UV hardening therapy: a novel intervention in patients with photosensitive cutaneous lupus erythematosus

C.J.G. Sanders; H.Y. Lam; C.A.F.M. Bruijnzeel - Koomen; V. Sigurdsson; H. van Weelden

doi:10.1016/j.jaad.2005.10.046

UV hardening therapy: a novel intervention in patients with photosensitive cutaneous lupus erythematosus

C.J.G. Sanders, H.Y. Lam, C.A.F.M. Bruijnzeel - Koomen, V. Sigurdsson, H. van Weelden

Dermatology and Allergology

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

BACKGROUND: Patients with cutaneous lupus erythematosus (LE) and a history of disease- related photoaggravation, confirmed by phototesting, may not respond to photoprotection and/or medical intervention. Ultraviolet B-hardening therapy may improve tolerance for environmental ultraviolet radiation (UVR) in photosensitive disorders.

OBJECTIVE: We studied the effect of UVB hardening on the cutaneous manifestations of patients with LE and their tolerance for UVR.

PATIENTS AND METHODS: A retrospective study of continuous, home-based, UVB-hardening therapy in 44 patients with cutaneous LE (systemic LE: 9 patients; chronic LE: 21 patients; subacute cutaneous LE: 10 patients; cutaneous LE not specified: 4 patients) who had confirmed photosensitivity. Exposure to the UVB source was performed year-round, 3 times weekly, with increasing doses to a maximum of 10 minutes per session. Tolerance for environmental UVR was established through questionnaires, phototesting, and assessment of disease activity by physician and patient.

RESULTS: Of 44 patients, 35 were able to gradually increase their monthly UVB doses. Nine patients dropped out because of insufficient efficacy or skin irritation, or were unable to adhere to the hardening regimen. Of the 35 patients who succeeded in hardening their skin with UVB, 28 patients reported an improved tolerance for environmental UVR. This outcome was confirmed by repeat phototesting in a subgroup. In only 5 patients, an improvement of cutaneous LE symptoms was noted by either physician or patient. No serious adverse events were encountered.

LIMITATIONS: This was a retrospective study and no control group was used.

CONCLUSION: This is the first report that describes UVB hardening as a potential therapy in patients with cutaneous LE and confirmed photosensitivity. This intervention may lead to improved tolerance for environmental UVR and, in a minority of patients, even to decreased cutaneous activity of LE.

Original language	English
Pages (from-to)	479-486
Number of pages	8
Journal	Journal of the American Academy of Dermatology
Volume	54
Issue number	3
DOIs	https://doi.org/10.1016/j.jaad.2005.10.046
Publication status	Published - 2006

Keywords

Female
Humans
Lupus Erythematosus, Cutaneous
Male
Photosensitivity Disorders
Retrospective Studies
Ultraviolet Therapy

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10.1016/j.jaad.2005.10.046

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@article{65ecc0a908e24b2491e061df65b6bf5e,

title = "UV hardening therapy: a novel intervention in patients with photosensitive cutaneous lupus erythematosus",

abstract = "BACKGROUND: Patients with cutaneous lupus erythematosus (LE) and a history of disease- related photoaggravation, confirmed by phototesting, may not respond to photoprotection and/or medical intervention. Ultraviolet B-hardening therapy may improve tolerance for environmental ultraviolet radiation (UVR) in photosensitive disorders.OBJECTIVE: We studied the effect of UVB hardening on the cutaneous manifestations of patients with LE and their tolerance for UVR.PATIENTS AND METHODS: A retrospective study of continuous, home-based, UVB-hardening therapy in 44 patients with cutaneous LE (systemic LE: 9 patients; chronic LE: 21 patients; subacute cutaneous LE: 10 patients; cutaneous LE not specified: 4 patients) who had confirmed photosensitivity. Exposure to the UVB source was performed year-round, 3 times weekly, with increasing doses to a maximum of 10 minutes per session. Tolerance for environmental UVR was established through questionnaires, phototesting, and assessment of disease activity by physician and patient.RESULTS: Of 44 patients, 35 were able to gradually increase their monthly UVB doses. Nine patients dropped out because of insufficient efficacy or skin irritation, or were unable to adhere to the hardening regimen. Of the 35 patients who succeeded in hardening their skin with UVB, 28 patients reported an improved tolerance for environmental UVR. This outcome was confirmed by repeat phototesting in a subgroup. In only 5 patients, an improvement of cutaneous LE symptoms was noted by either physician or patient. No serious adverse events were encountered.LIMITATIONS: This was a retrospective study and no control group was used.CONCLUSION: This is the first report that describes UVB hardening as a potential therapy in patients with cutaneous LE and confirmed photosensitivity. This intervention may lead to improved tolerance for environmental UVR and, in a minority of patients, even to decreased cutaneous activity of LE.",

keywords = "Female, Humans, Lupus Erythematosus, Cutaneous, Male, Photosensitivity Disorders, Retrospective Studies, Ultraviolet Therapy",

author = "C.J.G. Sanders and H.Y. Lam and {Bruijnzeel - Koomen}, C.A.F.M. and V. Sigurdsson and {van Weelden}, H.",

year = "2006",

doi = "10.1016/j.jaad.2005.10.046",

language = "English",

volume = "54",

pages = "479--486",

journal = "Journal of the American Academy of Dermatology",

issn = "0190-9622",

publisher = "Mosby Inc.",

number = "3",

}

TY - JOUR

T1 - UV hardening therapy

T2 - a novel intervention in patients with photosensitive cutaneous lupus erythematosus

AU - Sanders, C.J.G.

