Phototherapy in dermatologic patients aged 65 years and older: a five-year retrospective study

Phototherapy, one of the oldest dermatological treatment methods, has not been well-defined in terms of efficacy and safety, particularly in specific patient groups such as those 65 years and older.

Phototherapy has been used as a treatment option for a wide range of dermatological diseases since 1988. Although it is more commonly used in adult patients, its use in individuals aged 65 years and older requires particular consideration because of the specific characteristics of this age group. The aim of this study was to present data on patients aged 65 years and older who received treatment in our phototherapy unit over a five-year period.

The medical records of patients aged 65 years and older who received phototherapy in our unit between 1 January 2021 and 31 December 2025 were retrospectively reviewed. Age, sex, Fitzpatrick skin type, diagnosis, phototherapy modality, treatment duration, total number of sessions, cumulative doses, adverse effects, treatment response, treatment attendance, reason for treatment discontinuation, and the months during which treatment was administered were recorded.

Over the five-year study period, 688 patients received phototherapy in our unit, of these, 123 patients (17.9%) were aged 65 years and older. Psoriasis was the most common diagnosis, observed in 36 patients (29.3%). Phototherapy was administered in combination with systemic therapy in 23 patients (18.7%) and with local treatment in 6 patients (4.9%). Whole-body narrowband UVB (NB-UVB) was used in 95 patients (77.2%), localized NB-UVB in 23 (18.7%), whole-body PUVA in 4 (3.6%), and localized PUVA in 1 (0.8%). Among patients receiving NB-UVB, the median cumulative dose was 15.12 J/cm2 (range, 0.01-240.10), and the median total number of sessions was 29 (range, 1-175). Forty-five patients (36.6%) interrupted treatment at least once or attended irregularly. Adverse effects were observed in 14 patients (11.5%). Among the 123 patients, clinical response could be evaluated in 100 patients. Complete or near-complete response was observed in 42 patients (42.0%), partial response in 22 patients (22.0%), and no/minimal response or worsening in 36 patients (36.0%). For comparative analyses, 64 patients (64.0%) were classified as responders and 36 (36.0%) as non-responders. No significant differences were observed between responders and non-responders regarding age, sex, treatment regimen, treatment modality, or treatment adherence. However, higher cumulative NB-UVB doses and a greater number of NB-UVB sessions were significantly associated with treatment response.

Phototherapy remains an important and reliable therapeutic option in patients aged 65 years and older, particularly in those with severe or treatment-resistant disease and in patients for whom systemic therapies are contraindicated or unsuitable.