Phototherapy and dithranol treatment of psoriasis: new lamps for old

The response of psoriasis to ultraviolet radiation and dithranol was compared with the response to dithranol alone in 24 patients. The difference in rate of response, measured as change in plaque thickness, and the difference in time to complete clearance of psoriasis between irradiated and non-irradiated forearm lesions was significantly greater for patients treated using fluorescent lamps with negligible ultraviolet C emission (Wolff Helarium) than for those patients treated with a medium pressure mercury arc lamp (p less than 0.01) or an array of fluorescent sunlamps (p less than 0.05). The difference in therapeutic response shows that ultraviolet B phototherapy is effective when used in combination with dithranol. Nevertheless, radiation sources with substantial ultraviolet C emission, such as the medium pressure mercury arc lamp most commonly used to treat psoriasis in the United Kingdom, have little effect because delivery of therapeutic doses of ultraviolet B is limited by erythema induced by ultraviolet C.