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Psoriasis: General principles for phototherapy

  • All patients who are considered for treatment with phototherapy or photochemotherapy must have a complete history and physical examination.
  • Patients with a known history of lupus erythematosus or xeroderma pigmentosum should not be treated with phototherapy or photochemotherapy.
  • Patients with a history of a photosensitivity disorder, taking photosensitizing medications, with a history of melanoma, with atypical nevi, with multiple risk factors for melanoma, with multiple nonmelanoma skin cancers, or who are immunosuppressed as a result of organ transplantation should be screened carefully before initiating phototherapy or photochemotherapy.
  • They should also be advised that adherence to their follow-up visits is imperative to obtaining maximal results.
  • Office phototherapy and photochemotherapy should be performed under the direction of a dermatologist with the appropriate training and expertise.
  • Experts recommend that patients be examined approximately once a month or more often if necessary, although specific data on the frequency of evaluations during phototherapy or photochemotherapy are lacking.
  • Each patient’s treatment should be closely monitored by a nurse or phototherapy technician with proper training, and any abnormal findings should be transmitted to the treating dermatologist.
  • All phototherapy equipment should be maintained and regularly calibrated by appropriately trained personnel.
  • Accurate records of the dosage and number of treatments along with any side effects should be maintained for every patient.

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