Phototherapy Treatment Protocols: For Psoriasis and Other Phototherapy Responsive Dermatoses

Author: Michael D. Zanolli
Published: March 2000
Publisher: CRC Press
ISBN: 1850709920
Hardcover Book
Number of Pages: 158

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This is a step-by-step manual of protocols for ultraviolet light therapy in the dermatologist's office including the new modality of narrow band UVB. It provides complete technical information for UVB, NBUVB, PUVA, outpatient daycare (Goeckerman and Ingram), RePUVA, UVA/UVB combination, hand and foot therapy, scalp treatments and hydrotherapy. It also contains examples of patient education handouts, consent forms, laboratory flow sheets, tools for the quantitative measurement of psoriasis severity, and other useful information sheets. This is a practical manual for physicians with a phototherapy unit. In this comprehensive collection of protocols, instruction sheets, and patient information sheets, the authors address many variations of both UVA and UVB therapies. These are discussed not only by the type of treatment but also by particular disease. There exist many good texts in which the theories behind phototherapy are discussed, but there are few practical manuals on this subject. The authors aim to create a practical, on-site resource for dermatologists and technicians. Consent forms and protocols are meant to be used, copied, and modified by individual physicians to best fit their own practices. Newer treatments such as the use of narrow band UVB, retinoids, and vitamin D3 in phototherapy are included as well as more traditional regimens. The principal author has written extensively about phototherapy and treatment of photoresponsive diseases and is an authority on this subject. This ready-made, comprehensive manual is targeted at dermatologists with their own phototherapy unit. Technicians in the office can then use these protocols as a standard for patient therapy and refer to the manual when needed. Each therapy type and each disease is easily identified in the index. Because of this, however, there is a lot of repetition as many protocols differ little between treatments of disease types. The font is small and outdated, making the sheets more difficult to read. Patient information sheets, for example, may not copy clearly. Despite this, the book is easy to access, the authors' goals are well met, and the language used is appropriate for all intended audiences. This is a much-needed practical manualwhich is a nice supplement to existing theory-based texts on the subject of phototherapy and will be useful in any office where this treatment is offered. This manual of dermatologist protocols for ultraviolet light therapy includes the new modality of narrow band UVB. Includes sample treatment management forms; and information on skin types, procedures for determining UVB dose, differential diagnosis, photosensitivity-inducing agents, equipment manufacturers, and a sample home phototherapy treatment followup letter. Lacks illustrations and an index. Zanolli is at Vanderbilt U. Medical Center, Nashville, TN, and his coauthors are at Wake Forest U. School of Medicine, Winston-Salem, NC. Zanolli, Michael D., MD (Vanderbilt Univ); Feldman, Steven R. , MD, PhD (Wake Forest Univ); Clark, Adele R., PA-C (Wake Forest Univ); Fleischer, Alan B., Jr., MD (Wake Forest Univ)

Table of Contents
Acknowledgements
Introduction
Phototherapy Treatment Center (PTC) Initial Introduction 1
I Patient Instructions and Protocols
Psoriasis 7
Vitiligo 63
Atopic dermatitis 79
Pruritus 97
Cutaneous T-cell lymphoma (CTCL) 107
Other selected phototherapy responsive dermatologic diseases 118
II Patient Consent Forms
Ultraviolet B (UVB) phototherapy 121
Psoralen plus Ultraviolet A (PUVA) 122
Scalp treatments 123
Home Ultraviolet therapy 124
III Patient Educational Handouts
UVB phototherapy 127
Systemic PUVA 128
Topical bath/paint PUVA 129
Goeckerman regimen 130
Modified Ingram 131
IV Treatment Management Forms
Physician's orders 135
Phototherapy treatment record 136
Ophthalmology exam record 137
Self-administered psoriasis area and severity scoring instructions 138
Doctor-administered psoriasis area and severity scoring instructions 141
Flow Sheets
Skin types 149
Procedure for determination of the Minimal Erythema Dose (MED) for UVB 150
Procedure for determination of the Minimal Erythema Dose (MED) for Narrow Band UVB 151
Differential diagnosis 152
Some agents that may cause photosensitivity 155
Equipment manufacturers 156
Letter for home phototherapy treatment 157
Suggested reading list 158

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