Phototherapy is effective and safe in the short-term for a wide range of dermatoses in elderly patients, according to data released at the 23rd European Academy of Dermatology and Venereology (EADV) Congress in the Netherlands.
Dr. J. B. Powell, of the University Hospital Coventry in the UK, and colleagues analyzed outcomes in elderly patients who were currently receiving or had recently completed a course of phototherapy at a university teaching hospital where minimal erythema dose (MED) and minimal phototoxic dose (MPD) testing were not routinely performed.
Patients were considered elderly if they were 65 years of age or older.
While phototherapy is a “versatile” and effective treatment modality used successfully in children and adults, little information is available about its efficacy and safety in elderly populations, Dr. Powell observed.
Differences in the structure and physiology of aged skin, the presenting dermastoses, the possibility of polypharmacy, a history of skin cancer or pre-cancerous lesions, multiple co-morbidities, previous phototherapy, and any physical and/or cognitive decline seen in elderly patients may alter the response, suitability and safety of phototherapy compared with younger patients.
The analysis included 31 elderly patients who received a total of 739 individual phototherapy treatments. Treatment was narrowband ultraviolet B (nbUVB) in 88% of cases and psoralen combined with ultraviolet A (PUVA) in 12%.
Psoriasis was the reason for referral for phototherapy in 51% of cases, followed by eczema in 11% and nodular prurigo in 11%. Other dermatoses that led to a referral included Grover disease, polymorphic light eruption, granuloma annulare, scleromyxedema and erthroderma.
The acute adverse event rate was 1.89%. There were 13 episodes of mild erythema and one episode of moderate erythema. All erythema episodes occurred in patients receiving nbUVB.
Of patients receiving nbUVB for psoriasis, 91% achieved a clear/near clear response after an average of 30 treatments.
The data also showed that standard phototherapy protocols were adequate in the study cohort.
While the results support the efficacy and safety of phototherapy in elderly patients for a range of dermatoses, further examination of short- and long-term outcomes in this age group is needed, Dr. Powell said.
Jill Stein is a Paris-based freelance medical writer.