8 May, 2009
A new study claims that patients with psoriasis can be treated with ultraviolet B (UVB) as effectively and safely at home as they can in hospital.
Phototherapy is conventionally carried out in hospitals, but the research shows that patients having the therapy at home find it less of a burden and are more satisfied with the treatment.
Although UVB treatment is safe and effective, limited availability and time constraints within hospitals mean that few patients in the UK ever receive it.
The situation is compounded by the belief held by most dermatologists that home phototherapy is not as effective as hospital treatment, although there is no evidence to support this.
The new research by a team of experts in the Netherlands compared UVB phototherapy given at home with that received in hospital.
Writing in the online edition of the BMJ, they conclude that home phototherapy is equally as safe and effective as outpatient phototherapy, both clinically and in terms of quality of life.
The majority of patients said they would prefer home UVB therapy over hospital-based therapy in the future.
The authors suggest that current guidelines regarding the treatment of patients with psoriasis should be updated to reflect their findings.
Article Published 2/3/2009 in the Charleston Daily Mail
by Monica Orosz
Daily Mail staff
Chase Morris is a typical 6-year-old who loves video games, hates to sit still and enjoys playing all sports from football to baseball and basketball. He’s got bright eyes, a big smile and closely cropped blonde hair that are captured in numerous framed photos around his Poca home.
Parents Jennifer and Tony Morris have chronicled lots of moments of their only child’s life in photos, though not all of them are as happy. Jennifer also has stacks of photos illustrating Chase’s battle with psoriasis, a chronic skin condition she first noticed when he was just a few months old and had a little patch of dry skin.
That patch grew into many angry red spots and scales that irritated her little child and panicked the new mom. Because of Jennifer’s persistence in researching the disease, Chase has consistently gotten the best treatment she can find.
Though his condition means he has to sit still for a variety of daily treatments, Chase’s disease is considered in remission right now, meaning it is under control. He recently was selected as a poster boy of sorts for the disease – Chase’s photos grace the month of February in a calendar by the non-profit Psoriasis Cure Now, being distributed around the country to highlight the disease and the need for a cure.
The photos of a beaming Chase show what has happened after years of seeking just the right treatment. And what’s right now for Chase could change as he gets older. “I Google everything,” Jennifer said.
Psoriasis is a recurring disease of the immune system that causes dry skin and lesions. It can cause arthritic symptoms. It is not contagious, but there is no cure. It affects as many as 7.5 million Americans, according to the U.S. National Institutes of Health. It sounds simple: dry skin.
“It’s not just itchy skin,” Jennifer said. When psoriasis flares up it is unsightly at the least and drive-you-crazy itchy at its worst.
Chase has been known to scratch himself bloody in his sleep. At one point, 90 percent of Chase’s body was involved and his hair had begun falling out. In written material Jennifer sent to the psoriasis organization along with his photos, she chronicled Chase’s history and the heartbreak. “The nights were the toughest. Chase’s skin was so itchy that he could not sleep and would wake through the night crying. We got through the nights by applying Cetaphil lotion thick, and then I would wrap him up in a blanket and hold him. We would then talk about funny things or tell stories to take his mind off of the itching. “He would fall back to sleep; in the morning there would be blood on his sheets from the intense scratching he did in his sleep.”
Many of the treatments for psoriasis are hard-core and not necessarily appropriate for a pediatric case. Jennifer sought out experts and finally found a pediatric dermatologist in Virginia, Kelly Cordoro at the University of Virginia Children’s Hospital. Cordoro treated Chase for more than a year before moving across the country, though the family stays in touch by email and the Morrises have located a local dermatologist, Michelle Endicott, who now treats Chase.
It was Cordoro who recommended a light therapy bed to treat Chase – narrowband ultraviolet light helps the disease. Cost: $3,700. After lengthy negotiations, the family’s insurance company agreed to pay about $2,800 of the cost and the Morrises had to come up with the difference. “We had a huge family yard sale and raised enough money from that and donations to pay for it,” Jennifer said.
