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Ultraviolet Therapy.

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Presentation on theme: "Ultraviolet Therapy."— Presentation transcript:

1 Ultraviolet Therapy


3 Ultraviolet Radiation (UVR)
Electromagnetic spectrum (2000 to 4000 nm) Divided into three ranges: UV-A = Near UV (3200 to 4000 nm) Little or no physiologic effect UV-B = Middle UV (2900 to 3200 nm) Sunburn and age-related skin changes UV-C = Far UV (2000 to 2900 nm) Bactericidal


5 Ultraviolet Radiation
Most likely to be used UV-B or UV-C UVR depth of penetration is 1 to 2 mm Physiologic effects are superficial Used to treat various skin disorders

6 Effect on Cells UVR causes chemical excitation of cells
Results in alteration of cell biochemistry and cellular metabolism Affects synthesis of DNA and RNA Protein and enzyme production is altered, which may result in cell death

7 Effects on Skin: Erythema
Generalized response to UVR exposure Reddening of skin Acute inflammatory reaction End results: Erythema - sunburn Pigmentation - tanning Increased epidermal thickness

8 Effects on Skin: Photosensitization
Process in which a person becomes overly sensitive to UVR Acute effects of UVR exposure may be exacerbated if certain chemicals or medications are present on skin (or in body)

9 Effects on Skin: Tanning
Increase of pigmentation Protective mechanism activated by UVR exposure Increase of melanin Pigment responsible for darkening skin Melanin functions as a biologic filter of UVR By scattering radiation By absorbing UVR By dissipating absorbed energy as heat

10 Effects on Skin: Tanning
Artificial Tanning - produce only UV-A Production of UV-A is largely unregulated Effects of long-term exposure to UV-A are unknown

11 Effects on Skin: Long-term
Premature aging of the skin Dryness, cracking, and decreased elasticity Linked to UVR-induced DNA damage Skin cancer Most common malignant tumor found in humans Basal cell carcinoma (rarely metastasizes) Squamous cell carcinoma (metastasizes in 5%) Malignant melanoma (usually metastasizes) Damage to DNA suspected as cause Rate of cure exceeds 95% with early detection

12 Effects on Eyes UVR exposure causes acute inflammation called photokeratitis Delayed reaction, occurs within hours Signs/Symptoms: Conjunctivitis accompanied by erythema of adjacent facial skin Sensation of a foreign body on eye Photophobia Increased tear production Spasm of the ocular muscles

13 Systemic Effects Photosynthesis of vitamin D
Following exposure to UVR in UV-B range May be used to treat Ca++ and phosphorus disorders Rickets and tetany Treatment of choice; however, is dietary supplementation

14 Ultraviolet Generators
Carbon arc lamp Xenon compact arc lamp Fluorescent ultraviolet lamp (black light) Mercury arc lamp Most commonly used in sports medicine

15 Mercury Arc Lamp Mercury contained in a quartz envelope
Heavy metal in a liquid state At 8000°C, mercury atoms vaporize and become incandescent Emit ultraviolet, infrared, and visible light

16 Mercury Arc Lamp High-pressure lamp = “Hot” lamp
UVR produced falls within UV-B range Mainly used to produce erythema and accompanying photochemical reactions

17 Mercury Arc Lamp Low-pressure = “Cold” lamp
Does not require warm-up or cool-down Used mainly for bactericidal effect

18 Mercury Arc Lamp Positioning
Apply cosine law and inverse square law Distance of lamp must be kept constant if intensity of treatments is to be equal Standardized at each clinic Usually ranges between inches

19 Techniques of Application
Minimal Erythemal Dose (MED) Exposure time needed to produce a faint erythema of the skin 24 hours after exposure Question patient regarding photosensitizing drugs

20 Minimal Erythemal Dose
Patient draped only exposing test site Height of lamp adjusted to same level as testng Paper with five cutouts (1” square) 1” apart placed over test site Shutters are opened and cutouts exposed at 15-sec intervals

21 Minimal Erythemal Dose
Visual inspection after 24 hours to determine MED No erythema = suberythemal dose Erythema still present at 48 hours 1st degree erythemal dose (2.5 times MED) Erythema persists from hours 2nd degree erythemal dose (5 times MED) Erythema lasting past 72 hours 3rd degree erythemal dose

22 Minimal Erythemal Dose
Skin adapts to UVR exposure, therefore, MED will gradually increase with repeated treatments Must gradually increase exposure time to achieve the same reaction Increased by 5 seconds per treatment Height of lamp remains constant

23 Clinical Applications
Dermatologic conditions Psoriasis, acne, and hard to cure infectious skin conditions such as pressure sores Development of oral and topical medications has greatly reduced the use of ultraviolet

24 Indications Acne Aseptic wounds Folliculitis Pityriasis rosea
Tinea capitum Septic wounds Sinusitis Psoriasis Pressure sores Osteomalacia Diagnosis of skin disorders Increased vitamin D production Sterilization Tanning Hyperplasia

25 Contraindications Porphyrias Pellagra Lupus erythematosus Sarcoidosis
Xeroderma pigmentosum Acute psoriasis Acute eczema Herpes simplex Renal and hepatic insufficiencies Diabetes Hyperthyroidism Generalized dermatitis Advanced arteriosclerosis Active and progressive pulmonary tuberculosis

26 Thank you

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