Phototherapy for Psoriasis in Contemporary, Biologic-Focused Practice
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Updated: Nov 2, 2026

The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis
Published on: July 11, 2013
Samaa Fadel1, Steven R Feldman1
1Center for Dermatology Research, Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, North Carolina.
Abstract:
Phototherapy has been a cornerstone of psoriasis management since before the biologic era, and despite being eclipsed by systemic agents, it retains meaningful clinical utility. Narrowband ultraviolet B (NB-UVB) achieves clinically significant clearance rates, has been associated with greater improvement in overall health-related quality of life compared to adalimumab, and is effective across all skin tones. NB-UVB is associated with spatially distinct transcriptomic changes within plaques and downregulation of HLA-C-mediated antigen presentation on melanocytes. Home-based phototherapy, assessed in the LITE trial, performs non-inferiorly to office-based UV and is an accessible alternative. Coverage for home phototherapy is improving. Access barriers, insurance structure, and limited familiarity by prescribers remain obstacles to wider adoption. Addressing these through policy reform, expanded phototherapy coverage, and implementation science may represent an actionable path forward.
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