UVA therapy plus 8-methoxypsoralens (PUVA), 308 nm excimer laser (EL) and Full spectrum light (FSL).

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 109.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 139.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Sidbury R, Davis DM, Cohen DE, Cordoro KM, Berger TG, Bergman JN et al (2014) Guidelines of care for the management of atopic dermatitis: section 3. Management and treatment with phototherapy and systemic agents. J Am Acad Dermatol 71(2):327–349

    Article  PubMed  PubMed Central  Google Scholar 

  2. Song E, Reja D, Silverberg N, Rothe MJ (2015) Phototherapy: kids are not just little people. Clin Dermatol 33(6):672–680

    Article  PubMed  Google Scholar 

  3. Chan IHY, Murrell DF (2016) Itch Management: physical approaches (UV phototherapy, acupuncture). Curr Probl Dermatol 50:54–63

    Article  PubMed  Google Scholar 

  4. Carrascosa JM, Gardeazábal J, Pérez-Ferriols A, Alomar A, Manrique P, Jones-Caballero M et al (2005) Consensus document on phototherapy: PUVA therapy and narrow-band UVB therapy. Actas Dermosifiliogr 96(10):635–658

    Article  PubMed  Google Scholar 

  5. Meduri NB, Vandergriff T, Rasmussen H, Jacobe H (2007) Phototherapy in the management of atopic dermatitis: a systematic review. Photodermatol Photoimmunol Photomed 23(4):106–112

    Article  PubMed  Google Scholar 

  6. Pérez-Ferriols A, Aranegui B, Pujol-Montcusí JA, Martín-Gorgojo A, Campos-Domínguez M, Feltes RA et al (2015) Phototherapy in atopic dermatitis: a systematic review of the literature. Actas Dermosifiliogr 106(5):387–401

    Article  PubMed  Google Scholar 

  7. Bogaczewicz J, Malinowska K, Sysa-Jedrzejowska A, Wozniacka A (2016) Medium dose ultraviolet A1 phototherapy and mRNA expression of interleukin 8, interferon γ, and chemokine receptor 4 in acute skin lesions in atopic dermatitis. Postȩpy Dermatol Alergol 33(3):170–175

    Article  PubMed  PubMed Central  Google Scholar 

  8. Morita A, Werfel T, Stege H, Ahrens C, Karmann K, Grewe M et al (1997) Evidence that singlet oxygen-induced human T helper cell apoptosis is the basic mechanism of ultraviolet-A radiation phototherapy. J Exp Med 186(10):1763–1768

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Faergemann J, Larkö O (1987) The effect of UV-light on human skin microorganisms. Acta Derm Venereol 67(1):69–72

    CAS  PubMed  Google Scholar 

  10. Tintle S, Shemer A, Suárez-Fariñas M, Fujita H, Gilleaudeau P, Sullivan-Whalen M et al (2011) Reversal of atopic dermatitis with narrow-band UVB phototherapy and biomarkers for therapeutic response. J Allergy Clin Immunol 128(3.) 583-593-4

    Google Scholar 

  11. Morison WL, Parrish JA, Fitzpatrick TB (1978) Oral psoralen photochemotherapy of atopic eczema. Br J Dermatol 98(1):25–30

    Article  CAS  PubMed  Google Scholar 

  12. Pérez Ferriols A, Aguilera J, Aguilera P, de Argila D, Barnadas MA, de Cabo X et al (2014) Determination of minimal erythema dose and anomalous reactions to UVA radiation by skin phototype. Actas Dermosifiliogr 105(8):780–788

    Article  PubMed  Google Scholar 

  13. Jekler J, Larkö O (1991) UVA solarium versus UVB phototherapy of atopic dermatitis: a paired-comparison study. Br J Dermatol 125(6):569–572

    Article  CAS  PubMed  Google Scholar 

  14. Jekler J, Larkö O (1990) Combined UVA-UVB versus UVB phototherapy for atopic dermatitis: a paired-comparison study. J Am Acad Dermatol 22(1):49–53

    Article  CAS  PubMed  Google Scholar 

  15. Midelfart K, Stenvold S-E, Volden G (1985) Combined UVB and UVA phototherapy of atopic eczema. Dermatology 171(2):95–98

    Article  CAS  Google Scholar 

  16. Patrizi A, Raone B, Ravaioli GM (2015) Management of atopic dermatitis: safety and efficacy of phototherapy. Clin Cosmet Investig Dermatol 8:511–520

