PSORIASIS AND PHOTOTHERAPY

A new method for the management of psoriasis has been recently described by Parrish et al.' The ease with which this method can be used and the reported extraordinary high rate of clearing make it a most desirable addition to our dermatologic armamentarium. The most important questions that face us at this time are two: First, is the method not only useful but practical, and second, will there be significant adverse effects of this therapy? The question of practicality appears to rest partially in the hands of the manufacturers of the high-intensity ultraviolet A emitting fluorescent bulbs and fixtures,2 primarily because of the present very high cost of the recommended equipment. On the other hand, it may be not only necessary but desirable for many of us to use either natural sunlight or more reasonably priced artificial lamp sources that produce somewhat less intense radiation. The practitioner must be held responsible for delivering accurate doses of high intensity light, prescribing appropriate dosages of drugs, and protecting the patients from additional photosensitizing exposures to natural and/or artificial light to avoid calamities. The actual time required of the physician to conduct the procedure appears slight. However, with appropriate directions, the patient may even be able to carry out the procedure on himself. Perhaps of greater concern to those with special interests in investigative and clinical photobiology are the potential adverse latent effects of repeated high intensity ultraviolet A exposure and the psoralen-mediated phototoxic response on human skin. Recent investigations^ and Forbes, P. D.,' have shown that conPSORIASIS AND PHOTOTHERAPY