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Indian Journal of Dermatology,... 2015The aim of these guidelines is to review the available published literature regarding the effectiveness of phototherapy and photochemotherapy in atopic dermatitis and... (Review)
Review
BACKGROUND
The aim of these guidelines is to review the available published literature regarding the effectiveness of phototherapy and photochemotherapy in atopic dermatitis and put forward recommendations regarding their use in atopic dermatitis.
MATERIALS AND METHODS
A literature search was performed to collect data from PubMed, EMBASE, and the Cochrane Library published till March 2014. Keywords used were "phototherapy", "photochemotherapy", "NB-UVB", "BBUVB", "PUVA", "UVA1", "atopic dermatitis", and "atopic eczema". Systematic reviews, meta-analysis, national guidelines, randomized controlled trials, prospective open label studies, and retrospective case series in English literature mentioning use of above-mentioned keywords were reviewed.
RESULTS
Six hundred and eighty eight studies were evaluated, 38 of which fulfilled the criteria for inclusion in the guidelines.
CONCLUSIONS AND RECOMMENDATIONS
Both UV1 and narrow-band UVB are effective in significantly decreasing the eczema severity although UV1 may be preferred in acute flares and narrow-band UVB in chronic eczema, especially in adults (Level of evidence 1+, Grade of recommendation A). Among various doses of UVA1, medium dose UVA1 may be preferred over others as its efficacy is similar to high dose and better than low dose UVA1 phototherapy. Narrow-band UVB is preferred to broad-band UVB (Level of evidence 1+, Grade of recommendation A). Medium-dose UVA1 is similar in efficacy to narrow-band UVB (Level of evidence 1+, Grade of recommendation A). In children, despite its efficacy, narrow-band UVB phototherapy should be used only as a second line therapy due to its potential for long-term adverse effects (Level of evidence 2+, Grade of recommendation B).
Topics: Dermatitis, Atopic; Humans; Photochemotherapy; Ultraviolet Therapy
PubMed: 25566890
DOI: 10.4103/0378-6323.148557 -
Cancer Letters Feb 2019Phototherapy is a non-invasive or minimally invasive therapeutic strategy. Immunotherapy uses different immunological approaches, such as antibodies, vaccines,... (Review)
Review
Phototherapy is a non-invasive or minimally invasive therapeutic strategy. Immunotherapy uses different immunological approaches, such as antibodies, vaccines, immunoadjuvants, and cytokines to stimulate the host immune system to fight against diseases. In cancer treatment, phototherapy not only destroys tumor cells, but also induces immunogenic tumor cell death to initiate a systemic anti-tumor immune response. When combined with immunotherapy, the effectiveness of phototherapy can be enhanced. Because of their special physical, chemical, and sometimes immunological properties, nanomaterials have also been used to enhance phototherapy. In this article, we review the recent progress in nanotechnology-based phototherapy, including nano-photothermal therapy, nano-photochemical therapy, and nano-photoimmunological therapy in cancer treatment. Specifically, we focus on the immunological responses induced by nano-phototherapies.
Topics: Animals; Humans; Immunotherapy; Nanomedicine; Neoplasms; Phototherapy
PubMed: 30476523
DOI: 10.1016/j.canlet.2018.10.044 -
Journal of the American Academy of... Feb 2021Phototherapy is a safe and effective treatment for many dermatologic conditions. With the advent of novel biologics and small molecule inhibitors, it is important to... (Review)
Review
Phototherapy is a safe and effective treatment for many dermatologic conditions. With the advent of novel biologics and small molecule inhibitors, it is important to critically evaluate the role of phototherapy in dermatology. Surveys have shown that many dermatology residency programs do not dedicate time to teaching residents how to prescribe or administer phototherapy. Limitations of phototherapy include access to a center, time required for treatments, and insurance approval. Home phototherapy, a viable option, is also underused. However, it should be emphasized that modern phototherapy has been in use for over 40 years, has an excellent safety profile, and does not require laboratory monitoring. It can be safely combined with many other treatment modalities, including biologics and small molecule inhibitors. In addition, phototherapy costs significantly less than these novel agents. Dermatologists are the only group of physicians who have the expertise and proper training to deliver this treatment modality to our patients. Therefore, to continue to deliver high-quality, cost-effective care, it is imperative that phototherapy be maintained as an integral part of the dermatology treatment armamentarium.
