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Pruritus pp 425-436 | Cite as

Ultraviolet Phototherapy of Pruritus

Treatments, Exposures, Courses
  • Joanna WallengrenEmail author
Chapter

Abstract

The efficacy of phototherapy on itch results from apoptosis of immunocompetent cells, reduced production of inflammatory mediators and impairment of cutaneous nerve fibers. Relief of pruritus in inflammatory skin diseases may be expected within the first 3 weeks of phototherapy and often precedes resolution of skin lesions. Narrow band UVB (NB-UVB) has proved to be an effective form of phototherapy with less erythemogenic effect compared to broad band UVB (BB-UVB) and less carcinogenic potential compared to PUVA. NB-UVB is therefore the first choice in treatment of pruritus associated with atopic dermatitis, psoriasis, urticaria, cutaneous T-cells lymphoma and prurigo. When no sufficient effect has been obtained by use of UVB, PUVA is recommended and in case of atopic dermatitis and T-cell lymphoma – UVA1 “cold light.” Pruritus associated with systemic diseases such as renal failure, cholestasis, hematologic malignancies, infections, endocrine diseases, use of drugs as well as pruritus of undetermined origin may be treated in the same way. Only in pruritus due to chronic renal failure, BB-UVB has been shown to be more effective than NB-UVB.

A course of NB-UVB and BB-UVB for pruritus is performed three times a week, PUVA twice a week for 6 weeks and UVA1 five times weekly for 3 weeks. For patients with pruritus, a less aggressive protocol- such as suggested for cutaneous lymphoma rather than the one for psoriasis- is used. As relapse is quite common after discontinuation, the patients may be offered maintenance therapy twice and then once weekly for another 6 weeks or longer.

Keywords

Phototherapy Pruritus NB UVB BB-UVB UVA1 PUVA Atopic dermatitis Psoriasis Urticaria Cutaneous T-cells lymphoma Prurigo Renal failure Cholestasis Hematologic malignancies HIV Pruritus of undetermined origin 

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© Springer-Verlag London 2016

Authors and Affiliations

  1. 1.Department of Clinical Sciences, Section of DermatologyLund University, Skane University HospitalLundSweden

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