Cool Down Before Initiation of Phototherapy

Abstract

It is critical for every phototherapy provider to know that extremely intense erythema, such as in the case of erythroderma, is a contraindication to any type of phototherapy. Phototherapy, in reality, is a “double-edged sword” as it can either help or aggravate inflammation. If an intensely inflamed patient were to receive phototherapy by error, the intensity of inflammation can become so severe to the point that the patient may have to be hospitalized with whole body edema, pain, and other complications. Therefore, in such a case, a “cool down” procedure is required. Liberal amounts of topical corticosteroids under plastic occlusion can be effective in reducing inflammation. Phototherapy should then be initiated at very low dose and the dose increased very carefully.