Extract

Funding sources: The La Roche‐Posay Photodermatology Fellowship awarded by the British Photodermatology Group covered the travel expenses incurred in undertaking and presenting this project and attending other related meetings.

Conflicts of interest: none to declare.

Dear Editor, Erythemal episodes during phototherapy can be painful, can limit efficacy due to premature discontinuation of treatment and may contribute to chronic cutaneous damage. Many patients receiving phototherapy take photosensitive medications. Stern et al. investigated 1125 patients receiving maintenance psoralen–ultraviolet A (PUVA) photochemotherapy for psoriasis and did not detect a significant difference in the risk of erythemal episodes between those receiving photosensitizing medication and those who were not.1 However, among older (age ≥ 45 years) users of photoactive drugs, 10% discontinued PUVA for at least 1 month because of ‘burns’, compared with only 5% of ‘nonusers’.

In Tayside, a study of 401 patients receiving narrowband ultraviolet B (NB‐UVB) phototherapy revealed that some photosensitizing medications, particularly calcium channel antagonists, phenothiazines and nonsteroidal anti‐inflammatory drugs (NSAIDs), were associated with a lower baseline minimal erythema dose (MED).2

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