Topics: Biological Factors; Cost-Benefit Analysis; Dermatology; History, 20th Century; History, 21st Century; Humans; Phototherapy; Practice Patterns, Physicians'; Skin Diseases; Treatment Outcome
PubMed: 32339702
DOI: 10.1016/j.jaad.2020.04.095 -
Technology in Cancer Research &... 2023Carbonaceous nanomaterials (CNMs) have drawn tremendous biomedical research interest because of their unique structural features. Recently, CNMs, namely carbon dots,... (Review)
Review
Carbonaceous nanomaterials (CNMs) have drawn tremendous biomedical research interest because of their unique structural features. Recently, CNMs, namely carbon dots, fullerenes, graphene, etc, have been successful in establishing them as considerable nanotherapeutics for phototherapy applications due to their electrical, thermal, and surface properties. This review aims to crosstalk the current understanding of CNMs as multimodal compounds in photothermal and photodynamic therapies as an integrated approach to treating cancer. It also expounds on phototherapy's biomechanics and illustrates its relation to cancer biomodulation. Critical considerations related to the structural properties, fabrication approaches, surface functionalization strategies, and biosafety profiles of CNMs have been explained. This article provides an overview of the most recent developments in the study of CNMs used in phototherapy, emphasizing their usage as nanocarriers. To conquer the current challenges of CNMs, we can raise the standard of cancer therapy for patients. The review will be of interest to the researchers working in the area of photothermal and photodynamic therapies and aiming to explore CNMs and their conjugates in cancer therapy.
Topics: Humans; Phototherapy; Nanostructures; Carbon; Photochemotherapy; Neoplasms
PubMed: 37461375
DOI: 10.1177/15330338231186388 -
Dermatology Online Journal Dec 2010Outpatient phototherapy is a safe, effective, and low-cost treatment modality for moderate to severe psoriasis. Barriers to outpatient phototherapy including patient... (Review)
Review
BACKGROUND
Outpatient phototherapy is a safe, effective, and low-cost treatment modality for moderate to severe psoriasis. Barriers to outpatient phototherapy including patient inconvenience, patient co-pays, decreased physician compensation, and insurance disincentive structures have led to decreased use and underutilization of phototherapy. Home phototherapy can potentially overcome many of the barriers associated with outpatient treatment but is not widely used because of concerns over safety and efficacy, lack of resident and physician education, and lack of insurance coverage.
PURPOSE
The purpose of this study is to review the use of phototherapy with emphasis on the safety, efficacy, and practical use of home phototherapy.
METHODS
A comprehensive Pubmed literature search was done using the keywords NB-UVB, narrowband UVB, BB-UVB, broadband UVB, PUVA, psoralen and UVA, UVA, history of phototherapy, mechanism of phototherapy, phototherapy in dermatology, home phototherapy, and phototherapy for psoriasis. All relevant articles were reviewed.
CONCLUSIONS
Home NB-UVB phototherapy can be as safe, effective, and cost-effective as outpatient phototherapy. Further, home UVB is more convenient for patients, has higher patient satisfaction, and a lower treatment burden compared to outpatient phototherapy. Home NB-UVB should be considered as a treatment option for patients eligible for phototherapy.
Topics: Contraindications; Cost Control; Female; Home Nursing; Humans; Male; Multicenter Studies as Topic; Neoplasms, Radiation-Induced; Office Visits; PUVA Therapy; Patient Education as Topic; Patient Satisfaction; Photosensitizing Agents; Phototherapy; Psoriasis; Randomized Controlled Trials as Topic; Skin Neoplasms; Treatment Outcome
PubMed: 21199628
DOI: No ID Found -
Dermatologic Clinics Oct 2015Therapies based on ultraviolet light have long been established in mycosis fungoides (MF). They have traditionally included whole-body ultraviolet light B, both... (Review)
Review
Therapies based on ultraviolet light have long been established in mycosis fungoides (MF). They have traditionally included whole-body ultraviolet light B, both broad-band and narrow-band, and psoralen plus ultraviolet A. Phototherapy may be applied alone in early stage MF or in combination with systemic therapy in refractory early stage MF and advanced MF. This article reviews the most frequently used forms of phototherapy for MF with emphasis on efficacy, safety, and practical considerations.