    Article  PubMed  PubMed Central  Google Scholar 

  17. Grau-Salvat C, Vilata-Corell JJ, Azón-Massoliver A, Pérez-Ferriols A (2007) Use of psoralen plus UV-A therapy in the autonomous community of Valencia, Spain. Actas Dermosifiliogr 98(9):611–616

    Article  CAS  PubMed  Google Scholar 

  18. Der-Petrossian M, Seeber A, Hönigsmann H, Tanew A (2000) Half-side comparison study on the efficacy of 8-methoxypsoralen bath-PUVA versus narrow-band ultraviolet B phototherapy in patients with severe chronic atopic dermatitis. Br J Dermatol 142(1):39–43

    Article  CAS  PubMed  Google Scholar 

  19. Tzaneva S, Kittler H, Holzer G, Reljic D, Weber M, Hönigsmann H et al (2010) 5-Methoxypsoralen plus ultraviolet (UV) A is superior to medium-dose UVA1 in the treatment of severe atopic dermatitis: a randomized crossover trial. Br J Dermatol 162(3):655–660

    Article  CAS  PubMed  Google Scholar 

  20. Garritsen FM, MWD B, Limpens J, Spuls PI (2014) Photo(chemo)therapy in the management of atopic dermatitis: an updated systematic review with implications for practice and research. Br J Dermatol 170(3):501–513

    Article  CAS  PubMed  Google Scholar 

  21. Attili SK, Dawe RS, Ibbotson SH (2016) Ultraviolet A1 phototherapy: one center’s experience. Indian J Dermatol Venereol Leprol 23

    Google Scholar 

  22. Polderman MCA, Wintzen M, le Cessie S, Pavel S (2005) UVA-1 cold light therapy in the treatment of atopic dermatitis: 61 patients treated in the Leiden University Medical Center. Photodermatol Photoimmunol Photomed 21(2):93–96

    Article  PubMed  Google Scholar 

  23. Krutmann J, Czech W, Diepgen T, Niedner R, Kapp A, Schöpf E (1992) High-dose UVA1 therapy in the treatment of patients with atopic dermatitis. J Am Acad Dermatol 26(2):225–230

    Article  CAS  PubMed  Google Scholar 

  24. Krutmann J, Diepgen TL, Luger TA, Grabbe S, Meffert H, Sönnichsen N et al (1998) High-dose UVA1 therapy for atopic dermatitis: results of a multicenter trial. J Am Acad Dermatol 38(4):589–593

    Article  CAS  PubMed  Google Scholar 

  25. Tzaneva S, Seeber A, Schwaiger M, Hönigsmann H, Tanew A (2001) High-dose versus medium-dose UVA1 phototherapy for patients with severe generalized atopic dermatitis. J Am Acad Dermatol 45(4):503–507

    Article  CAS  PubMed  Google Scholar 

  26. Dittmar HC, Pflieger D, Schöpf E, Simon JC (2001) UVA1 phototherapy. Pilot study of dose finding in acute exacerbated atopic dermatitis. Hautarzt Z Für Dermatol Venerol Verwandte Geb 52(5):423–427

    Article  CAS  Google Scholar 

  27. von Kobyletzki G, Pieck C, Hoffmann K, Freitag M, Altmeyer P (1999) Medium-dose UVA1 cold-light phototherapy in the treatment of severe atopic dermatitis. J Am Acad Dermatol 41(6):931–937

    Article  Google Scholar 

  28. George SA, Bilsland DJ, Johnson BE, Ferguson J (1993) Narrow-band (TL-01) UVB air-conditioned phototherapy for chronic severe adult atopic dermatitis. Br J Dermatol 128(1):49–56

    Article  CAS  PubMed  Google Scholar 

  29. Rodenbeck DL, Silverberg JI, Silverberg NB (2016) Phototherapy for atopic dermatitis. Clin Dermatol 34(5):607–613

    Article  PubMed  Google Scholar 

  30. Heinlin J, Schiffner-Rohe J, Schiffner R, Einsele-Krämer B, Landthaler M, Klein A et al (2011) A first prospective randomized controlled trial on the efficacy and safety of synchronous balneophototherapy vs. narrow-band UVB monotherapy for atopic dermatitis. J Eur Acad Dermatol Venereol 25(7):765–773

    Article  CAS  PubMed  Google Scholar 

  31. Pérez-Ferriols A (2013) The minimal erythema dose (MED) project: in search of consensus on phototesting. Actas Dermosifiliogr 104(7):541–542

    Article  PubMed  Google Scholar 

  32. Selvaag E, Caspersen L, Bech-Thomsen N, Wulf HC (2005) Optimized UVB treatment of atopic dermatitis using skin reflectance measurements. A controlled, left–right comparison trial. Acta Derm Venereol 85(2):144–146

