Table II.
UVA1 phototherapy protocol and dosing regimen
| 1. Patients should be treated 2–3 limes per week. |
| 2. Treat whole body except for face and genitals. |
| 3. Goggles should be worn at all times by the patient and the phototherapist. |
| 4. For skin phototypes ≤ Fitzpatrick III. start at 40 J/cm2. For skin phototypes ≥ IV, start at 70 J/cm2.. Increase by 10–20 J/cm2 per treatment to a maximum of 120 J/cm2. No need to apply emollient. |
| 5. Maintain dose as long as no erythema occurs. |
| If sunburn erythema should occur: |
| • Mild to moderate- decrease dose by 10%. Once the patient tolerates the reduced dose without erythema, increase as tolerated per above protocol. |
| • Severe- notify the PI who will evaluate the patient. |
| • If erythema is a repeated problem, notify physician. Erythema is unusual with UVA1 light treatments. A recurrent problem warrants a physician evaluation. |
| 6. Assess after 10–15 treatments* |
| • Good response- maintain dose (no extension or new lesions and erythema and signs of disease activity improved |
| • Partial response – to maximal dose (120 J/cm2) per protocol, no new lesions, minimal extension of exisiting lesions, and/or persistent erythema persistent/worsening erythema |
| • No response- worsening (new lesions or lesion extension, persistent/worsening erythema); stop UVA1 phototherapy and consider alternative therapy |
| 7. Reassess after another 10–15 treatments (for a total of 20–30 treatments or 6 weeks of treatment)** |
| • Good response or maximal improvement (no new lesions or extension of existing lesions; complete resolution of erythema and signs of activity, i.e. erythema) - stop UVA1 |
| • Partial or no response- discontinue UVA1 and consider alternative therapy |