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Phototherapy and DNA Damage: A Systematic Review
Aislyn Oulee1, Grace S Ahn2, Sogol S Javadi3
1Dr. Oulee is with the University of California Riverside School of Medicine in Riverside, California.
The Journal of Clinical and Aesthetic Dermatology
|June 26, 2023
Summary
Phototherapy offers a cost-effective, less toxic treatment for skin conditions. However, it poses risks of DNA damage and skin cancer, necessitating careful patient selection and monitoring.
Area of Science:
- Dermatology
- Photobiology
- Oncology
Background:
- Phototherapy is a popular, cost-effective, and less toxic treatment for immune-mediated dermatological conditions.
- Concerns exist regarding phototherapy's potential risks, particularly for patients susceptible to malignancies.
Purpose of the Study:
- To systematically review the risks and benefits of phototherapy for dermatology providers.
- To highlight phototherapy's impact on patients at risk for malignancies.
Main Methods:
- Systematic review of phototherapy risks and benefits.
- Analysis of DNA damage mechanisms (CPDs, 6-4PPs, ROS) induced by phototherapy.
- Comparison of side effect profiles and DNA damage potential across different phototherapy modalities (NB-UVB, BB-UVB, PUVA).
Main Results:
- Phototherapy-induced DNA photolesions (CPDs, 6-4PPs) and reactive oxygen species (ROS) can increase carcinogenesis risk.
- Different modalities have varying risks; PUVA poses a long-term malignancy risk (up to 25 years).
- Optimal radiation dosage, considering skin pigmentation and photoadaptation, is crucial.
Conclusions:
- Dermatology providers must weigh phototherapy's benefits against risks, especially malignancy potential.
- Minimizing deleterious skin changes may involve adjunctive therapies, but routine skin exams are paramount.
- Informed patient selection and vigilant monitoring are essential for preventing phototherapy-induced neoplasia.
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