Phototherapy and Photochemotherapy

  • James L. Griffith
  • Allison J. Zarbo
  • Henry W. LimEmail author
Part of the Updates in Clinical Dermatology book series (UCD)


Phototherapy and photochemotherapy have remained cornerstones in the management of psoriasis and other cutaneous conditions for more than 3000 years. Currently, ultraviolet (UV)-based therapy is one of the first-line therapies for psoriasis due to its high response rate, relative low cost, and minimal generalized immunosuppression compared to other systemic therapies. This chapter will outline the basic principles of photomedicine and photochemistry before delving into the evidence behind the use of current and emerging UV, laser, and light therapies in psoriasis. Practical considerations, such as their indications, contraindications, administration, combination therapies, relevant adverse effects, and application in special populations (pregnancy, pediatrics, and those without access to in-office treatment), will also be discussed.


Phototherapy Photochemotherapy Psoriasis Blue light Narrowband ultraviolet B (NB-UVB) Psoralen plus ultraviolet A (PUVA) Goeckerman Pulsed dye laser (PDL) Intense pulsed light (IPL) Photodynamic therapy (PDT) 


  1. 1.
    Fitzpatrick TB, Pathak MA. Historical aspects of methoxsalen and other furocoumarins. J Invest Dermatol. 1959;32(2, Part 2):229–31.PubMedCrossRefPubMedCentralGoogle Scholar
  2. 2.
    Goeckerman WH. Treatment of psoriasis. Northwest Med. 1925;24:229–31.Google Scholar
  3. 3.
    Ingram JT. The approach to psoriasis. Br Med J. 1953;2(4836):591–4.PubMedPubMedCentralCrossRefGoogle Scholar
  4. 4.
    Ingram JT. The significance and management of psoriasis. Br Med J. 1954;2(4892):823–8.PubMedPubMedCentralCrossRefGoogle Scholar
  5. 5.
    Fahmy IR, Abu-Shady H, Schönberg A, Sina A. A crystalline principle from Ammi majus L. Nature. 1947;160:468–9.PubMedCrossRefPubMedCentralGoogle Scholar
  6. 6.
    Fahmy IR, Abu-Shady H. Ammi majus Linn: pharmacognostical study and isolation of a crystalline constituent, ammoidin. Q J Pharm Pharmacol. 1947;20:281–91.PubMedPubMedCentralGoogle Scholar
  7. 7.
    Parrish JA, Fitzpatrick TB, Tanenbaum L, Pathak MA. Photochemotherapy of psoriasis with oral methoxsalen and longwave ultraviolet light. N Engl J Med. 1974;291(23):1207–11.PubMedCrossRefPubMedCentralGoogle Scholar
  8. 8.
    Roelandts R. History of human photobiology. In: Lim HW, Hönigsmann H, Hawk JLM, editors. Photodermatology. New York: Informa Healthcare USA, Inc.; 2007. p. 1–14.Google Scholar
  9. 9.
    van Weelden H, De La Faille HB, Young E, van der Leun JC. A new development in UVB phototherapy of psoriasis. Br J Dermatol. 1988;119(1):11–9.PubMedCrossRefPubMedCentralGoogle Scholar
  10. 10.
    Green C, Ferguson J, Lakshmipathi T, Johnson BE. 311 nm UVB phototherapy—an effective treatment for psoriasis. Br J Dermatol. 1988;119(6):691–6.PubMedCrossRefPubMedCentralGoogle Scholar
  11. 11.
    Menter A, Korman NJ, Elmets CA, Feldman SR, Gelfand JM, Gordon KB, et al. Guidelines of care for the management of psoriasis and psoriatic arthritis: Section 5. Guidelines of care for the treatment of psoriasis with phototherapy and photochemotherapy. J Am Acad Dermatol. 2010;62(1):114–35.PubMedCrossRefPubMedCentralGoogle Scholar
  12. 12.
    Almutawa F, Thalib L, Hekman D, Sun Q, Hamzavi I, Lim HW. Efficacy of localized phototherapy and photodynamic therapy for psoriasis: a systematic review and meta-analysis. Photodermatol Photoimmunol Photomed. 2015;31(1):5–14.PubMedCrossRefPubMedCentralGoogle Scholar
  13. 13.
    Maranda EL, Nguyen AH, Lim VM, Hafeez F, Jimenez JJ. Laser and light therapies for the treatment of nail psoriasis. J Eur Acad Dermatol Venereol. 2016;30(8):1278–84.PubMedCrossRefPubMedCentralGoogle Scholar
  14. 14.
    Anders A, Altheide HJ, Knalmann M, Tronnier H. Action spectrum for erythema in humans investigated with dye lasers. Photochem Photobiol. 1995;61(2):200–5.PubMedCrossRefPubMedCentralGoogle Scholar
  15. 15.
    Diffey BL. Observed and predicted minimal erythema doses: a comparative study. Photochem Photobiol. 1994;60(4):380–2.PubMedCrossRefPubMedCentralGoogle Scholar
  16. 16.
    CIE Standard. Erythema reference action spectrum and standard erythema dose. CIE S 007/E-1998.1998; Vienna: Commission Internationale de l’Eclairage.Google Scholar
  17. 17.
    Young AR, Chadwick CA, Harrison GI, Nikaido O, Ramsden J, Potten CS. The similarity of action spectra for thymine dimers in human epidermis and erythema suggests that DNA is the chromophore for erythema. J Invest Dermatol. 1998;111(6):982–8.PubMedCrossRefPubMedCentralGoogle Scholar
  18. 18.
    McLoone P, Simics E, Barton A, Norval M, Gibbs NK. An action spectrum for the production of cis-urocanic acid in human skin in vivo. J Invest Dermatol. 2005;124(5):1071–4.PubMedCrossRefPubMedCentralGoogle Scholar
  19. 19.
    de Gruijl FR. Action spectrum for photocarcinogenesis. Recent Results Cancer Res. 1995;139:21–30.PubMedCrossRefPubMedCentralGoogle Scholar
  20. 20.
    CIE 132/2; TC 6-32 report: action spectrum for photocarcinogenesis (non-melanoma skin cancers). Commission Internationale de l’Eclairage; 2000; Vienna.Google Scholar
  21. 21.
    Irwin C, Barnes A, Veres D, Kaidbey K. An ultraviolet radiation action spectrum for immediate pigment darkening. Photochem Photobiol. 1993;57(3):504–7.PubMedCrossRefPubMedCentralGoogle Scholar
  22. 22.
    Calzavara-Pinton PG, Venturini M, Sala R. Photodynamic therapy: update 2006. Part 1: Photochemistry and photobiology. J Eur Acad Dermatol Venereol. 2007;21(3):293–302.PubMedCrossRefPubMedCentralGoogle Scholar
  23. 23.
    Mahmoud BH, Ruvolo E, Hexsel CL, Liu Y, Owen MR, Kollias N, et al. Impact of long-wavelength UVA and visible light on melanocompetent skin. J Invest Dermatol. 2010;130(8):2092–7.PubMedCrossRefPubMedCentralGoogle Scholar
  24. 24.
