Patients with the skin disease psoriasis can be treated at home with light from an ultraviolet B lamp. This is just as effective and safe as light therapy given in hospital. The patients, however, find the home therapy more practical and pleasant. Dermatologists from University Medical Center (UMC) Utrecht describe this research in the British Medical Journal that was published on May 8, 2009. Up until now, many dermatologists (skin specialists) were not comfortable with the idea of patients handling their own treatment.
For the trial that was conducted for this research, Mayke Koek an epidemiologist from University Medical Center (UMC) Utrecht divided nearly two hundred psoriasis patients from fourteen hospitals into two groups. Patients in the group for home therapy were set up with an ultraviolet B phototherapy lamp at home. Subsequently, they were trained on its use by a nurse during a home visit. The patients were instructed to administer the therapy three or four times a week. Patients in the other group received the same treatment in the hospital outpatient setting. For this purpose, they had to visit the hospital three to four times a week.
After eight to ten weeks, Koek analyzed the effectiveness and safety of the treatment as well as the patient satisfaction. The treatment worked equally well in both groups – the severity of the psoriasis was greatly reduced in both groups. Safety was also found to be equally good in both groups. However, patients in the home therapy group found the treatment less taxing and were more satisfied with the treatment than those in the other group.
“Our results clearly show that home treatment with ultraviolet B lamps is a good alternative for the same treatment in hospital”, Koek states. “However, the current psoriasis guideline advises caution regarding the prescribing of phototherapy at home. We now think that the guideline should be adjusted accordingly.”
Koek says: “Phototherapy in hospital costs the patient a lot of time as well as the fact that it usually takes place during office hours. This is often a problem for people who are working. Providing phototherapy at home solves this problem and saves the patients both considerable time and inconvenience. Another important factor here is that in other countries, psoriasis patients who live in sparsely populated areas are often not able to undergo phototherapy because the distance to the hospital is too great. Home therapy therefore offers the ideal solution for these patients as well.”
This kind of home ultraviolet B therapy has been available since the 1970s. But because many dermatologists think that it is more risky – because any incorrect dosages could lead to more side effects occurring -- home treatment with phototherapy has never really got off the ground. Psoriasis is a very common skin disease that causes red, scaly patches on the skin that itch. In the Netherlands there are about 350,000 people with this chronic skin condition.
Mayke Koek conducted the study under the supervision of Dr Vigfús Sigurdsson and Professor Carla Bruijnzeel-Koomen from the Department of Dermatology at University Medical Center (UMC) Utrecht and Professor Erik Buskens from the Julius Center for Health Sciences and Primary Care and the University Medical Center Groningen (UMCG). The study was financed through a research grant from the Netherlands Organization for Health Research and Development (ZonMW).