Phototherapy in pediatric patients: 5-years single center experience

Abstract

Objective: Phototherapy is a treatment option that has been used for many years in the treatment of various skin diseases. While it has more widespread use in adult patients, its use is more limited in the pediatric age group due to the long-term risk of skin cancer. In our study, we would like to present the data of pediatric patients we treated in our phototherapy unit for 5 years. Methods: In our study, medical records of patients under the age of 18, whom we treated in our phototherapy unit between 01. January 2018 and 31 December 2022, were retrospectively reviewed. Age, gender, skin type, diagnosis, rate of patients receiving narrow band ultraviolet B (nbUVB) and psoralen ultraviolet A (PUVA), rate of patients receiving local and cabin phototherapy, duration of treatment, total number of sessions, cumulative doses, frequency of patients who continued the treatment regularly, side effects, treatment response, and months of treatment were recorded. Results: During 5 years, 688 patients received phototherapy in our unit. Thirty-three (4.4%) of these patients were under the age of 18. Median age of pediatric patients was 15 (3-17), female to male ratio was 19/14. Psoriasis (54.5%) was the most common diagnosis. Other diagnoses were vitiligo (18.2%), atopic dermatitis (15.2%), pityriasis lichenoides chronica (6.1%), alopecia totalis (3%), and pityriasis rubra pilaris (3%). Of the patients, 27 (81.8%) received cabin nbUVB, 5 (15.2%) local nbUVB, 1 local topical PUVA (3%). Side effects were observed in 4 patients (12.1%). Erythema was observed in 2 patients (6.1%), itching and dryness were observed in 1 patient (3.1%), and vesicular eruption on the face was observed in 1 patient (3.1%). Complete or almost complete recovery was observed in 4 patients (12.9%), and partial recovery was observed in 11 patients (35.5%), while 16 patients (51.6%) did not benefit from the treatment. Conclusion: Phototherapy was most commonly used in patients with psoriasis in the pediatric age group. The incidence of side effects was lower than similar studies in the literature. However, response rates to treatment were lower than those reported in the literature.

Keywords

• Phototherapy
• narrowband UVB
• PUVA
• childhood

References

1. Torres AE, Lyons AB, Hamzavi IH, Lim HW. Role of phototherapy in the era of biologics. J Am Acad Dermatol. 2021;84:479-485.
2. Slimani Y, Elfatoiki FZ, Skali HD, Hali F, Chiheb S. Phototherapy in children: Epidemiology, clinical profile, and outcome. Photodermatol Photoimmunol Photomed. 2021;37:224-225.
3. Taşkapan O. Çocuklarda Atopik Dermatit [Atopic Dermatitis in Children]. Archives of the Turkish Dermatology & Venerology/Turkderm. 2011;45:90-98.
4. Açıkgöz G, Çalışkan E. Pediatrik Dermatolojide Fototerapi [Phototherapy in Pediatric Dermatology]. Archives of the Turkish Dermatology & Venerology/ Turkderm. 2011; 45:143-148.
5. Ersoy-Evans S, Altaykan A, Sahin S, Kölemen F. Phototherapy in childhood. Pediatr Dermatol. 2008;25:599-605.
6. Rathod DG, Muneer H, Masood S. Phototherapy. [Updated 2023 Feb 16]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/ NBK563140/
7. Berneburg M, Röcken M, Benedix F. Phototherapy with narrowband vs broadband UVB. Acta Derm Venereol. 2005;85:98-108.
8. Juarez MC, Grossberg AL. Phototherapy in the Pediatric Population. Dermatol Clin. 2020;38:91-108.

9. Brazzelli V, Carugno A, Rivetti N, Cananzi R, Barruscotti S, Borroni G. Narrowband UVB phototherapy for pediatric generalized pityriasis lichenoides. Photodermatol Photoimmunol Photomed. 2013;29:330-333.
10. Jury CS, McHenry P, Burden AD, Lever R, Bilsland D. Narrowband ultraviolet B (UVB) phototherapy in children. Clin Exp Dermatol. 2006;31:196-199.
11. Pavlovsky M, Baum S, Shpiro D, Pavlovsky L, Pavlotsky F. Narrow band UVB: is it effective and safe for paediatric psoriasis and atopic dermatitis? J Eur Acad Dermatol Venereol. 2011;25:727-729.
12. Brazzelli V, Prestinari F, Castello M, et al. Useful treatment of vitiligo in 10 children with UV-B narrowband (311 nm). Pediatr Dermatol. 2005;22:257-261.
13. Holme SA, Anstey AV. Phototherapy and PUVA photochemotherapy in children. Photodermatol Photoimmunol Photomed. 2004;20:69-75.