The light bed – a misnomer, since it really stands up – now holds a place of honor in the family room. Every other day or so, Chase dons protective eyewear, sheds his clothes (they call it “going commando”) and spends five or six minutes in front of the lights.
It’s an interminable time for a 6-year-old and Jennifer tells him it’s his choice. Chase knows it helps, so he usually toughs it out. He also suffers through a nightly combing by his mom to loosen dry patches on his scalp. “I usually wait until he’s lying down, watching TV,” she said. She smooths mineral oil or prescription lotion into his hair.
Chase can apply lotion to his body now. “Every morning, he gets up and takes a shower,” Jennifer said. Flare-ups are perhaps inevitable and Chase already has faced down stares and comments about red patches. Jennifer worries kids will be cruel, but has noticed adults are more likely to blurt out comments. “Once someone asked him what happened to his skin and he said, ‘I got bitten by a shark,’ ” she said, laughing at the memory.
Contact writer Monica Orosz at email@example.com or 348-4830.
BRYAN — Many of Daavlin Co.’s products look like tanning booths.
Some may give users a bronzed glow, but their true benefits are much deeper.
Dermatologists in numerous countries — including the United States, Canada, Saudi Arabia, India, and Japan — use and prescribe the Bryan company’s ultraviolet phototherapy equipment to treat patients for skin conditions.
Among them is psoriasis, a disease where people commonly shed dead skin cells rapidly and have scale-covered lesions on up to 80 percent of their bodies.
Daavlin got its start in 1981, after David Swanson left his post as vice president of international sales at the former Elders Pharmaceuticals Inc. in Bryan. It was there he learned about a soon-to-be-approved treatment for psoriasis that used both medicine and ultraviolet light. He decided to tart a company to sell equipment for the treatment, said Mr. Swanson, Daavlin’s president and chief executive.
Now Daavlin is one of five companies nationwide that makes ultraviolet phototherapy equipment, which used alone now is favored for treating psoriasis because it doesn’t have the side effects of the drug-combination therapy, Mr. Swanson said.
“There’s been some major ups and downs over the years, but we’re here,” he said.
This year, the firm expects to have $4.5 million in sales, the CEO said. Revenues have tripled since 1999, when the company moved into its current location, boosting morale and attracting more employees, he said.
Daavlin’s business is roughly divided among making equipment for clinical, home, and international customers, as well as servicing products. Prices run from $520 for a hand-held device to $19,000 for a clinical machine.
Unlike other medical equipment manufacturers, Daavlin is more concerned about helping patients than making profits or satisfying shareholders, said Dr. Iltefat Hamzavi of Hamzavi Dermatology in Port Huron, Mich.
He uses Daavlin equipment to help teach medical students and to treat patients with psoriasis, rashes, t-cell lymphoma, and vitiligo, where skin pigmentation is lost, the doctor said.
“Their service is really good,” he said. “They’re really customer-oriented.”
The Daavlin 3 series, which is used by dermatologists, comes with such details as hooks for patient clothing and pockets for other items on the outside of the cabinet. Among other computerized features, users can be told in Arabic, Slovakian, French, and other languages how much longer they have to stand inside the cabinet surrounded by bulbs until their treatment is finished.
The Bryan company, which has had trouble since Hurricane Katrina getting parts and materials from the Gulf Coast, started focusing on exporting equipment in 1989. The company was given the Ohio Governor’s Excellence in Exporting Award in 2001 and opened a sales office and warehouse in Belgium last year.
Conventional wisdom recommends having 25 percent to 30 percent of sales in exports to offset recessions, Mr. Swanson said.
“If the U.S. is down for whatever reason, chances are good some other country will be up,” he said.
Contact Julie M. McKinnon at: firstname.lastname@example.org or 419-724-6087.
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