Topics: Humans; Mycosis Fungoides; PUVA Therapy; Phototherapy; Skin Neoplasms; Treatment Outcome; Ultraviolet Therapy
PubMed: 26433842
DOI: 10.1016/j.det.2015.05.005 -
Physiological Research Dec 2022Phototherapy is the most effective non-invasive method of neonatal hyperbilirubinemia treatment. Application of this method can be associated with side effects including... (Review)
Review
Phototherapy is the most effective non-invasive method of neonatal hyperbilirubinemia treatment. Application of this method can be associated with side effects including changes in the cardiovascular system. During phototherapy, the primary effects in the cardiovascular system include cutaneous vasodilation leading to skin hyperperfusion and subsequent redistribution of blood. The increased blood flow through the skin is associated with increased transepidermal water loss. Further effects include an increase in cerebral blood flow. Redistribution of blood to the cutaneous bed is compensated by hypoperfusion in the splanchnic area (mostly postprandial) and a significant reduction of the renal blood flow. Regarding closure/reopening of the ductus arteriosus, the results suggest that that phototherapy does not affect ductal patency. During phototherapy the cardiac output can be slightly reduced due to a decreased stroke volume, especially in preterm newborns. Systemic blood pressure is decreased and heart rate is elevated in both preterm and term newborns during phototherapy. The heart rate variability is slightly reduced. Symbolic dynamics analysis of the short-term HRV showed that during phototherapy the activity of the ANS regulating the heart rate is shifted towards the dominancy of the sympathetic activity. The responses in the cardiovascular system of premature/mature newborns without other pathology confirm a well physiologically functioning control of this system, even under specific conditions of phototherapy.
Topics: Infant, Newborn; Humans; Heart; Ductus Arteriosus, Patent; Cardiac Output; Phototherapy
PubMed: 36647906
DOI: 10.33549/physiolres.935002 -
Indian Journal of Dermatology,... 2015Both phototherapy and photochemotherapy have been used in all stages of mycosis fungoides since they improve the symptoms and have a favourable adverse effect profile. (Review)
Review
BACKGROUND
Both phototherapy and photochemotherapy have been used in all stages of mycosis fungoides since they improve the symptoms and have a favourable adverse effect profile.
MATERIALS AND METHODS
We performed an extensive search of published literature using keywords like "phototherapy", "photochemotherapy", "NBUVB", "PUVA", "UVA1", "mycosis fungoides", and "Sezary syndrome", and included systematic reviews, meta-analysis, national guidelines, randomized controlled trials (RCTs), prospective open label studies, and retrospective case series. These were then arranged according to their levels of evidence.
RESULTS
Five hundred and forty three studies were evaluated, of which 107 fulfilled the criteria for inclusion in the guidelines.