    Weinstabl A, Hoff-Lesch S, Merk HF, von Felbert V. Prospective randomized study on the efficacy of blue light in the treatment of psoriasis vulgaris. Dermatology. 2011;223(3):251–9.PubMedCrossRefPubMedCentralGoogle Scholar
  25. 25.
    Pfaff S, Liebmann J, Born M, Merk HF, von Felbert V. Prospective randomized long-term study on the efficacy and safety of UV-free blue light for treating mild psoriasis vulgaris. Dermatology. 2015;231(1):24–34.PubMedCrossRefPubMedCentralGoogle Scholar
  26. 26.
    Kleinpenning MM, Otero ME, van Erp PE, Gerritsen MJ, van de Kerkhof PC. Efficacy of blue light vs. red light in the treatment of psoriasis: a double-blind, randomized comparative study. J Eur Acad Dermatol Venereol. 2012;26(2):219–25.PubMedCrossRefPubMedCentralGoogle Scholar
  27. 27.
    Awakowicz P, Bibinov N, Born M, Busse B, Gesche R, Helmke A, et al. Biological stimulation of the human skin applying health promoting light and plasma sources. Contrib Plasma Physics. 2009;49:641–7.CrossRefGoogle Scholar
  28. 28.
    Spencer JM, Hadi SM. The excimer lasers. J Drugs Dermatol. 2004;3(5):522–5.PubMedPubMedCentralGoogle Scholar
  29. 29.
    Bulat V, Situm M, Dediol I, Ljubicic I, Bradic L. The mechanisms of action of phototherapy in the treatment of the most common dermatoses. Coll Antropol. 2011;35(Suppl 2):147–51.PubMedPubMedCentralGoogle Scholar
  30. 30.
    Wong T, Hsu L, Liao W. Phototherapy in psoriasis: a review of mechanisms of action. J Cutan Med Surg. 2013;17(1):6–12.PubMedCrossRefPubMedCentralGoogle Scholar
  31. 31.
    Tartar D, Bhutani T, Huynh M, Berger T, Koo J. Update on the immunological mechanism of action behind phototherapy. J Drugs Dermatol. 2014;13(5):564–8.PubMedPubMedCentralGoogle Scholar
  32. 32.
    Diffey BL, Kochevar IE. Basic principles of photobiology. In: Lim HW, Hönigsmann H, Hawk JLM, editors. Photodermatology. New York: Informa Healthcare USA, Inc.; 2007. p. 15–28.Google Scholar
  33. 33.
    NCGC. Psoriasis: assessment and management of psoriasis. National Institute for Health and Clinical Excellence (NICE): Guidance. London: Royal College of Physicians; 2012.Google Scholar
  34. 34.
    Pathirana D, Ormerod AD, Saiag P, Smith C, Spuls PI, Nast A, et al. European S3-guidelines on the systemic treatment of psoriasis vulgaris. J Eur Acad Dermatol Venereol. 2009;23(Suppl 2):1–70.PubMedCrossRefPubMedCentralGoogle Scholar
  35. 35.
    Kerstein RL, Lister T, Cole R. Laser therapy and photosensitive medication: a review of the evidence. Lasers Med Sci. 2014;29(9):1449–52.PubMedCrossRefPubMedCentralGoogle Scholar
  36. 36.
    Berne B, Blom I, Spangberg S. Enhanced response of psoriasis to UVB therapy after pretreatment with a lubricating base. A single-blind controlled study. Acta Derm Venereol. 1990;70(6):474–7.PubMedPubMedCentralGoogle Scholar
  37. 37.
    Fetil E, Akarsu S, Ilknur T, Kusku E, Gunes AT. Effects of some emollients on the transmission of ultraviolet. Photodermatol Photoimmunol Photomed. 2006;22(3):137–40.PubMedCrossRefPubMedCentralGoogle Scholar
  38. 38.
    LeVine MJ, Parrish JA. Outpatient phototherapy of psoriasis. Arch Dermatol. 1980;116(5):552–4.PubMedCrossRefPubMedCentralGoogle Scholar
  39. 39.
    Larkö O, Swanbeck G. Home solarium treatment of psoriasis. Br J Dermatol. 1979;101(1):13–6.PubMedCrossRefPubMedCentralGoogle Scholar
  40. 40.
    Boer J, Schothorst AA, Suurmond D. UV-B phototherapy of psoriasis. Dermatologica. 1980;161(4):250–8.PubMedCrossRefPubMedCentralGoogle Scholar
  41. 41.
    Stern RS, Armstrong RB, Anderson TF, Bickers DR, Lowe NJ, Harber L, et al. Effect of continued ultraviolet B phototherapy on the duration of remission of psoriasis: a randomized study. J Am Acad Dermatol. 1986;15(3):546–52.PubMedCrossRefPubMedCentralGoogle Scholar
  42. 42.
    Boztepe G, Karaduman A, Sahin S, Hayran M, Kolemen F. The effect of maintenance narrow-band ultraviolet B therapy on the duration of remission for psoriasis: a prospective randomized clinical trial. Int J Dermatol. 2006;45(3):245–50.PubMedCrossRefPubMedCentralGoogle Scholar
  43. 43.
    Karvonen J, Kokkonen EL, Ruotsalainen E. 311 nm UVB lamps in the treatment of psoriasis with the Ingram regimen. Acta Derm Venereol. 1989;69(1):82–5.PubMedPubMedCentralGoogle Scholar
  44. 44.
    Larkö O. Treatment of psoriasis with a new UVB-lamp. Acta Derm Venereol. 1989;69(4):357–9.PubMedPubMedCentralGoogle Scholar
  45. 45.
    Coven TR, Burack LH, Gilleaudeau R, Keogh M, Ozawa M, Krueger JG. Narrowband UV-B produces superior clinical and histopathological resolution of moderate-to-severe psoriasis in patients compared with broadband UV-B. Arch Dermatol. 1997;133(12):1514–22.PubMedCrossRefPubMedCentralGoogle Scholar
  46. 46.
    Walters IB, Burack LH, Coven TR, Gilleaudeau P, Krueger JG. Suberythemogenic narrow-band UVB is markedly more effective than conventional UVB in treatment of psoriasis vulgaris. J Am Acad Dermatol. 1999;40(6 Pt 1):893–900.PubMedCrossRefPubMedCentralGoogle Scholar
  47. 47.
    Archier E, Devaux S, Castela E, Gallini A, Aubin F, Le Maitre M, et al. Efficacy of psoralen UV-A therapy vs. narrowband UV-B therapy in chronic plaque psoriasis: a systematic literature review. J Eur Acad Dermatol Venereol. 2012;26(Suppl 3):11–21.PubMedCrossRefPubMedCentralGoogle Scholar
  48. 48.