AU - Lam, H.Y.

AU - Bruijnzeel - Koomen, C.A.F.M.

AU - Sigurdsson, V.

AU - van Weelden, H.

PY - 2006

Y1 - 2006

N2 - BACKGROUND: Patients with cutaneous lupus erythematosus (LE) and a history of disease- related photoaggravation, confirmed by phototesting, may not respond to photoprotection and/or medical intervention. Ultraviolet B-hardening therapy may improve tolerance for environmental ultraviolet radiation (UVR) in photosensitive disorders.OBJECTIVE: We studied the effect of UVB hardening on the cutaneous manifestations of patients with LE and their tolerance for UVR.PATIENTS AND METHODS: A retrospective study of continuous, home-based, UVB-hardening therapy in 44 patients with cutaneous LE (systemic LE: 9 patients; chronic LE: 21 patients; subacute cutaneous LE: 10 patients; cutaneous LE not specified: 4 patients) who had confirmed photosensitivity. Exposure to the UVB source was performed year-round, 3 times weekly, with increasing doses to a maximum of 10 minutes per session. Tolerance for environmental UVR was established through questionnaires, phototesting, and assessment of disease activity by physician and patient.RESULTS: Of 44 patients, 35 were able to gradually increase their monthly UVB doses. Nine patients dropped out because of insufficient efficacy or skin irritation, or were unable to adhere to the hardening regimen. Of the 35 patients who succeeded in hardening their skin with UVB, 28 patients reported an improved tolerance for environmental UVR. This outcome was confirmed by repeat phototesting in a subgroup. In only 5 patients, an improvement of cutaneous LE symptoms was noted by either physician or patient. No serious adverse events were encountered.LIMITATIONS: This was a retrospective study and no control group was used.CONCLUSION: This is the first report that describes UVB hardening as a potential therapy in patients with cutaneous LE and confirmed photosensitivity. This intervention may lead to improved tolerance for environmental UVR and, in a minority of patients, even to decreased cutaneous activity of LE.

AB - BACKGROUND: Patients with cutaneous lupus erythematosus (LE) and a history of disease- related photoaggravation, confirmed by phototesting, may not respond to photoprotection and/or medical intervention. Ultraviolet B-hardening therapy may improve tolerance for environmental ultraviolet radiation (UVR) in photosensitive disorders.OBJECTIVE: We studied the effect of UVB hardening on the cutaneous manifestations of patients with LE and their tolerance for UVR.PATIENTS AND METHODS: A retrospective study of continuous, home-based, UVB-hardening therapy in 44 patients with cutaneous LE (systemic LE: 9 patients; chronic LE: 21 patients; subacute cutaneous LE: 10 patients; cutaneous LE not specified: 4 patients) who had confirmed photosensitivity. Exposure to the UVB source was performed year-round, 3 times weekly, with increasing doses to a maximum of 10 minutes per session. Tolerance for environmental UVR was established through questionnaires, phototesting, and assessment of disease activity by physician and patient.RESULTS: Of 44 patients, 35 were able to gradually increase their monthly UVB doses. Nine patients dropped out because of insufficient efficacy or skin irritation, or were unable to adhere to the hardening regimen. Of the 35 patients who succeeded in hardening their skin with UVB, 28 patients reported an improved tolerance for environmental UVR. This outcome was confirmed by repeat phototesting in a subgroup. In only 5 patients, an improvement of cutaneous LE symptoms was noted by either physician or patient. No serious adverse events were encountered.LIMITATIONS: This was a retrospective study and no control group was used.CONCLUSION: This is the first report that describes UVB hardening as a potential therapy in patients with cutaneous LE and confirmed photosensitivity. This intervention may lead to improved tolerance for environmental UVR and, in a minority of patients, even to decreased cutaneous activity of LE.

KW - Female

KW - Humans

KW - Lupus Erythematosus, Cutaneous

KW - Male

KW - Photosensitivity Disorders

KW - Retrospective Studies

KW - Ultraviolet Therapy

U2 - 10.1016/j.jaad.2005.10.046

DO - 10.1016/j.jaad.2005.10.046

M3 - Article

C2 - 16488300

SN - 0190-9622

VL - 54

SP - 479

EP - 486

JO - Journal of the American Academy of Dermatology

JF - Journal of the American Academy of Dermatology

IS - 3

ER -

UV hardening therapy: a novel intervention in patients with photosensitive cutaneous lupus erythematosus

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