CONCLUSIONS AND RECOMMENDATIONS
Photochemotherapy in the form of psoralens with ultraviolet A (PUVA) is a safe, effective, and well tolerated first line therapy for the management of early stage mycosis fungoides (MF), that is, stage IA, IB, and IIA (Level of evidence 1+, Grade of recommendation B). The evidence for phototherapy in the form of narrow-band UVB (NB-UVB) is less robust (Level of evidence 2++, Grade of recommendation B) but may be considered at least as effective as PUVA in the treatment of early-stage MF as an initial therapy. In patients with patches and thin plaques, NB-UVB should be preferentially used. PUVA may be reserved for patients with thick plaques and those who relapse after initial NB-UVB therapy. For inducing remission, three treatment sessions per week of PUVA phototherapy or three sessions per week of NB-UVB phototherapy may be advised till the patient achieves complete remission. In cases of relapse, patients may be started again on PUVA monotherapy or PUVA may be combined with adjuvants like methotrexate and interferon (Level of evidence 2+, Grade of recommendation B). Patients with early-stage MF show good response to combination treatments like PUVA with methotrexate, bexarotene or interferon-α-2b. However, whether these combinations hold a significant advantage over monotherapy is inconclusive. For late stage MF, the above-mentioned combination therapy may be used as first-line treatment (Level of evidence 3, Grade of recommendation C). Currently, there is no consensus regarding maintenance therapy with phototherapy once remission is achieved. Maintenance therapy should not be employed for PUVA routinely and may be reserved for patients who experience an early relapse after an initial course of phototherapy (Level of evidence 2+, Grade of recommendation B). Bath-water PUVA may be tried as an alternative to oral PUVA in case the latter cannot be administered as the former may show similar efficacy (Level of evidence 2-, Grade of recommendation C). In pediatric MF and in hypopigmented MF, both NB-UVB and PUVA may be tried (Level of evidence 3, Grade of recommendation D).
Topics: Humans; Mycosis Fungoides; PUVA Therapy; Phototherapy; Prospective Studies; Randomized Controlled Trials as Topic; Retrospective Studies; Skin Neoplasms; Ultraviolet Therapy
PubMed: 25751327
DOI: 10.4103/0378-6323.152169 -
Indian Journal of Dermatology,... 2010The concept of phototherapy and photochemotherapy is not new, and sophisticated ultraviolet (UV) treatment modalities are available for almost three decades. However,... (Review)
Review
The concept of phototherapy and photochemotherapy is not new, and sophisticated ultraviolet (UV) treatment modalities are available for almost three decades. However, phototherapy has not been used in children as extensively as in adults, probably due to long-term safety concerns. Photochemotherapy (psoralen plus UVA) is not considered to be safe in the younger age group. UV therapies can be useful treatment options for children with selected dermatological conditions provided they are used under carefully controlled conditions. Presently there is insufficient data available to provide recommendations regarding the safe maximum dose and duration of phototherapy in children. Developments of new UV delivery systems and devices are aimed at improving the safety and efficacy of phototherapy. In this review, we discuss the published literature on phototherapy and photochemotherapy in children, drawbacks of their use in pediatric population and future prospects.
Topics: Child; Contraindications; Humans; India; Photochemotherapy; Phototherapy; Skin Diseases
PubMed: 20826991
DOI: 10.4103/0378-6323.69074 -
Dalton Transactions (Cambridge, England... Sep 2022Phototherapy, the use of light to selectively ablate cancerous tissue, is a compelling prospect. Phototherapy is divided into two major domains: photodynamic and... (Review)
Review
Phototherapy, the use of light to selectively ablate cancerous tissue, is a compelling prospect. Phototherapy is divided into two major domains: photodynamic and photothermal, whereby photosensitizer irradiation generates reactive oxygen species or heat, respectively, to disrupt the cancer microenvironment. Phthalocyanines (Pcs) are prominent phototherapeutics due to their desirable optical properties and structural versatility. Targeting of Pc photosensitizers historically relied on the enhanced permeation and retention effect, but the weak specificity engendered by this approach has hindered bench-to-clinic translation. To improve specificity, antibody and peptide active-targeting groups have been employed to some effect. An alternative targeting method exploits the binding of anticancer drugs to direct the photosensitizer close to essential cellular components, allowing for precise, synergistic phototherapy. This Perspective explores the use of Pc-drug conjugates as targeted anticancer phototherapeutic systems with examples of Pc-platin, Pc-kinase, and Pc-anthracycline conjugates discussed in detail.
Topics: Antineoplastic Agents; Cell Line, Tumor; Humans; Indoles; Isoindoles; Nanoparticles; Neoplasms; Photochemotherapy; Photosensitizing Agents; Phototherapy; Tumor Microenvironment
PubMed: 36018269
DOI: 10.1039/d2dt02040h