    Fowler J, Weatherhead S. Can the Psoriasis Area and Severity Index score measured 4 weeks into a course of narrowband ultraviolet B phototherapy be used to predict final Psoriasis Area and Severity Index response? Br J Dermatol. 2016;175(Suppl 1):102–3.Google Scholar
  49. 49.
    Menter A, Cram DL. The Goeckerman regimen in two psoriasis day care centers. J Am Acad Dermatol. 1983;9(1):59–65.PubMedCrossRefPubMedCentralGoogle Scholar
  50. 50.
    Lee E, Koo J, Berger T. UVB phototherapy and skin cancer risk: a review of the literature. Int J Dermatol. 2005;44(5):355–60.PubMedCrossRefPubMedCentralGoogle Scholar
  51. 51.
    Perry HO, Soderstrom CW, Schulze RW. The Goeckerman treatment of psoriasis. Arch Dermatol. 1968;98(2):178–82.PubMedCrossRefPubMedCentralGoogle Scholar
  52. 52.
    Fitzmaurice S, Bhutani T, Koo J. Goeckerman regimen for management of psoriasis refractory to biologic therapy: the University of California San Francisco experience. J Am Acad Dermatol. 2013;69(4):648–9.PubMedCrossRefPubMedCentralGoogle Scholar
  53. 53.
    Serrao R, Davis MD. Goeckerman treatment for remission of psoriasis refractory to biologic therapy. J Am Acad Dermatol. 2009;60(2):348–9.PubMedCrossRefPubMedCentralGoogle Scholar
  54. 54.
    de Miguel R, el-Azhary R. Efficacy, safety, and cost of Goeckerman therapy compared with biologics in the treatment of moderate to severe psoriasis. Int J Dermatol. 2009;48(6):653–8.PubMedCrossRefPubMedCentralGoogle Scholar
  55. 55.
    Cort DH, Schleider NR, Moskowitz RS, Horwitz SN, Frost P. Retrospective analysis of a modified Goeckerman regimen for the treatment of psoriasis. Cutis. 1980;25(2):201–3. 6-9PubMedPubMedCentralGoogle Scholar
  56. 56.
    DesGroseilliers JP, Cullen AE, Rouleau GA. Ambulatory Goeckerman treatment of psoriasis: experience with 200 patients. Can Med Assoc J. 1981;124(8):1018–20.PubMedPubMedCentralGoogle Scholar
  57. 57.
    Gupta R, Debbaneh M, Butler D, Huynh M, Levin E, Leon A, et al. The Goeckerman regimen for the treatment of moderate to severe psoriasis. J Vis Exp. 2013;11(77):e50509.Google Scholar
  58. 58.
    Çaliskan E, Tunca M, Açikgöz G, Arca E, Yürekli A, Akar A. Narrow band ultraviolet-B versus Goeckerman therapy for psoriasis with and without acritretin: a retrospective study. Indian J Dermatol Venereol Leprol. 2015;81(6):584–7.PubMedCrossRefPubMedCentralGoogle Scholar
  59. 59.
    Feldman SR. Where has Goeckerman treatment gone? J Dermatol Treat. 2005;16(2):73–4.CrossRefGoogle Scholar
  60. 60.
    Trott J, Gerber W, Hammes S, Ockenfels HM. The effectiveness of PUVA treatment in severe psoriasis is significantly increased by additional UV 308-nm excimer laser sessions. Eur J Dermatol. 2008;18(1):55–60.PubMedPubMedCentralGoogle Scholar
  61. 61.
    Feldman SR, Mellen BG, Housman TS, Fitzpatrick RE, Geronemus RG, Friedman PM, et al. Efficacy of the 308-nm excimer laser for treatment of psoriasis: results of a multicenter study. J Am Acad Dermatol. 2002;46(6):900–6.PubMedCrossRefPubMedCentralGoogle Scholar
  62. 62.
    Bónis B, Kemény L, Dobozy A, Bor Z, Szabó G, Ignácz F. 308 nm UVB excimer laser for psoriasis. Lancet (London, England). 1997;350(9090):1522.CrossRefGoogle Scholar
  63. 63.
    Mudigonda T, Dabade TS, Feldman SR. A review of targeted ultraviolet B phototherapy for psoriasis. J Am Acad Dermatol. 2012;66(4):664–72.PubMedCrossRefPubMedCentralGoogle Scholar
  64. 64.
    Wolff K, Gschnait F, Honigsmann H, Konrad K, Parrish JA, Fitzpatrick TB. Phototesting and dosimetry for photochemotherapy. Br J Dermatol. 1977;96(1):1–10.PubMedCrossRefPubMedCentralGoogle Scholar
  65. 65.
    Vassantachart JM, Soleymani T, Wu JJ. Comparison of phototherapy guidelines for psoriasis: a critical appraisal and comprehensive review. J Drugs Dermatol. 2016;15(8):995–1000.PubMedPubMedCentralGoogle Scholar
  66. 66.
    Herzinger T, Berneburg M, Ghoreschi K, Gollnick H, Hölzle E, Hönigsmann H, et al. S1-Guidelines on UV phototherapy and photochemotherapy. J Dtsch Dermatol Ges. 2016;14(8):853–76.PubMedCrossRefPubMedCentralGoogle Scholar
  67. 67.
    Asawanonda P, Anderson RR, Chang Y, Taylor CR. 308-nm excimer laser for the treatment of psoriasis: a dose-response study. Arch Dermatol. 2000;136(5):619–24.PubMedCrossRefPubMedCentralGoogle Scholar
  68. 68.
    Trehan M, Taylor CR. High-dose 308-nm excimer laser for the treatment of psoriasis. J Am Acad Dermatol. 2002;46(5):732–7.PubMedCrossRefPubMedCentralGoogle Scholar
  69. 69.
    PHAROS EX-308 Operations Guide. Carlsbad: Ra Medical Systems.Google Scholar
  70. 70.
    XTRAC treatment guidelines card. 12-95359-01. Rev. E. Carlsbad: PhotoMedex; 2009.Google Scholar
  71. 71.
    Stern RS, Laird N. The carcinogenic risk of treatments for severe psoriasis. Photochemotherapy Follow-up Study. Cancer. 1994;73(11):2759–64.PubMedCrossRefPubMedCentralGoogle Scholar
  72. 72.
    Hearn RM, Kerr AC, Rahim KF, Ferguson J, Dawe RS. Incidence of skin cancers in 3867 patients treated with narrow-band ultraviolet B phototherapy. Br J Dermatol. 2008;159(4):931–5.PubMedCrossRefPubMedCentralGoogle Scholar
  73. 73.
    Studniberg HM, Weller P. PUVA, UVB, psoriasis, and nonmelanoma skin cancer. J Am Acad Dermatol. 1993;29(6):1013–22.PubMedCrossRefPubMedCentralGoogle Scholar
  74. 74.
    Stern RS. Genital tumors among men with psoriasis exposed to psoralens and ultraviolet A radiation (PUVA) and ultraviolet B radiation. The Photochemotherapy Follow-up Study. N Engl J Med. 1990;322(16):1093–7.PubMedCrossRefPubMedCentralGoogle Scholar
  75. 75.
