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Minimal erythema dose after multiple UV exposures depends on pre-exposure skin pigmentation

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Abstract:

Background/purpose:

Phototherapy consists of multiple ultraviolet (UV) exposures. Most previous studies have focused on erythema following a single UV exposure in fair-skinned persons. Although it is well known that phototherapy lowers the daily UV-threshold dose for erythema in clinical practice, this is insufficiently documented under controlled experimental conditions. The purpose of this study was to quantify the change in the daily threshold for a dose specific erythema grade after 1–4 consecutive daily UV exposures. Methods:

Forty-nine healthy volunteers (skin type II–V) with varying pigmentation quantified by skin reflectance. Two UV sources were used: a narrowband UVB (Philips TL01) and a Solar Simulator (Solar Light Co.). Just perceptible erythema after 24 h was chosen as the minimal erythema dose (+); besides + and ++ were assessed. Results:

We found a positive and significant exponential relationship between skin pigmentation and UV dose to elicit a specific erythema grade on the back after 1–4 UV exposures. After repetitive UV exposures the UV dose had to be lowered more in dark-skinned persons compared with fair-skinned persons to elicit a certain erythema grade. This applied to both UV sources and all erythema grades. Conclusion:

In the dark-skinned persons the daily UV dose after the 4 days UV exposure should be lowered by 40–50% to avoid burns compared with the single UV exposure. For the most fair-skinned persons essentially no reduction in the daily UV dose was needed. Our results indicate that the pre-exposure pigmentation level can guide the UV dosage in phototherapy.

Keywords: UVA; UVB; erythema; phototherapy; pigmentation

Document Type: Research Article

DOI: http://dx.doi.org/10.1111/j.1600-0781.2004.00104.x

Publication date: August 1, 2004

mksg/ppp/2004/00000020/00000004/art00002
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