Problemi non correnti
Fototerapia con raggi ultravioletti in dermatologia pediatrica
PHOTOTHERAPY WITH ULTRAVIOLET RAYS IN PAEDIATRIC DERMATOLOGY
VITO DI LERNIA
Struttura Complessa di Dermatologia, Arcispedale Santa Maria Nuova, Azienda Ospedaliera di Reggio Emilia
Aprile 2007 - pagg. 237 -241
Abstract
Phototherapy consists in using artificial ultraviolet rays to treat chronic or chronic–recidivant dermatosis. It can be performed by adding exogenous photo-senisibilizers (PUVA and bath-PUVA) or without adding them (UBV). The latter possibility, in particular phototherapy with narrow band UBV rays, thanks to a favourable benefits/risks ratio, can be carried out with the due cautions also in paediatric age. In particular it may represent a useful therapeutic choice in psoriasis, atopical dermatitis and in vitiligo. In psoriasis the treatment can be performed in case of a diffused area, when the usage of topicals becomes problematic. In atopical dermatitis, especially in sub-acute and chronic cases, phototherapy with UVB, besides reducing itching, can have beneficial effects on the barrier function of cutis. At present it represents the first class treatment though it requires prolonged treatment cycles in generalised vitiligo. Although at the moment an increase in carcinogenic risks in the patients treated with UVB has not been demonstrated, like in all medical treatments, the usage of phototherapy requires, considering the habitually prolonged treatment and the chronicity of the treated pathologies, a careful evaluation of the risks/benefits ratio.
Parole chiave
Suggerite dall'AI
Classificazione MeSH
Bibliografia
1. Abdulla FR, Feldman SR, Williford PM,
Krowchuk D, Kaur M. Tanning and skin cancer.
Pediatr Dermatol 2005;22:501-12.
2. Parrish JA, Fitzpatrick TB, Tanenbaum L, Pathak MA. Photochemotherapy of psoriasis with oral methoxsalen and longwave ultraviolet light. N Engl J Med 1974;291:1207-11.
3. Rudikoff D, Lebowl M. Atopic dermatitis. Lancet 1998;351:1715-21.
4. Krutmann J, Czech W, Diepgen T, et al. High- dose UVA1 therapy in the treatment of patients with atopic dermatitis. J Am Acad Dermatol 1992;26:225-30.
5. Larko O. Treatment of psoriasis with a new UVB lamp. Acta Derm Venereol 1989;69:357-9
6. Pasic A, Ceovic R, Lipozencic J, et al. Phototherapy in pediatric patients. Pediatr Dermatol 2003;20:71-7.
7. Tay YK, Morelli JG, Weston WL. Experience with UVB phototherapy in children. Pediatr Dermatol 1996;13:406-9.
8. Darsow U, Lubbe J, Taieb A, et al. Position paper on diagnosis and treatment of atopic dermatitis. JEADV 2005;19:296-95.
9. Brazzelli V, Prestinari F, Castello M, et al. Useful tretment of vitiligo in 10 children with UV-B narrowband (311 nm). Pediatr Dermatol 2005;22:257-61.
10. Kanwar AJ, Dogra S. Narrow-band UVB for the treatment of generalized vitiligo in children. Clin Exp Dermatol 2005;30:332-6.
11. Njoo MD, Bos JD, Westerhof W. Treatment of generalized vitiligo in children with narrowband (TL-01) UVB radiation therapy. J Am Acad Dermatol 2000;42:245-53.
12. Njoo MD, Spuls PI, Bos JD, et al. Non-surgical repigmentation therapies in vitiligo. Arch Dermatol 1998;34:1532-40.
13. Fry A, Verne J. Preventing skin cancer. BMJ 2003;326:114-5.
14. Matsumura Y, Ananthaswamy HN. Molecular mechanism of photocarcinogenesis. Front Biosci 2002:7:765-83.
15. Naldi L, Imberti GL, Parazzini F, et al. Pigmentary traits, modality of sun reaction, history of sunburns, and melanocytic nevi as risk factors for cutaneous malignant melanoma in the Italian population. Cancer 2000;88:2703- 10.
16. Forman AB. Long-term follow-up of skin cancer in the PUVA 48 cooperative study. Arch Dermatol 1989;125:152-6.
17. Lee E, Koo J, Berger T. UVB phototherapy and skin cancer risk: a review of the literature. Int J Dermatol 2005;44:355-60.
18. Young AR. Tanning devices - Fast Track to skin cancer? Pigment Cell Res 2004;17:2-9.
2. Parrish JA, Fitzpatrick TB, Tanenbaum L, Pathak MA. Photochemotherapy of psoriasis with oral methoxsalen and longwave ultraviolet light. N Engl J Med 1974;291:1207-11.
3. Rudikoff D, Lebowl M. Atopic dermatitis. Lancet 1998;351:1715-21.
4. Krutmann J, Czech W, Diepgen T, et al. High- dose UVA1 therapy in the treatment of patients with atopic dermatitis. J Am Acad Dermatol 1992;26:225-30.
5. Larko O. Treatment of psoriasis with a new UVB lamp. Acta Derm Venereol 1989;69:357-9
6. Pasic A, Ceovic R, Lipozencic J, et al. Phototherapy in pediatric patients. Pediatr Dermatol 2003;20:71-7.
7. Tay YK, Morelli JG, Weston WL. Experience with UVB phototherapy in children. Pediatr Dermatol 1996;13:406-9.
8. Darsow U, Lubbe J, Taieb A, et al. Position paper on diagnosis and treatment of atopic dermatitis. JEADV 2005;19:296-95.
9. Brazzelli V, Prestinari F, Castello M, et al. Useful tretment of vitiligo in 10 children with UV-B narrowband (311 nm). Pediatr Dermatol 2005;22:257-61.
10. Kanwar AJ, Dogra S. Narrow-band UVB for the treatment of generalized vitiligo in children. Clin Exp Dermatol 2005;30:332-6.
11. Njoo MD, Bos JD, Westerhof W. Treatment of generalized vitiligo in children with narrowband (TL-01) UVB radiation therapy. J Am Acad Dermatol 2000;42:245-53.
12. Njoo MD, Spuls PI, Bos JD, et al. Non-surgical repigmentation therapies in vitiligo. Arch Dermatol 1998;34:1532-40.
13. Fry A, Verne J. Preventing skin cancer. BMJ 2003;326:114-5.
14. Matsumura Y, Ananthaswamy HN. Molecular mechanism of photocarcinogenesis. Front Biosci 2002:7:765-83.
15. Naldi L, Imberti GL, Parazzini F, et al. Pigmentary traits, modality of sun reaction, history of sunburns, and melanocytic nevi as risk factors for cutaneous malignant melanoma in the Italian population. Cancer 2000;88:2703- 10.
16. Forman AB. Long-term follow-up of skin cancer in the PUVA 48 cooperative study. Arch Dermatol 1989;125:152-6.
17. Lee E, Koo J, Berger T. UVB phototherapy and skin cancer risk: a review of the literature. Int J Dermatol 2005;44:355-60.
18. Young AR. Tanning devices - Fast Track to skin cancer? Pigment Cell Res 2004;17:2-9.
Corrispondenza: vito.dilernia@asmn.re.it