    Flindt-Hansen H, McFadden N, Eeg-Larsen T, Thune P. Effect of a new narrow-band UVB lamp on photocarcinogenesis in mice. Acta Derm Venereol. 1991;71(3):245–8.PubMedPubMedCentralGoogle Scholar
  76. 76.
    Gibbs NK, Traynor NJ, MacKie RM, Campbell I, Johnson BE, Ferguson J. The phototumorigenic potential of broad-band (270-350 nm) and narrow-band (311-313 nm) phototherapy sources cannot be predicted by their edematogenic potential in hairless mouse skin. J Invest Dermatol. 1995;104(3):359–63.PubMedCrossRefPubMedCentralGoogle Scholar
  77. 77.
    Man I, Crombie IK, Dawe RS, Ibbotson SH, Ferguson J. The photocarcinogenic risk of narrowband UVB (TL-01) phototherapy: early follow-up data. Br J Dermatol. 2005;152(4):755–7.PubMedCrossRefPubMedCentralGoogle Scholar
  78. 78.
    Schleider NR, Moskowitz RS, Cort DH, Horwitz SN, Frost P. Effects of emollients on ultraviolet-radiation-induced erythema of the skin. Arch Dermatol. 1979;115(10):1188–91.PubMedCrossRefPubMedCentralGoogle Scholar
  79. 79.
    Lebwohl M, Martinez J, Weber P, DeLuca R. Effects of topical preparations on the erythemogenicity of UVB: implications for psoriasis phototherapy. J Am Acad Dermatol. 1995;32(3):469–71.PubMedCrossRefPubMedCentralGoogle Scholar
  80. 80.
    Lowe NJ, Wortzman MS, Breeding J, Koudsi H, Taylor L. Coal tar phototherapy for psoriasis reevaluated: erythemogenic versus suberythemogenic ultraviolet with a tar extract in oil and crude coal tar. J Am Acad Dermatol. 1983;8(6):781–9.PubMedCrossRefPubMedCentralGoogle Scholar
  81. 81.
    Pittelkow MR, Perry HO, Muller SA, Maughan WZ, O'Brien PC. Skin cancer in patients with psoriasis treated with coal tar. A 25-year follow-up study. Arch Dermatol. 1981;117(8):465–8.PubMedCrossRefPubMedCentralGoogle Scholar
  82. 82.
    Boer J, Smeenk G. Effect of short-contact anthralin therapy on ultraviolet B irradiation of psoriasis. J Am Acad Dermatol. 1986;15(2 Pt 1):198–204.PubMedCrossRefPubMedCentralGoogle Scholar
  83. 83.
    Lebwohl M, Berman B, France DS. Addition of short-contact anthralin therapy to an ultraviolet B phototherapy regimen: assessment of efficacy. J Am Acad Dermatol. 1985;13(5 Pt 1):780–4.PubMedCrossRefPubMedCentralGoogle Scholar
  84. 84.
    Meola T Jr, Soter NA, Lim HW. Are topical corticosteroids useful adjunctive therapy for the treatment of psoriasis with ultraviolet radiation? A review of the literature. Arch Dermatol. 1991;127(11):1708–13.PubMedCrossRefPubMedCentralGoogle Scholar
  85. 85.
    Petrozzi JW. Topical steroids and UV radiation in psoriasis. Arch Dermatol. 1983;119(3):207–10.PubMedCrossRefPubMedCentralGoogle Scholar
  86. 86.
    Larkö O, Swanbeck G, Svartholm H. The effect on psoriasis of clobetasol propionate used alone or in combination with UVB. Acta Derm Venereol. 1984;64(2):151–4.PubMedPubMedCentralGoogle Scholar
  87. 87.
    Dover JS, McEvoy MT, Rosen CF, Arndt KA, Stern RS. Are topical corticosteroids useful in phototherapy for psoriasis? J Am Acad Dermatol. 1989;20(5 Pt 1):748–54.PubMedCrossRefPubMedCentralGoogle Scholar
  88. 88.
    Molin L. Topical calcipotriol combined with phototherapy for psoriasis. The results of two randomized trials and a review of the literature. Calcipotriol-UVB Study Group. Dermatology. 1999;198(4):375–81.PubMedPubMedCentralCrossRefGoogle Scholar
  89. 89.
    Ramsay CA, Schwartz BE, Lowson D, Papp K, Bolduc A, Gilbert M. Calcipotriol cream combined with twice weekly broad-band UVB phototherapy: a safe, effective and UVB-sparing antipsoriatric combination treatment. The Canadian Calcipotriol and UVB Study Group. Dermatology. 2000;200(1):17–24.PubMedCrossRefPubMedCentralGoogle Scholar
  90. 90.
    Ashcroft DM, Li Wan Po A, Williams HC, Griffiths CE. Combination regimens of topical calcipotriene in chronic plaque psoriasis: systematic review of efficacy and tolerability. Arch Dermatol. 2000;136(12):1536–43.PubMedCrossRefPubMedCentralGoogle Scholar
  91. 91.
    Lebwohl M, Hecker D, Martinez J, Sapadin A, Patel B. Interactions between calcipotriene and ultraviolet light. J Am Acad Dermatol. 1997;37(1):93–5.PubMedCrossRefPubMedCentralGoogle Scholar
  92. 92.
    Lebwohl M, Quijije J, Gilliard J, Rollin T, Watts O. Topical calcitriol is degraded by ultraviolet light. J Invest Dermatol. 2003;121(3):594–5.PubMedCrossRefPubMedCentralGoogle Scholar
  93. 93.
    Asawanonda P, Nateetongrungsak Y. Methotrexate plus narrowband UVB phototherapy versus narrowband UVB phototherapy alone in the treatment of plaque-type psoriasis: a randomized, placebo-controlled study. J Am Acad Dermatol. 2006;54(6):1013–8.PubMedCrossRefPubMedCentralGoogle Scholar
  94. 94.
    Paul BS, Momtaz K, Stern RS, Arndt KA, Parrish JA. Combined methotrexate—ultraviolet B therapy in the treatment of psoriasis. J Am Acad Dermatol. 1982;7(6):758–62.PubMedCrossRefPubMedCentralGoogle Scholar
  95. 95.
    Calzavara-Pinton P, Leone G, Venturini M, Sala R, Colombo D, La Parola IL, et al. A comparative non randomized study of narrow-band (NB) (312 +/- 2 nm) UVB phototherapy versus sequential therapy with oral administration of low-dose Cyclosporin A and NB-UVB phototherapy in patients with severe psoriasis vulgaris. Eur J Dermatol. 2005;15(6):470–3.PubMedPubMedCentralGoogle Scholar
  96. 96.
    Kampitak T, Asawanonda P. The efficacy of combination treatment with narrowband UVB (TL-01) and acitretin vs narrowband UVB alone in plaque-type psoriasis: a retrospective study. J Med Assoc Thai. 2006;89(Suppl 3):S20–4.PubMedPubMedCentralGoogle Scholar
  97. 97.
