Phototherapy in the management of childhood dermatoses

In the last decade, phototherapy, i.e. the use of ultraviolet light with or without a photosensitizer, has been routinely employed in the treatment of childhood dermatoses. With the advent of narrow-spectrum phototherapy emitting UVB wavelengths of 311 (±1) nm and PUVA baths, the use of phototherapy in pediatric patients has become by far safer and more efficient, while being associated with lower erythemogenic potential and longer period of remission. A review is presented of the basic mechanisms of phototherapy and photochemotherapy (PUVA), modes of administering these therapies in pediatric patients, and the main indications for this therapeutic option, with special reference to the management of psoriasis as the most common indication for phototherapy in children. It is emphasized that the use of phototherapy in children requires close cooperation with parents and high competence of the dermatologist-venereologist and other medical professionals engaged in therapy administration. The risk of skin cancer increases with the cumulative dosage of UVB radiation and PUVA therapies received during the lifetime. Therefore, it is of paramount importance to make an accurate indication for phototherapy in childhood, along with strict follow up of the cumulative UV dosage administered.

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