Clin Cosmet Investig Dermatol. 2015;8:511-520.
Atopic dermatitis (AD) is a common chronic inflammatory skin disease that can affect all age groups. Phototherapy represents a valid second-line intervention in those cases where non-pharmacological and topical measures have failed. This review illustrates the main trials comparing the efficacy and safety of the different forms of phototherapy. Clinicians mainly refer to the indications included in the American Academy of Dermatology psoriasis guidelines devised by Menter et al in 2010. The efficacy of phototherapy (considering all forms) in AD has been established in adults and children, as well as for acute (UVA1) and chronic (NB-UVB) cases. Phototherapy is generally considered to be safe and well tolerated, with a low but established percentage of short-term and long-term adverse effects, with the most common being photodamage, xerosis, erythema, actinic keratosis, sunburn, and tenderness. A carcinogenic risk related to UV radiation has not been excluded. Phototherapy also has some limitations related to costs, availability, and patient compliance. In conclusion, phototherapy is an optimal second-line treatment for AD. It can be used as monotherapy or in combination with systemic drugs, in particular corticosteroids.