    Yelverton CB, Yentzer BA, Clark A, Pearce DJ, Balkrishnan R, Camacho FT, et al. Home narrowband UV-B phototherapy in combination with low-dose acitretin in patients with moderate to severe psoriasis. Arch Dermatol. 2008;144(9):1224–5.PubMedCrossRefPubMedCentralGoogle Scholar
  98. 98.
    Yentzer BA, Yelverton CB, Pearce DJ, Camacho FT, Makhzoumi Z, Clark A, et al. Adherence to acitretin and home narrowband ultraviolet B phototherapy in patients with psoriasis. J Am Acad Dermatol. 2008;59(4):577–81.PubMedCrossRefPubMedCentralGoogle Scholar
  99. 99.
    Lowe NJ, Prystowsky JH, Bourget T, Edelstein J, Nychay S, Armstrong R. Acitretin plus UVB therapy for psoriasis. Comparisons with placebo plus UVB and acitretin alone. J Am Acad Dermatol. 1991;24(4):591–4.PubMedCrossRefPubMedCentralGoogle Scholar
  100. 100.
    Ruzicka T, Sommerburg C, Braun-Falco O, Koster W, Lengen W, Lensing W, et al. Efficiency of acitretin in combination with UV-B in the treatment of severe psoriasis. Arch Dermatol. 1990;126(4):482–6.PubMedCrossRefPubMedCentralGoogle Scholar
  101. 101.
    Ozdemir M, Engin B, Baysal I, Mevlitoglu I. A randomized comparison of acitretin-narrow-band TL-01 phototherapy and acitretin-psoralen plus ultraviolet A for psoriasis. Acta Derm Venereol. 2008;88(6):589–93.PubMedPubMedCentralGoogle Scholar
  102. 102.
    Ortonne JP, Khemis A, Koo JY, Choi J. An open-label study of alefacept plus ultraviolet B light as combination therapy for chronic plaque psoriasis. J Eur Acad Dermatol Venereol. 2005;19(5):556–63.PubMedCrossRefPubMedCentralGoogle Scholar
  103. 103.
    Legat FJ, Hofer A, Wackernagel A, Salmhofer W, Quehenberger F, Kerl H, et al. Narrowband UV-B phototherapy, alefacept, and clearance of psoriasis. Arch Dermatol. 2007;143(8):1016–22.PubMedCrossRefPubMedCentralGoogle Scholar
  104. 104.
    Kircik L, Bagel J, Korman N, Menter A, Elmets CA, Koo J, et al. Utilization of narrow-band ultraviolet light B therapy and etanercept for the treatment of psoriasis (UNITE): efficacy, safety, and patient-reported outcomes. J Drugs Dermatol. 2008;7(3):245–53.PubMedPubMedCentralGoogle Scholar
  105. 105.
    Momtaz TK, Parrish JA. Combination of psoralens and ultraviolet A and ultraviolet B in the treatment of psoriasis vulgaris: a bilateral comparison study. J Am Acad Dermatol. 1984;10(3):481–6.CrossRefGoogle Scholar
  106. 106.
    Wainwright NJ, Dawe RS, Ferguson J. Narrowband ultraviolet B (TL-01) phototherapy for psoriasis: which incremental regimen? Br J Dermatol. 1998;139(3):410–4.PubMedCrossRefPubMedCentralGoogle Scholar
  107. 107.
    Vun YY, Jones B, Al-Mudhaffer M, Egan C. Generalized pustular psoriasis of pregnancy treated with narrowband UVB and topical steroids. J Am Acad Dermatol. 2006;54(2 Suppl):S28–30.PubMedCrossRefPubMedCentralGoogle Scholar
  108. 108.
    Spuls PI, Bossuyt PM, van Everdingen JJ, Witkamp L, Bos JD. The development of practice guidelines for the treatment of severe plaque form psoriasis. Arch Dermatol. 1998;134(12):1591–6.PubMedCrossRefPubMedCentralGoogle Scholar
  109. 109.
    Tauscher AE, Fleischer AB Jr, Phelps KC, Feldman SR. Psoriasis and pregnancy. J Cutan Med Surg. 2002;6(6):561–70.PubMedCrossRefPubMedCentralGoogle Scholar
  110. 110.
    Bibbins-Domingo K, Grossman DC, Curry SJ, Davidson KW, Epling JWJ, García FA, et al. Folic acid supplementation for the prevention of neural tube defects: US Preventive Services Task Force Recommendation Statement. JAMA. 2017;317(2):183–9.PubMedCrossRefPubMedCentralGoogle Scholar
  111. 111.
    Zhang M, Goyert G, Lim HW. Folate and phototherapy: what should we inform our patients? J Am Acad Dermatol. 2017;77(5):958–64.PubMedCrossRefPubMedCentralGoogle Scholar
  112. 112.
    Tay YK, Morelli JG, Weston WL. Experience with UVB phototherapy in children. Pediatr Dermatol. 1996;13(5):406–9.PubMedCrossRefPubMedCentralGoogle Scholar
  113. 113.
    Jury CS, McHenry P, Burden AD, Lever R, Bilsland D. Narrowband ultraviolet B (UVB) phototherapy in children. Clin Exp Dermatol. 2006;31(2):196–9.PubMedCrossRefPubMedCentralGoogle Scholar
  114. 114.
    Pahlajani N, Katz BJ, Lozano AM, Murphy F, Gottlieb A. Comparison of the efficacy and safety of the 308 nm excimer laser for the treatment of localized psoriasis in adults and in children: a pilot study. Pediatr Dermatol. 2005;22(2):161–5.PubMedCrossRefPubMedCentralGoogle Scholar
  115. 115.
    Song E, Reja D, Silverberg N, Rothe MJ. Phototherapy: kids are not just little people. Clin Dermatol. 2015;33(6):672–80.PubMedCrossRefPubMedCentralGoogle Scholar
  116. 116.
    Holme SA, Anstey AV. Phototherapy and PUVA photochemotherapy in children. Photodermatol Photoimmunol Photomed. 2004;20(2):69–75.PubMedCrossRefPubMedCentralGoogle Scholar
  117. 117.
    Collins P, Ferguson J. Narrowband (TL-01) UVB air-conditioned phototherapy for atopic eczema in children. Br J Dermatol. 1995;133(4):653–5.PubMedCrossRefPubMedCentralGoogle Scholar
  118. 118.
    Koek MB, Buskens E, van Weelden H, Steegmans PH, Bruijnzeel-Koomen CA, Sigurdsson V. Home versus outpatient ultraviolet B phototherapy for mild to severe psoriasis: pragmatic multicentre randomised controlled non-inferiority trial (PLUTO study). BMJ. 2009;b1542:338.Google Scholar
  119. 119.
