For psoriasis patients, the most important concern is the treatment and treatment effect. At present, there are more methods to treat psoriasis, but there are still few methods with satisfactory treatment effects.
Ultraviolet light therapy in physical therapy is an effective method for treating psoriasis, and its combined application with drugs can not only improve the therapeutic effect but also reduce the occurrence of adverse reactions. In addition, bathing therapy can also be chosen.
1.What are the commonly used ultraviolet light therapies at present?
Ultraviolet light therapy
(1) NB-UVB: UVB phototherapy should be carried out at least 3 times a week in order to stabilize and improve the skin lesions of existing psoriasis patients. If UVB phototherapy is given less than 3 times a week, the rate of lesion improvement will be significantly reduced.
Patients with scattered plaque psoriasis throughout the body require at least 20 to 30 sessions of UVB phototherapy to achieve significant results.
Patients should receive treatment for approximately 3 months, followed by maintenance therapy, which is NB-UVB once or twice a week and can vary from a few months to several years depending on the patient.
Adverse effects of NB-UVB include erythema and blistering. The higher the BMI and waist circumference of psoriasis patients, the higher the incidence of phototherapy-associated erythema, so this group of patients should be extra careful when using phototherapy.
(2) 308nm excimer laser: It is suitable for limited rashes, or plaque psoriasis where other treatments are ineffective, and has the characteristics of long-lasting efficacy and low recurrence rate.
Generally, 1 to 3 treatments per week, with a minimum interval of 48 hours between each treatment when considering the availability of resources and personnel and patient convenience.
The initial dose is determined by the patient’s minimal erythema volume, which can be 1 to 3 times the minimal erythema volume. Subsequent dose increases are based on the patient’s responsiveness to treatment and associated adverse effects.
If there is no mild erythema, the dose may be increased by 15-25%. In the case of intense erythema, the dose may be reduced by 15-25%. If blistering or crusting occurs, the treatment cannot be continued.
(3) Photochemotherapy: It is a kind of therapy to treat psoriasis by irradiating UVA after taking internal or external photosensitizer, and the most commonly used method is PUVA.
PUVA enters the lesion tissue to a deeper degree compared with UVB, especially for thicker lesion areas such as palmoplantar with better efficacy. In addition, patients with nail involvement usually do well with PUVA, with 70% of patients having better results after 3 to 4 months of treatment.
However, the treatment also has adverse effects, and common adverse effects include nausea, dizziness, headache, burning, and itching. It also has photosensitivity, so patients taking psoralen should avoid sun exposure and can use topical UVA shades.
(4) LED ultraviolet light therapy: LED ultraviolet light therapy device treatment is equivalent to the application of 308nm excimer light treatment, and less adverse reactions, especially suitable for the treatment of patients with mild and moderate involvement area and as an adjunct to systemic drug therapy.
Using larger energy for treatment, complications such as blistering rarely occur, making it more suitable for home phototherapy use.
2.Bath therapy
Although phototherapy is effective, each person’s response effect and the optimal treatment period are different. Intradermal spectral photometric imaging technology can be used to achieve the purpose of pre-judging the effectiveness of phototherapy and avoiding unnecessary treatment. In addition to light therapy, bathing therapy also has a better effect on psoriasis.
Shower therapy
First of all, how does bathing therapy improve psoriasis?
Generally, a large pool or tub of hot spring water is chosen for bathing. Hot spring water is rich in a variety of macronutrients, trace elements, chemical substances and radioactive substances, which can promote the metabolism of the body, promote the absorption and remission of inflammation, soften and dissolve the surface layer, soften hyperkeratotic cells and remove scales. It can reduce inflammation, improve blood circulation, and promote the regression of skin lesions.
Of course, there are also precautions for using bathing therapy!
– The water temperature should be 39℃~41℃, and the patient should feel warm and comfortable, and the water temperature can be gradually increased as the patient’s tolerance improves.
– The treatment time is 10 minutes, 20 minutes, 30 minutes, gradually extended.
– Patients with heart disease, the water temperature should be lower.
– For the elderly and infirm, the bath should not be taken on an empty stomach, and sugar-salted water or mineral water should be consumed promptly after the bath.
– For those with arthritic mobility problems, assist the patient to enter the bath.
– If the patient has palpitations, chest tightness, nausea, sweating, dizziness, etc., the nurse should help him/her to get out of the bath immediately, put him/her on the bed, take the head low and foot high position, or drink sugar saline, and notify the doctor if necessary.
References
[1]Wang Huifeng,Zhang Yujie,Gao Yu. Research progress of phototherapy in the treatment of psoriasis [J]. Chinese Journal of Clinical Physicians (Electronic Edition),2014,8(20):3694-3698.
[2]Zhou Zhaokun,Zhou Guangming. Advances in the treatment of psoriasis[J]. Medical Review,2014,20(02):291-294.
[3]Tian Hongqing. Physiotherapy of psoriasis[A]. Proceedings of the Shandong Academic Conference on Integrative Dermatology and Venereal Diseases [C].2009[C]. .2011:127-133.
[4]Jiao Ruixue,Wen Ru. The care of psoriasis physiotherapy[J]. Chinese Journal of Misdiagnosis,2007,7(20):4884-4885.