Treatment of skin diseases using artificial sources of ultraviolet (UV) radiation has been practised in hospitals since the early part of the twentieth century following the pioneering work of Finsen and others. The treatment of malignant disease using ionising radiation (radiotherapy) started at about the same time, with the clinical practice of radiotherapy evolving and adapting to new knowledge in radiobiology and physics.
Developments in radiobiology led to fractionation and optimisation techniques, whilst activity in medical physics has resulted in widespread use of high-voltage linear accelerators and computerised treatment planning. However, while considerable progress has been made in cellular and cutaneous photobiology, and in the technology of ultraviolet lamps, it is apparent that developments in phototherapy have not kept pace with scientific progress, as has been the case with radiotherapy. One reason for this may be the infrequent close clinical collaboration between physicists and dermatologists, in contrast to that which has existed for many years between physicists and radiotherapists. There is clearly scope for this situation to be addressed.
The treatment of skin diseases with UV radiation alone (normally UVB-emitting sources) is termed phototherapy and when used in conjunction with drugs that photosensitise the skin (e.g. psoralens), the term photochemotherapy is used. Psoriasis, a disease characterised by red, scaly plaques and affecting about 2 per cent of the population, is the skin disease most frequently treated by UV radiation.
More recently, there has been considerable interest in using phototherapy for treating atopic eczema, another common skin disease characterised by an itchy, inflammatory eruption. There are a number of areas where the rigorous application of physical science to photo(chemo)therapy is likely to result in greater efficiency and safety in treating these and other skin diseases by ultraviolet radiation.
Diffey BL. Ultraviolet phototherapy of skin diseases. Physics and Engineering in Medicine in the New Millennium, IPEM 2000, 65-67.
Regional Medical Physics Department, Freeman Hospital, Newcastle upon Tyne, NE7 7DN, UK.
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