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| |  AAD: Commercial Tanning Beds Provide Effective and Accessible Light Therapy for Psoriasis By Pamela Harrison Special to DG News NEW ORLEANS, LA -- February 25, 2002 -- Commercial tanning bed therapy coupled with use of acitretin is highly effective for treating moderate to severe plaque-like psoriasis and is far more accessible for most patients than more traditional forms of light therapy given as either PUVA or UVB. These findings were presented here yesterday during a poster session at the 60th annual meeting of the American Academy of Dermatology. "More rapid clearance of psoriasis can be achieved when acitretin is combined with PUVA [psoralen plus ultraviolet A light] or UVB [ultraviolet B light]," observed lead author Dr. Christopher Carlin, department of dermatology, University of Utah, Salt Lake City. Adverse events associated with the use of retinoids can be attenuated with additional PUVA and UVB light therapy as much lower doses of acitretin can be used than with the combination approach. On the other hand, the cost and availability of both PUVA and UVB light therapy can be prohibitive, as Dr. Carlin and colleagues observed. Noting that many patients with psoriasis already use commercial tanning beds to help control their psoriasis, the Stall Lake City group initially reviewed charts of 26 patients with moderate to severe psoriasis who had been treated with either acitretin or etretinate and commercial tanning bed therapy. "Results of 23 patients available for chart analysis showed clearance or near clearance in 19 patients and moderate improvement in two others, while the remaining two patients had no change," the authors observed. They then recruited 17 additional patients who took acitretin, 25 mg a day, plus tanning bed light therapy an average of 4.1 times a week for 12 weeks. (Wolff tanning beds at tanning salons with a mean UVB percent output of 4.7 percent were used). Patients started with only two minutes per tanning session, and each subsequent session was increased by one minute, for a maximum time per session of 30 minutes. At the end of 12 weeks, 14 patients had completed the study and among these the mean reduction in both the PASI and NPFPS scores was approximately 79 percent. "Clearance or near clearance by PASI score was also seen in 71 percent of patients," the authors added. The most common adverse events were caused by the retinoid and included cheilitis, reported in about two-thirds of patients, and dry skin. The tanning bed therapy itself was associated with few adverse events and, as is true for both PUVA and UVB light therapy, a lower dose of the retinoid can be used when patients use concomitant tanning bed therapy. "Based on the cost of treatment at our institution, acitretin in combination with tanning bed light [therapy] was less expensive than acitretin plus PUVA, acitretin plus UVB or PUVA, UVB or acitretin therapy alone," the authors concluded.
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