Abstract
Phototherapy is widely used to treat inflammatory skin diseases such as psoriasis and atopic dermatitis. Repeated suberythemogenic doses of UV-light reduce inflammation in these diseases and ultimately may lead to a complete disappearance of cutaneous symptoms for weeks or months. Chronic pruritus is an important and highly distressing symptom of many of these inflammatory skin diseases. Interestingly, pruritus is also reduced or completely abolished by UV-treatment of psoriasis and atopic dermatitis, and sometimes reduction of pruritus is the first indication for skin improvement by phototherapy. The cutaneous nervous system is an integral part of skin anatomy, and free nerve endings of sensory cutaneous nerve fibers reach up into the epidermis getting in close contact with epidermal cells and mediators from epidermal cells released into the intercellular space. Stimulation of “pruriceptors” within this group of sensory nerve fibers generates a neuronal signal eventually transmitted via the dorsal root and the spinal cord to the brain, where it is recognized as “itch”. UV-light may directly affect cutaneous sensory nerve fibers or, via the release of mediators from cells within the skin, indirectly modulate their function as well as the transmission of itch to the central nervous system inducing the clinically recognized antipruritic effect of phototherapy.
Highlights
The Antipruritic Effect of PhototherapyDepartment of Dermatology and Venerology, Medical University of Graz, Graz, Austria Reviewed by: Irina Khamaganova, Pirogov Russian National Research Medical University, Russia Piergiacomo Calzavara-pinton, Università degli Studi di Brescia, Italy Specialty section: This article was submitted to Dermatology, a section of the journal
It has long been recognized that “UV-responsive” skin diseases improve during summer months and worsen during winter, and exposure to natural sunlight, i.e., heliotherapy, is a common way of psoriasis patients to improve their skin lesions
Phototherapy is capable of improving chronic pruritus in a variety of different pruritic skin diseases beside psoriasis and atopic dermatitis (AD), such as lichen planus, pityriasis lichenoides, urticaria pigmentosa, chronic spontaneous urticaria, parapsoriasis, and cutaneous T-cell lymphoma (CTCL) (e.g., Sezary-Syndrome) [4]
Summary
Department of Dermatology and Venerology, Medical University of Graz, Graz, Austria Reviewed by: Irina Khamaganova, Pirogov Russian National Research Medical University, Russia Piergiacomo Calzavara-pinton, Università degli Studi di Brescia, Italy Specialty section: This article was submitted to Dermatology, a section of the journal
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