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A retrospective review of phototherapy in children, at a tertiary paediatric dermatology unit

A retrospective review of phototherapy in children, at a tertiary paediatric dermatology unit
A retrospective review of phototherapy in children, at a tertiary paediatric dermatology unit

Background/Purpose: To examine the efficacy, tolerability and safety of phototherapy in children, in whom there is currently a paucity of data. Materials and Methods: Retrospective review of children under 18 years who received narrowband UVB (NB-UVB), broadband UVB (BB-UVB) phototherapy or psoralen with UVA (PUVA) photochemotherapy between 2003 and 2017 at a tertiary Paediatric dermatology centre in Southampton, UK. Results: 100 children aged 6-17 years were included. The majority of children had psoriasis (74), atopic dermatitis (10) or vitiligo (8), with others having rarer dermatoses. Grade 2 erythema or above occurred in 46% of all included children and 42% (36/86) of those receiving NB-UVB; however, grade 3 and 4 reactions were infrequent and only 3 children stopped treatment due to burning. NB-UVB was particularly effective in those with psoriasis; 55/65 (85%) significantly improved, and 72% had not relapsed after 2 years. However, its effectiveness in atopic dermatitis was less convincing; in a small group of children, 6/10 (60%) significantly improved, but 66% relapsed within 3 months. Conclusions: Our analysis demonstrates that NB-UVB is effective in children with psoriasis and vitiligo, with potential to achieve extended periods of remission in psoriasis. Its usefulness in atopic dermatitis is less clear. The long-term safety of NB-UVB in children is still unknown, but it appears to be a well-tolerated treatment and should be considered in children for a variety of inflammatory dermatoses before progressing to immunosuppressive therapies.

Ultraviolet A, Ultraviolet B, children, phototherapy
Seccombe, Ella
c94bccb0-633b-4f23-af74-a9fce172cf12
Department, University Hospital Southampton
086dea97-9e3f-424f-b046-fd9e0c038fa4
Wynne, Matthew David
620bb4c3-3368-4977-b7e8-c39cf1f3c363
Clancy, Cornelius
0c4c1b55-2684-4729-a684-77b18fa2f6b2
Godfrey, Keith
0931701e-fe2c-44b5-8f0d-ec5c7477a6fd
Fityan, Adam
fd9c1bbc-6bfb-49fb-9cb6-f9a16f8595f8
Seccombe, Ella
c94bccb0-633b-4f23-af74-a9fce172cf12
Department, University Hospital Southampton
086dea97-9e3f-424f-b046-fd9e0c038fa4
Wynne, Matthew David
620bb4c3-3368-4977-b7e8-c39cf1f3c363
Clancy, Cornelius
0c4c1b55-2684-4729-a684-77b18fa2f6b2
Godfrey, Keith
0931701e-fe2c-44b5-8f0d-ec5c7477a6fd
Fityan, Adam
fd9c1bbc-6bfb-49fb-9cb6-f9a16f8595f8

Seccombe, Ella, Department, University Hospital Southampton, Wynne, Matthew David, Clancy, Cornelius, Godfrey, Keith and Fityan, Adam (2020) A retrospective review of phototherapy in children, at a tertiary paediatric dermatology unit. Photodermatology, Photoimmunology & Photomedicine. (doi:10.1111/phpp.12604).

Record type: Article

Abstract

Background/Purpose: To examine the efficacy, tolerability and safety of phototherapy in children, in whom there is currently a paucity of data. Materials and Methods: Retrospective review of children under 18 years who received narrowband UVB (NB-UVB), broadband UVB (BB-UVB) phototherapy or psoralen with UVA (PUVA) photochemotherapy between 2003 and 2017 at a tertiary Paediatric dermatology centre in Southampton, UK. Results: 100 children aged 6-17 years were included. The majority of children had psoriasis (74), atopic dermatitis (10) or vitiligo (8), with others having rarer dermatoses. Grade 2 erythema or above occurred in 46% of all included children and 42% (36/86) of those receiving NB-UVB; however, grade 3 and 4 reactions were infrequent and only 3 children stopped treatment due to burning. NB-UVB was particularly effective in those with psoriasis; 55/65 (85%) significantly improved, and 72% had not relapsed after 2 years. However, its effectiveness in atopic dermatitis was less convincing; in a small group of children, 6/10 (60%) significantly improved, but 66% relapsed within 3 months. Conclusions: Our analysis demonstrates that NB-UVB is effective in children with psoriasis and vitiligo, with potential to achieve extended periods of remission in psoriasis. Its usefulness in atopic dermatitis is less clear. The long-term safety of NB-UVB in children is still unknown, but it appears to be a well-tolerated treatment and should be considered in children for a variety of inflammatory dermatoses before progressing to immunosuppressive therapies.

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Accepted/In Press date: 15 August 2020
e-pub ahead of print date: 29 August 2020
Additional Information: Publisher Copyright: © 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
Keywords: Ultraviolet A, Ultraviolet B, children, phototherapy

Identifiers

Local EPrints ID: 443613
URI: http://eprints.soton.ac.uk/id/eprint/443613
PURE UUID: 41e3bdab-97ef-47dc-b4d3-37a273140716
ORCID for Keith Godfrey: ORCID iD orcid.org/0000-0002-4643-0618

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Date deposited: 04 Sep 2020 16:32
Last modified: 13 Aug 2022 04:10

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Contributors

Author: Ella Seccombe
Author: University Hospital Southampton Department
Author: Matthew David Wynne
Author: Cornelius Clancy
Author: Keith Godfrey ORCID iD
Author: Adam Fityan

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