Five Years of Practical Experience of Phototherapy Clinic in Dermatology Department - Tripoli Central Hospital

Abstract

Phototherapy is used to treat a variety of skin diseases. Different types of phototherapy are used in the treatment of skin
conditions; primarily for psoriasis and vitiligo, for which phototherapy was first introduced. This cross sectional descriptive
study of five year interval was conducted in a phototherapy clinic, dermatology department-Tripoli central hospital. The
data was collected from files of the patients attending the clinic from December 2007 to December 2012. The ollected
data was packaged and analyzed by SPSS-version16. Descriptive statistic was used for age, sex, residency, marital state,
occupation, skin type, diagnosis, treatment type and follow up. For inferential statistics, Chi square, and the Anova test
were used. A P.value <0.005 was considered significant.
The total number of patients who attended the clinic was 1279. Of which the female patients were 57.6%, the male patients
were 42.4% with the minimum age of 5 years, maximum of 87 years and mean age of 33 ±15. The most common skin type
was type IV (98.4%). Most of the patients were resident in Tripoli (69.8%). The most common disease we treated was
vitiligo (43%) followed by psoriasis (34.7%), progressive macular hypomelnosis (PMH) (8.7%), cutaneus T-cell lymphoma
(CTCL) (3.8%), and pruritus (3.8%). Narrow band- ultraviolet B (NB-UVB) was the commonest treatment type used
(83.8%) while systemic psoralen plus ultraviolet A (PUVA) was only (11.8%). Of the patients, 56.6% completed their
treatment regularly, while (14.3%) were irregular, reported (2.6%) therapy failure and (26.5%) drop out. For NB-UVB the
maximum number of sessions recorded was 199 sessions and the highest cumulative dose was 874 J/cm². For systemic
PUVA the maximum number of sessions was 188 sessions with 940 J/cm² as the highest cumulative dose.
The study concluded that, the indications and need for phototherapy are increasing and many skin diseases can be treated
successfully with phototherapy without relevant complications. Therefore phototherapy should be easily accessible to
all the patients. Also the study found the number of sessions, and cumulative doses (especially for NB-UVB) are related
significantly to the diagnosis of the disease. Long term follow up needs to be conducted on patients exposed to phototherapy
to establish whether there exists a correlation between the treatment, and possible side effects such as photo-aging, and
development of cancer.