    Rajpara AN, O’Neill JL, Nolan BV, Yentzer BA, Feldman SR. Review of home phototherapy. Dermatol Online J. 2010;16(12):2.PubMedPubMedCentralGoogle Scholar
  120. 120.
    Lapolla W, Yentzer BA, Bagel J, Halvorson CR, Feldman SR. A review of phototherapy protocols for psoriasis treatment. J Am Acad Dermatol. 2011;64(5):936–49.PubMedCrossRefPubMedCentralGoogle Scholar
  121. 121.
    Yelverton CB, Kulkarni AS, Balkrishnan R, Feldman SR. Home ultraviolet B phototherapy: a cost-effective option for severe psoriasis. Manag Care Interface. 2006;19(1):33–6. 9PubMedPubMedCentralGoogle Scholar
  122. 122.
    Koek MB, Sigurdsson V, van Weelden H, Steegmans PH, Bruijnzeel-Koomen CA, Buskens E. Cost effectiveness of home ultraviolet B phototherapy for psoriasis: economic evaluation of a randomized controlled trial (PLUTO study). BMJ. 2010;340:c1490.PubMedPubMedCentralCrossRefGoogle Scholar
  123. 123.
    Hung R, Ungureanu S, Edwards C, Gambles B, Anstey AV. Home phototherapy for psoriasis: a review and update. Clin Exp Dermatol. 2015;40(8):827–2; quiz 32–3PubMedCrossRefPubMedCentralGoogle Scholar
  124. 124.
    Psoriasis: the assessment and managing of psoriasis. Cost report. Implementing NICE guidance. January 1, 2017.
  125. 125.
    Henseler T, Wolff K, Honigsmann H, Christophers E. Oral 8-methoxypsoralen photochemotherapy of psoriasis. The European PUVA study: a cooperative study among 18 European centres. Lancet. 1981;1(8225):853–7.PubMedCrossRefPubMedCentralGoogle Scholar
  126. 126.
    Melski JW, Tanenbaum L, Parrish JA, Fitzpatrick TB, Bleich HL. Oral methoxsalen photochemotherapy for the treatment of psoriasis: a cooperative clinical trial. J Invest Dermatol. 1977;68(6):328–35.PubMedCrossRefPubMedCentralGoogle Scholar
  127. 127.
    Spuls PI, Witkamp L, Bossuyt PM, Bos JD. A systematic review of five systemic treatments for severe psoriasis. Br J Dermatol. 1997;137(6):943–9.PubMedCrossRefPubMedCentralGoogle Scholar
  128. 128.
    Griffiths CE, Clark CM, Chalmers RJ, Li Wan Po A, Williams HC. A systematic review of treatments for severe psoriasis. Health Technol Assess. 2000;4(40):1–125.PubMedCrossRefPubMedCentralGoogle Scholar
  129. 129.
    Yones SS, Palmer RA, Garibaldinos TT, Hawk JL. Randomized double-blind trial of the treatment of chronic plaque psoriasis: efficacy of psoralen-UV-A therapy vs narrowband UV-B therapy. Arch Dermatol. 2006;142(7):836–42.PubMedCrossRefPubMedCentralGoogle Scholar
  130. 130.
    Cooper EJ, Herd RM, Priestley GC, Hunter JA. A comparison of bathwater and oral delivery of 8-methoxypsoralen in PUVA therapy for plaque psoriasis. Clin Exp Dermatol. 2000;25(2):111–4.PubMedCrossRefPubMedCentralGoogle Scholar
  131. 131.
    Collins P, Rogers S. Bath-water compared with oral delivery of 8-methoxypsoralen PUVA therapy for chronic plaque psoriasis. Br J Dermatol. 1992;127(4):392–5.PubMedCrossRefPubMedCentralGoogle Scholar
  132. 132.
    Lowe NJ, Weingarten D, Bourget T, Moy LS. PUVA therapy for psoriasis: comparison of oral and bath-water delivery of 8-methoxypsoralen. J Am Acad Dermatol. 1986;14(5 Pt 1):754–60.PubMedCrossRefPubMedCentralGoogle Scholar
  133. 133.
    Turjanmaa K, Salo H, Reunala T. Comparison of trioxsalen bath and oral methoxsalen PUVA in psoriasis. Acta Derm Venereol. 1985;65(1):86–8.PubMedPubMedCentralGoogle Scholar
  134. 134.
    Stern RS, Thibodeau LA, Kleinerman RA, Parrish JA, Fitzpatrick TB. Risk of cutaneous carcinoma in patients treated with oral methoxsalen photochemotherapy for psoriasis. N Engl J Med. 1979;300(15):809–13.PubMedCrossRefPubMedCentralGoogle Scholar
  135. 135.
    Stern RS, Laird N, Melski J, Parrish JA, Fitzpatrick TB, Bleich HL. Cutaneous squamous-cell carcinoma in patients treated with PUVA. N Engl J Med. 1984;310(18):1156–61.PubMedCrossRefPubMedCentralGoogle Scholar
  136. 136.
    Nijsten TE, Stern RS. The increased risk of skin cancer is persistent after discontinuation of psoralen+ultraviolet A: a cohort study. J Invest Dermatol. 2003;121(2):252–8.PubMedCrossRefPubMedCentralGoogle Scholar
  137. 137.
    Morison WL, Baughman RD, Day RM, Forbes PD, Hoenigsmann H, Krueger GG, et al. Consensus workshop on the toxic effects of long-term PUVA therapy. Arch Dermatol. 1998;134(5):595–8.PubMedCrossRefPubMedCentralGoogle Scholar
  138. 138.
    Lindelöf B. Risk of melanoma with psoralen/ultraviolet A therapy for psoriasis. Do the known risks now outweigh the benefits? Drug Saf. 1999;20(4):289–97.PubMedCrossRefPubMedCentralGoogle Scholar
  139. 139.
    Stern RS, Nichols KT, Vakeva LH. Malignant melanoma in patients treated for psoriasis with methoxsalen (psoralen) and ultraviolet A radiation (PUVA). The PUVA Follow-Up Study. N Engl J Med. 1997;336(15):1041–5.PubMedCrossRefPubMedCentralGoogle Scholar
  140. 140.
    Forman AB, Roenigk HH Jr, Caro WA, Magid ML. Long-term follow-up of skin cancer in the PUVA-48 cooperative study. Arch Dermatol. 1989;125(4):515–9.PubMedCrossRefPubMedCentralGoogle Scholar
  141. 141.
    Chuang TY, Heinrich LA, Schultz MD, Reizner GT, Kumm RC, Cripps DJ. PUVA and skin cancer. A historical cohort study on 492 patients. J Am Acad Dermatol. 1992;26(2 Pt 1):173–7.PubMedCrossRefPubMedCentralGoogle Scholar
  142. 142.
    Wolff K. Should PUVA be abandoned? N Engl J Med. 1997;336(15):1090–1.PubMedCrossRefPubMedCentralGoogle Scholar
  143. 143.
