Hum Matthew, Kalia Sunil, Gniadecki Robert
1 Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.
2 Photomedicine Institute, Vancouver Coastal Health and Department of Dermatology and Skin Science, University of British Columbia, Vancouver, BC, Canada.
J Cutan Med Surg. 2019 Jan/Feb;23(1):91-96. doi: 10.1177/1203475418800947. Epub 2018 Sep 15.
Conventional, full-body phototherapy equipment is costly and therefore patients are usually treated in dermatology centres. Such office-based therapy is often not feasible for those patients who live far away from a phototherapy centre due to lost time and wages, inability to travel because of extensive skin disease, or prohibitive travel costs. Home phototherapy has emerged as a modality that meets the needs of those patients. Our aim was to review available studies on UV sources, treatment protocols, efficacy, and safety of home phototherapy. A literature review was conducted on PubMed using the terms "home" AND "phototherapy" AND ("guide" OR "approach" OR "review" OR "protocol"). From the data extracted, narrowband UVB (311 nm) offers the best balance between safety and efficacy and is recommended for home phototherapy by most authors. Treatment is safe and possible adverse effects are related to overexposure (erythema, blistering). The usual treatment protocol was administering treatments on alternating days, including weekends, with dosing based on the patient's Fitzpatrick skin type. We also provide information on the available home phototherapy systems in Canada and their reimbursement. Home phototherapy is underused in Canada. Narrowband UVB phototherapy sources equipped with a 3-dimensional panel provides a practical and safe option.
传统的全身光疗设备价格昂贵，因此患者通常在皮肤科中心接受治疗。对于那些因时间和工资损失、因广泛皮肤病而无法出行或旅行成本过高而居住在远离光疗中心的患者来说，这种基于门诊的治疗往往不可行。家庭光疗已成为一种满足这些患者需求的治疗方式。我们的目的是回顾关于家庭光疗的紫外线光源、治疗方案、疗效和安全性的现有研究。在PubMed上进行了一项文献综述，使用的关键词为“家庭”和“光疗”以及（“指南”或“方法”或“综述”或“方案”）。从提取的数据来看，窄谱中波紫外线（311nm）在安全性和疗效之间提供了最佳平衡，大多数作者推荐其用于家庭光疗。治疗是安全的，可能的不良反应与过度暴露（红斑、水疱）有关。通常的治疗方案是在包括周末在内的隔天进行治疗，剂量根据患者的菲茨帕特里克皮肤类型确定。我们还提供了加拿大现有的家庭光疗系统及其报销情况的信息。家庭光疗在加拿大的使用不足。配备三维面板的窄谱中波紫外线光疗源提供了一种实用且安全的选择。
