How We Can Save Phototherapy

Phototherapy is considered an effective procedure for psoriasis, however many residents are weary of prescribing it because they don’t fully understand how it works, according to Abby Van Voorhees, MD, chair of dermatology at the Eastern Virginia Medical School. She spoke about the issue at the 20th Resident Meeting National Psoriasis Foundation late last month.

During her presentation, Dr. Van Voorhees described a typical scenario in which the resident will ask a nurse to treat a patient using phototherapy. However, when the patient returns for a follow-up six to eight weeks later, the resident is confused as to how the procedure worked and how it’s administered. As a result, when they finish training and go into practice they avoid prescribing phototherapy as a treatment.

Dr. Van Voorhees is concerned that there are fewer opportunities for residents to learn about phototherapy than there used to be, making it challenging for them to develop an appreciation for the practice. At the meeting, she tried to close the knowledge gap by explaining how to determine phototherapy dosage, how to carry out the procedure, anticipating clinical reactions, and how to respond if there’s an interruption.   

“Residents need to know how to evaluate patients for phototoxicity. It occurs at different times with different modalities and looks and sounds different,” she said. “I want residents to feel that phototherapy is no longer a black box. It needs to be a treatment where they can understand what’s happening when the patient leaves them and goes to the next therapy session.”