    Stern RS, Kleinerman RA, Parrish JA, Fitzpatrick TB, Bleich HL. Phototoxic reactions to photoactive drugs in patients treated with PUVA. Arch Dermatol. 1980;116(11):1269–71.PubMedCrossRefPubMedCentralGoogle Scholar
  144. 144.
    Murase JE, Lee EE, Koo J. Effect of ethnicity on the risk of developing nonmelanoma skin cancer following long-term PUVA therapy. Int J Dermatol. 2005;44(12):1016–21.PubMedCrossRefPubMedCentralGoogle Scholar
  145. 145.
    Marcil I, Stern RS. Squamous-cell cancer of the skin in patients given PUVA and cyclosporin: nested cohort crossover study. Lancet. 2001;358(9287):1042–5.PubMedCrossRefPubMedCentralGoogle Scholar
  146. 146.
    Malanos D, Stern RS. Psoralen plus ultraviolet A does not increase the risk of cataracts: a 25-year prospective study. J Am Acad Dermatol. 2007;57(2):231–7.PubMedCrossRefPubMedCentralGoogle Scholar
  147. 147.
    Hannuksela-Svahn A, Sigurgeirsson B, Pukkala E, Lindelof B, Berne B, Hannuksela M, et al. Trioxsalen bath PUVA did not increase the risk of squamous cell skin carcinoma and cutaneous malignant melanoma in a joint analysis of 944 Swedish and Finnish patients with psoriasis. Br J Dermatol. 1999;141(3):497–501.PubMedCrossRefPubMedCentralGoogle Scholar
  148. 148.
    Hannuksela A, Pukkala E, Hannuksela M, Karvonen J. Cancer incidence among Finnish patients with psoriasis treated with trioxsalen bath PUVA. J Am Acad Dermatol. 1996;35(5 Pt 1):685–9.PubMedCrossRefPubMedCentralGoogle Scholar
  149. 149.
    Menter MA, See JA, Amend WJ, Ellis CN, Krueger GG, Lebwohl M, et al. Proceedings of the psoriasis combination and rotation therapy conference. Deer Valley, Utah, Oct. 7–9, 1994. J Am Acad Dermatol. 1996;34(2 Pt 1):315–21.PubMedCrossRefPubMedCentralGoogle Scholar
  150. 150.
    Torras H, Aliaga A, Lopez-Estebaranz JL, Hernandez I, Gardeazabal J, Quintanilla E, et al. A combination therapy of calcipotriol cream and PUVA reduces the UVA dose and improves the response of psoriasis vulgaris. J Dermatolog Treat. 2004;15(2):98–103.PubMedCrossRefPubMedCentralGoogle Scholar
  151. 151.
    Youn JI, Park BS, Park SB, Kim SD, Suh DH. Comparison of calcipotriol and PUVA with conventional PUVA in the treatment of psoriasis. J Dermatol Treat. 2000;11:125–30.CrossRefGoogle Scholar
  152. 152.
    Frappaz A, Thivolet J. Calcipotriol in combination with PUVA: a randomized double blind placebo study in severe psoriasis. Eur J Dermatol. 1993;3:351–4.Google Scholar
  153. 153.
    Tzaneva S, Honigsmann H, Tanew A, Seeber A. A comparison of psoralen plus ultraviolet A (PUVA) monotherapy, tacalcitol plus PUVA and tazarotene plus PUVA in patients with chronic plaque-type psoriasis. Br J Dermatol. 2002;147(4):748–53.PubMedCrossRefPubMedCentralGoogle Scholar
  154. 154.
    Behrens S, Grundmann-Kollmann M, Peter RU, Kerscher M. Combination treatment of psoriasis with photochemotherapy and tazarotene gel, a receptor-selective topical retinoid. Br J Dermatol. 1999;141(1):177.PubMedCrossRefPubMedCentralGoogle Scholar
  155. 155.
    Schmoll M, Henseler T, Christophers E. Evaluation of PUVA, topical corticosteroids and the combination of both in the treatment of psoriasis. Br J Dermatol. 1978;99(6):693–702.PubMedCrossRefPubMedCentralGoogle Scholar
  156. 156.
    Morison WL, Parrish JA, Fitzpatrick TB. Controlled study of PUVA and adjunctive topical therapy in the management of psoriasis. Br J Dermatol. 1978;98(2):125–32.PubMedCrossRefPubMedCentralGoogle Scholar
  157. 157.
    Lauharanta J, Geiger JM. A double-blind comparison of acitretin and etretinate in combination with bath PUVA in the treatment of extensive psoriasis. Br J Dermatol. 1989;121(1):107–12.PubMedCrossRefPubMedCentralGoogle Scholar
  158. 158.
    Saurat JH, Geiger JM, Amblard P, Beani JC, Boulanger A, Claudy A, et al. Randomized double-blind multicenter study comparing acitretin-PUVA, etretinate-PUVA and placebo-PUVA in the treatment of severe psoriasis. Dermatologica. 1988;177(4):218–24.PubMedCrossRefPubMedCentralGoogle Scholar
  159. 159.
    Tanew A, Guggenbichler A, Honigsmann H, Geiger JM, Fritsch P. Photochemotherapy for severe psoriasis without or in combination with acitretin: a randomized, double-blind comparison study. J Am Acad Dermatol. 1991;25(4):682–4.PubMedCrossRefPubMedCentralGoogle Scholar
  160. 160.
    Lebwohl M. Acitretin in combination with UVB or PUVA. J Am Acad Dermatol. 1999;41(3 Pt 2):S22–4.PubMedCrossRefPubMedCentralGoogle Scholar
  161. 161.
    Nijsten TE, Stern RS. Oral retinoid use reduces cutaneous squamous cell carcinoma risk in patients with psoriasis treated with psoralen-UVA: a nested cohort study. J Am Acad Dermatol. 2003;49(4):644–50.PubMedCrossRefPubMedCentralGoogle Scholar
  162. 162.
    Bavinck JN, Tieben LM, Van der Woude FJ, Tegzess AM, Hermans J, ter Schegget J, et al. Prevention of skin cancer and reduction of keratotic skin lesions during acitretin therapy in renal transplant recipients: a double-blind, placebo-controlled study. J Clin Oncol. 1995;13(8):1933–8.PubMedCrossRefPubMedCentralGoogle Scholar
  163. 163.
    McKenna DB, Murphy GM. Skin cancer chemoprophylaxis in renal transplant recipients: 5 years of experience using low-dose acitretin. Br J Dermatol. 1999;140(4):656–60.PubMedCrossRefPubMedCentralGoogle Scholar
  164. 164.
    McNamara IR, Muir J, Galbraith AJ. Acitretin for prophylaxis of cutaneous malignancies after cardiac transplantation. J Heart Lung Transplant. 2002;21(11):1201–5.PubMedCrossRefPubMedCentralGoogle Scholar
  165. 165.
    Yuan ZF, Davis A, Macdonald K, Bailey RR. Use of acitretin for the skin complications in renal transplant recipients. N Z Med J. 1995;108(1002):255–6.PubMedPubMedCentralGoogle Scholar
  166. 166.
