Management of atopic dermatitis using photo(chemo)therapy

The conclusions that may be drawn by interpreting the current literature on the efficacy of photo(chemo)therapy in the treatment of atopic dermatitis (AD) are limited by several factors including publication bias, small sample sizes, high variability of parameters used in different studies, and in particular the lack of randomized controlled trials comparing different photo(chemo)therapeutic modalities. The newer ultraviolet (UV) modalities, such as medium-dose UVA1 and narrowband (NB) UVB, with a high output and a narrow emission spectrum may be considered the probably most efficacious regimens for treating acute and chronic AD, respectively, in particular when compared to conventional broadband UV regimens. There are no prospective trials on AD patients comparing NB UVB and UVA1 with more complex regimens such as heliotherapy, balneophototherapy, psoralen plus UVA (PUVA), and extracorporeal photophoresis. Support for the role of the aforementioned regimens in the treatment of AD is generally weaker than for the newer modalities including medium-dose UVA1 and NB UVB. When photo(chemo)therapy is considered for AD patients, its use is very much dedicated by the cost-effectiveness, availability, and the practicality of attending the clinic several times a week.