Media Release 26 Sep 2007

Phototherapy and skin disease

Seasonal changes can bring misery to people affected by skin diseases such as eczema and psoriasis.

Skin is the largest organ in the body and accounts for about seven per cent of total body weight and when problems occur it can have a major effect on a person’s overall health and well being.

Psoriasis and eczema are common inflammatory skin conditions that cause considerable discomfort. Although not life threatening, they can be difficult to endure and may disrupt the sufferer’s everyday life

Eczema (atopic dermatitis) is a recurring, non-infectious, inflammatory skin condition affecting up to one in 10 Australians at some stage throughout their lives,

Eczema is characterised by excruciating itching and is most commonly found on the hands, face, neck and arm and leg folds. The skin often becomes very dry and red, with a scaly and thickened appearance.

Psoriasis, on the other hand, is the result of inflammation that causes an over production of skin cells resulting in bright red patches covered with silvery scales.

Serious cases may lead to painful cracking, fissuring and infection of the skin. Chronic plaque psoriasis (the most common form) usually affects the scalp, knees, trunk and elbows and may have an associated itch.

“Often mild forms of these diseases can be relieved with medications and education,” said Michelle McLaughlin, Clinical Nurse Consultant at Royal North Shore Hospital’s PUVA/UVB Unit.

“Patients we see in our unit tend to have moderate to severe conditions and topical creams and ointments have not given them much relief to date.”

“We usually think of UV rays as harmful, but narrow-band UVB, known as phototherapy, has proven beneficial for these types of skin diseases,” Michelle said.

PUVA is an acronym for psoralen (a light-sensitizing medication) combined with exposure to ultraviolet light A (UVA). UVA, like UVB, is found in sunlight. By itself, however, UVA is not usually used to clear psoriasis. It is relatively ineffective unless used with a light-sensitizing medication such as psoralen

Patients attend the PUVA/UVB Unit for a course of treatment up to three times a week over a couple of months. The patient stands in a specially designed cabinet containing light tubes and is initially exposed to the UVB for a short time (seconds to minutes).

This timing steadily increases with tolerance. UV treatment aims to decrease itchiness, inflammation and improve the skin’s appearance. The amount of UV is carefully monitored according to a number of factors including skin type, age and skin condition.

The winter months are particularly busy at the PUVA/UVB Unit as skin conditions tend to flare up due to the decrease in natural light and cooler, dryer weather which dictates a change in lifestyle.
During this time the unit treats up to 40 patients a day with phototherapy.
The PUVA/UVB nurses help patients learn about their skin condition and its management including how to cleanse and moisturise and how to use prescribed creams and medications.

There is even advice on choosing clothes so they don’t increase itching or irritation.

While there is no known cure for these common skin diseases, with careful management and appropriate therapy, most patients can obtain substantial relief if not remission of their symptoms.

Media Contact: RNSH Penelope Little 9926 7199 / 0413 025 742

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