    Article  PubMed  Google Scholar 

  33. Reynolds NJ, Franklin V, Gray JC, Diffey BL, Farr PM (2001) Narrow-band ultraviolet B and broad-band ultraviolet A phototherapy in adult atopic eczema: a randomised controlled trial. Lancet 357(9273):2012–2016

    Article  CAS  PubMed  Google Scholar 

  34. Gambichler T, Othlinghaus N, Tomi NS, Holland-Letz T, Boms S, Skrygan M et al (2009) Medium-dose ultraviolet (UV) A1 vs. narrowband UVB phototherapy in atopic eczema: a randomized crossover study. Br J Dermatol 160(3):652–658

    Article  CAS  PubMed  Google Scholar 

  35. Legat FJ, Hofer A, Brabek E, Quehenberger F, Kerl H, Wolf P (2003) NArrowband uv-b vs medium-dose uv-a1 phototherapy in chronic atopic dermatitis. Arch Dermatol 139(2):223–223

    Article  PubMed  Google Scholar 

  36. Majoie IML, Oldhoff JM, van Weelden H, Laaper-Ertmann M, Bousema MT, Sigurdsson V et al (2009) Narrowband ultraviolet B and medium-dose ultraviolet A1 are equally effective in the treatment of moderate to severe atopic dermatitis. J Am Acad Dermatol 60(1):77–84

    Article  PubMed  Google Scholar 

  37. Fernández-Guarino M, Aboin-Gonzalez S, Barchino L, Velazquez D, Arsuaga C, Lázaro P (2016) Treatment of moderate and severe adult chronic atopic dermatitis with narrow-band UVB and the combination of narrow-band UVB/UVA phototherapy. Dermatol Ther 29(1):19–23

    Article  PubMed  Google Scholar 

  38. Brenninkmeijer EEA, Spuls PI, Lindeboom R, Van Der Wal AC, Bos JD, Wolkerstorfer A (2010) Excimer laser vs. clobetasol propionate 0·05% ointment in prurigo form of atopic dermatitis: a randomized controlled trial, a pilot. Br J Dermatol 163(4):823–831

    Article  CAS  PubMed  Google Scholar 

  39. Byun HJ, Lee HI, Kim B, Kim MN, Hong H, Choi Y et al (2011) Full-spectrum light phototherapy for atopic dermatitis. Int J Dermatol 50(1):94–101

    Article  PubMed  Google Scholar 

  40. Dogra S, Mahajan R (2015) Indian association of dermatologists, venereologists and leprologists. Phototherapy for atopic dermatitis. Indian J Dermatol Venereol Leprol 81(1):10–15

    Article  PubMed  Google Scholar 

  41. Tzung T-Y, Lin C-B, Chen Y-H, Yang C-Y (2006) Pimecrolimus and narrowband UVB as monotherapy or combination therapy in children and adolescents with atopic dermatitis. Acta Derm Venereol 86(1):34–38

    CAS  PubMed  Google Scholar 

  42. Granlund H, Erkko P, Remitz A, Langeland T, Helsing P, Nuutinen M et al (2001) Comparison of cyclosporin and UVAB phototherapy for intermittent one-year treatment of atopic dermatitis. Acta Derm Venereol 81(1):22–27

    Article  CAS  PubMed  Google Scholar 

  43. Valkova S, Velkova A (2004) UVA/UVB phototherapy for atopic dermatitis revisited. J Dermatol Treat 15(4):239–244

    Article  CAS  Google Scholar 

  44. Jury CS, McHenry P, Burden AD, Lever R, Bilsland D (2006) Narrowband ultraviolet B (UVB) phototherapy in children. Clin Exp Dermatol 31(2):196–199

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Dermatology Department, University General Hospital of Valencia, Av. Tres Cruces n°2, 46014, Valencia, Spain

    José María Ortiz-Salvador & Amparo Pérez-Ferriols Ph.D.

Authors
  1. José María Ortiz-Salvador
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Amparo Pérez-Ferriols Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to José María Ortiz-Salvador .

Editor information

Editors and Affiliations

  1. Faculty of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom

    Shamim I. Ahmad

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Ortiz-Salvador, J.M., Pérez-Ferriols, A. (2017). Phototherapy in Atopic Dermatitis. In: Ahmad, S. (eds) Ultraviolet Light in Human Health, Diseases and Environment. Advances in Experimental Medicine and Biology, vol 996. Springer, Cham. https://doi.org/10.1007/978-3-319-56017-5_23

Download citation

Publish with us

Policies and ethics

Search

Navigation