What are the AAD-NPF joint guidelines on the use of targeted UVB phototherapy to treat psoriasis?

Updated: Nov 20, 2020
  • Author: Jacquiline Habashy, DO, MSc; Chief Editor: William D James, MD  more...
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Answer

Targeted UVB phototherapy

The recommended targeted UVB phototherapy for adults with localized plaque psoriasis (< 10% body surface area), for individual plaque psoriasis lesions, or for patients with more extensive disease includes excimer 308-nm laser, excimer 308-nm light, and targeted NB-UVB 311- to 313-nm light.

For maximal efficacy, the recommended treatment frequency for targeted UVB phototherapy in adults with localized plaque psoriasis is 2-3 times per week, rather than once every 1-2 weeks.

In adults with localized plaque psoriasis, the initial dose of targeted UVB phototherapy is based on the minimal erythema dose or by a fixed-dose or skin-phototype protocol.

For treating localized plaque psoriasis in adults, the most effective targeted UVB phototherapy is excimer 308-nm laser, followed by excimer 308-nm light, followed by localized NB-UVB 311- to 312-nm light.

For adults with plaque psoriasis (including palmoplantar psoriasis), a recommended targeted UVB phototherapy includes excimer 308-nm laser and excimer 308-nm light.

Treatment of plaque psoriasis in adults with excimer 308-nm laser may be combined with topical steroid therapy.

A recommended targeted UVB phototherapy treatment for adults with scalp psoriasis is excimer 308-nm laser.

PUVA therapy

In the treatment of localized plaque psoriasis in adults, particularly those with palmoplantar psoriasis or palmoplantar pustular psoriasis, topical phototherapy with PUVA is deemed superior to NB-UVB 311- to 313-nm light.

A recommended treatment for psoriasis in adults is oral PUVA.

A recommended treatment for moderate-to-severe psoriasis in adults is bath PUVA.


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