    Morison WL, Momtaz K, Parrish JA, Fitzpatrick TB. Combined methotrexate-PUVA therapy in the treatment of psoriasis. J Am Acad Dermatol. 1982;6(1):46–51.PubMedCrossRefPubMedCentralGoogle Scholar
  167. 167.
    Shehzad T, Dar NR, Zakria M. Efficacy of concomitant use of PUVA and methotrexate in disease clearance time in plaque type psoriasis. J Pak Med Assoc. 2004;54(9):453–5.PubMedPubMedCentralGoogle Scholar
  168. 168.
    MacKie RM, Fitzsimons CP. Risk of carcinogenicity in patients with psoriasis treated with methotrexate or PUVA singly or in combination. J Am Acad Dermatol. 1983;9(3):467–9.PubMedCrossRefPubMedCentralGoogle Scholar
  169. 169.
    Calzavara-Pinton P. Narrow band UVB (311 nm) phototherapy and PUVA photochemotherapy: a combination. J Am Acad Dermatol. 1998;38(5 Pt 1):687–90.PubMedCrossRefPubMedCentralGoogle Scholar
  170. 170.
    Grundmann-Kollmann M, Ludwig R, Zollner TM, Ochsendorf F, Thaci D, Boehncke WH, et al. Narrowband UVB and cream psoralen-UVA combination therapy for plaque-type psoriasis. J Am Acad Dermatol. 2004;50(5):734–9.PubMedCrossRefPubMedCentralGoogle Scholar
  171. 171.
    Pham CT, Koo JY. Plasma levels of 8-methoxypsoralen after topical paint PUVA. J Am Acad Dermatol. 1993;28(3):460–6.PubMedCrossRefPubMedCentralGoogle Scholar
  172. 172.
    Neild VS, Scott LV. Plasma levels of 8-methoxypsoralen in psoriatic patients receiving topical 8-methoxypsoralen. Br J Dermatol. 1982;106(2):199–203.PubMedCrossRefPubMedCentralGoogle Scholar
  173. 173.
    Stern RS, Nichols KT. Therapy with orally administered methoxsalen and ultraviolet A radiation during childhood increases the risk of basal cell carcinoma. The PUVA Follow-up Study. J Pediatr. 1996;129(6):915–7.PubMedCrossRefPubMedCentralGoogle Scholar
  174. 174.
    Pasić A, Ceović R, Lipozencić J, Husar K, Susić SM, Skerlev M, et al. Phototherapy in pediatric patients. Pediatr Dermatol. 2003;20(1):71–7.PubMedCrossRefPubMedCentralGoogle Scholar
  175. 175.
    Vonderheid EC, Bigler RD, Rogers RD, Rogers TJ, Kadin ME, Griffin TD. Effect of extracorporeal photopheresis on selected immunologic parameters in psoriasis vulgaris. Yale J Biol Med. 1989;62(6):653–64.PubMedPubMedCentralGoogle Scholar
  176. 176.
    Wilfert H, Hönigsmann H, Steiner G, Smolen J, Wolff K. Treatment of psoriatic arthritis by extracorporeal photochemotherapy. Br J Dermatol. 1990;122(2):225–32.PubMedCrossRefPubMedCentralGoogle Scholar
  177. 177.
    Vonderheid EC, Kang CA, Kadin M, Bigler RD, Griffin TD, Rogers TJ. Extracorporeal photopheresis in psoriasis vulgaris: clinical and immunologic observations. J Am Acad Dermatol. 1990;23(4 Pt 1):703–12.PubMedCrossRefPubMedCentralGoogle Scholar
  178. 178.
    de Misa RF, Azaña JM, Harto A, Boizeda P, Moreno R, Ledo A. Psoriatic arthritis: one year of treatment with extracorporeal photochemotherapy. J Am Acad Dermatol. 1994;30(6):1037–8.PubMedCrossRefPubMedCentralGoogle Scholar
  179. 179.
    Vahlquist C, Larsson M, Ernerudh J, Berlin G, Skogh T, Vahlquist A. Treatment of psoriatic arthritis with extracorporeal photochemotherapy and conventional psoralen-ultraviolet A irradiation. Arthritis Rheum. 1996;39(9):1519–23.PubMedCrossRefPubMedCentralGoogle Scholar
  180. 180.
    McKenna KE, Whittaker S, Rhodes LE, Taylor P, Lloyd JJ, Ibbotson S, et al. Evidence-based practice of photopheresis 1987–2001: a report of a workshop of the British Photodermatology Group and the U. K. Skin Lymphoma Group. Br J Dermatol. 2006;154(1):7–20.PubMedCrossRefPubMedCentralGoogle Scholar
  181. 181.
    Garza FZC, Liebmann J, Born M, Hilbers PA, van Riel NA. A dynamic model for prediction of psoriasis management by blue light irradiation. Front Physiol. 2017;26(8):28.Google Scholar
  182. 182.
    Maari C, Viau G, Bissonnette R. Repeated exposure to blue light does not improve psoriasis. J Am Acad Dermatol. 2003;49(1):55–8.PubMedCrossRefPubMedCentralGoogle Scholar
  183. 183.
    Al-Mutairi N, Noor T, Al-Haddad A. Single blinded left-to-right comparison study of excimer laser versus pulsed dye laser for the treatment of nail psoriasis. Dermatol Ther (Heidelb). 2014;4(2):197–205.CrossRefGoogle Scholar
  184. 184.
    Huang YC, Chou CL, Chiang YY. Efficacy of pulsed dye laser plus topical tazarotene versus topical tazarotene alone in psoriatic nail disease: a single-blind, intrapatient left-to-right controlled study. Lasers Surg Med. 2012;45(2):102–7.PubMedCrossRefPubMedCentralGoogle Scholar
  185. 185.
    Treewittayapoom C, Singvahanont P, Chanprapaph K, Haneke E. The effect of different pulse durations in the treatment of nail psoriasis with 595-nm pulsed dye laser: a randomised, double-blind, intrapatient left-to-right study. J Am Acad Dermatol. 2012;66(5):807–12.PubMedCrossRefPubMedCentralGoogle Scholar
  186. 186.
    Fernández-Guarino M, Harto A, Sánchez-Ronco M, García-Morales I, Jaén P. Pulsed dye laser vs. photodynamic therapy in the treatment of refractory nail psoriasis: a comparative pilot study. J Eur Acad Dermatol Venereol. 2009;23(8):891–5.PubMedCrossRefPubMedCentralGoogle Scholar
  187. 187.
    Tawfik AA. Novel treatment of nail psoriasis using the intense pulsed light: a one-year follow-up study. Dermatol Surg. 2014;40(7):763–8.PubMedPubMedCentralGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • James L. Griffith
    • 1
  • Allison J. Zarbo
    • 1
  • Henry W. Lim
    • 1
    Email author
  1. 1.Department of DermatologyHenry Ford HospitalDetroitUSA

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