From the academy
Joint American Academy of Dermatology–National Psoriasis Foundation guidelines of care for the management and treatment of psoriasis with phototherapy

https://doi.org/10.1016/j.jaad.2019.04.042Get rights and content

Psoriasis is a chronic inflammatory disease involving multiple organ systems and affecting approximately 3.2% of the world's population. In this section of the guidelines of care for psoriasis, we will focus the discussion on ultraviolet (UV) light–based therapies, which include narrowband and broadband UVB, UVA in conjunction with photosensitizing agents, targeted UVB treatments such as with an excimer laser, and several other modalities and variations of these core phototherapies, including newer applications of pulsed dye lasers, intense pulse light, and light-emitting electrodes. We will provide an in-depth, evidence-based discussion of efficacy and safety for each treatment modality and provide recommendations and guidance for the use of these therapies alone or in conjunction with other topical and/or systemic psoriasis treatments.

Key words

climatotherapy
Goeckerman
grenz ray
intense pulsed dye laser
narrowband ultraviolet light A (NB-UVA)
narrowband ultraviolet light B (NB-UVB)
photochemotherapy
photodynamic therapy
phototherapy
psoralen ultraviolet light A
psoriasis
pulsed dye laser
PUVA (topical
bath
oral)
visible light

Abbreviations used

ALA
5-aminolevulinic acid
BB
broadband
BSA
body surface area
FAE
fumaric acid ester
IPL
intense pulsed light
MAL
methyl aminolevulinic acid
MED
minimal erythema dose
8-MOP
methoxypsoralen
MTX
methotrexate
NAPSI
Nail Psoriasis Severity Index
NB
narrowband
PASI
Psoriasis Area and Severity Index
PASI 75
75% improvement in Psoriasis Area and Severity Index score
PASI 90
90% improvement in Psoriasis Area and Severity Index score
PDL
pulsed dye laser
PDT
photodynamic therapy
PpIX
protoporphyrin IX
PUVA
psoralen plus ultraviolet A
QoL
quality of life
RCT
randomized controlled trial
SAPASI
Self-Administered Psoriasis Area Severity Index
TMP
trimethylpsoralen
UV
ultraviolet
UVA
ultraviolet A
UVB
ultraviolet B

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Funding sources: None.

Conflicts of interest: Listed in text.

Reprints not available from the authors.

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