1. U L T R A V I O L E T
R A D I A T I O N

2. ULTRAVIOLET RADIATION (UVR)
Radiation between the visible light & X-ray sections of the electromagnetic spectrum. (J. Ritter)
VISIBLE LIGHT
IRR
UVR
RADIO f

3. NATURE OF UVR 1. Strongly absorbed in air (*short-wavelength UVR)
2. Behave like visible radiation in terms of properties (reflection, refraction, transmission and absorption)
3. Transmit more energy, thus, producing more chemical changes not just simply heat

4. CATEGORIES OF UVR UVB UVC UVA Wavelength (nm) Other Names 320-400
Other Names
Long
Medium
Short
Blacklight
Erythemal
Germicidal
Near
Far

5. CATEGORIES OF UVR
Near UVR- nearer the visible light spectrum but are longer in wavelength
*Longer wavelength are more beneficial (BIOTIC)
Shorter wavelength are ABIOTIC

6. PRODUCTIONS OF UVR
I. NATURAL WAY: SUN
II. ARTIFICIAL WAY

7. I. NATURAL WAY: SUN
5-10% of the sun’s energy is in the UVR range ( nm)
UVA 6.3% of sunlight during summer; UVB 0.5%
Both UVA & UVB can be involved in sunburn and skin diseases

8. II. ARTIFICIAL WAY
Passage of electric current thru gas (vaporized mercury)
Collision with the electrons flowing between the lamp’s electrodes
Mercury atoms become excited
Excited electrons return to particular electronic states in the mercury atom
Release some of the energy they have absorbed
RADIATION

9. II. ARTIFICIAL WAY
UVR can be produced if the temperature is high enough and pressure is low
UVR= T° P°

10. ARTIFICIAL UVR APPARATUS
John Low
Wadsworth
1. Kromayer lamp
1. Water-cooled lamp (Kromayer lamp)
2. Fluorescent lamp
3. Medium pressure mercury arc lamp (Alpine Sunlamp)
3. Air-cooled lamp (Alpine Sunlamp)
4. Low pressure mercury vapor discharge tubes

11. KROMAYER LAMP a.k.a. water-cooled lamps
requires pre-heating of 5 minutes
a medium pressure mercury vapor designed to be used in contact with the tissue (i.e. treatment of localized pressure areas and ulcers).

12. A. KROMAYER LAMP
wavelengths of the rays produced are concentrated at 366 nm but a wide range of both UVA & UVB are produced.

14. B. FLUORESCENT LAMPS
low-pressure mercury discharge tubes with a phosphor coating on the inside
absorbs short UVR which causes excitation of the phosphor atoms and remission at a longer wavelength

16. B. FLUORESCENT LAMPS gives considerable UVA & UVB output; NO UVC
more commonly used for Psoriasis affecting large body areas

17. C. ALPINE SUN LAMP a.k.a air-cooled lamps
generally used for treatment of generalized skin conditions like Acne and Psoriasis
Usually applied at a distance of cm

19. D. LOW PRESSURE MERCURY VAPOR DISCHARGE TUBES
Components:
a. Tube or envelope made of quartz or special glass to allow UVR to pass through
b. Metal electrodes sealed in the ends of the tube
c. Electric circuit to regulate electric current

20. PHYSIOLOGIC EFFECTS 1. Erythema or redding & tanning
- only encountered when UVB (at nm) treatment is used.
Minimal Erythemal Dose = smallest UVR dose to result in erythema that is just detectable by eye between 8-24 hrs after exposure

21. PHYSIOLOGIC EFFECTS 2. Pigmentation
- results from formation of melanin in deep regions of the skin & migration of melanin noticeable about 2 days after exposure
- UVB at 300 nm

22. PHYSIOLOGIC EFFECTS 3. Hyperplasia - occurs at 72 hrs using UVB
4. Increase skin growth
- increase keratinocyte cell turnover so that skin grows more rapidly for a time leading to shedding of most superficial cells at an earlier stage

23. PHYSIOLOGIC EFFECTS 5. Vitamin D production
- UVB convert sterols in the skin (7-dehydrocholesterol) to vitamin D at nm
6. Destruction of bacteria
-occurs by suppressing DNA and RNA synthesis at UVB at nm

24. PHYSIOLOGIC EFFECTS 7. Wound healing - using UVB at 260-280 nm
8. Increase production of RBC
9. Stimulation of steroid metabolism
- UVR promotes vasomotor responses causing antirachitic effect

25. PHYSIOLOGIC EFFECTS 10. Immunosuppressive effects
- UVB destroys Langerhans cells & stimulate proliferation of suppressor T cells

26. PHYSIOLOGIC EFFECTS 11. Conjunctivitis / photokeratitis / cataract
- conjunctivitis occur at UVB with 270 nm
- cataracts at UVA since it can pass thru the eye’s lens

27. PHYSIOLOGIC EFFECTS
12. Premature aging of the skin (dry, wrinkled, decreased function of sebaceous and sweat glands)
13. Skin cancers
14. Psychological effects

28. INDICATIONS OF UVR 1. Skin diseases a.) Psoriasis treatment
b.) Acne vulgaris treatment
To accelerate skin growth, help control infection, sterilize skin surface temporarily

29. INDICATIONS OF UVR
2. Healing of wounds (venus ulcers & pressure sores)
To increase rate of skin growth and to provide antibiotic effect

30. INDICATIONS OF UVR 3. Vitiligo 4. Protection of hypersensitive skin
Tanning and thickening of the skin
4. Protection of hypersensitive skin

31. INDICATIONS OF UVR
5. Alopecia
6. Treatment of vitamin D deficiency

32. INDICATIONS OF UVR 7. Pruritus due to biliary cirrhosis or uremia
8. Jaundice for newborn babies

33. CONTRAINDICATIONS 1. Acute skin conditions (acute eczema, dermatitis)
2. Skin damage due to ionizing radiations like deep X-ray therapy

34. CONTRAINDICATIONS
3. Systemic lupus erythematosus can be triggered or exacerbated
4. Photoallergy / photosensitivity (albinism will not tolerate UVR)

35. CONTRAINDICATIONS 5. Porphyrias (rare metabolic disorder)
6. Pellagra (dermititis due to severe niacin deficiency)

36. CONTRAINDICATIONS
7. Acute febrile illness (pulmonary tuberculosis, severe cardiac involvement, acute diabetes mellitus)
8. Recent skin graft

37. PRECAUTIONS Patients with:
a.) little pigmentation, often seen in blondes and redheads.
b.) conditions like syphilis, alcoholism, cardiac or renal disease, acute psoriasis, acute eczema, elderly and infants.

38. PRECAUTIONS
c.) Ingested certain food like strawberries, eggs or shellfish before treatment.
d.) Taking any of the ff: birth control, pills, tetracycline, diuretics and insulin.
e.) Recent superficial heat treatment before UVR radiation.

39. DANGERS OF USING UVR 1. Eyes (conjunctivitis)
2. Overdose (too long exposure; too close to the lamp)
3. Previously protected skin
4. Electric shock
5. Burns
6. Chill
7. Sensitizers
8. Change of lamp

40. Approx. duration of erythema
LEVELS OF UVR ERYTHEMA E1 E2 E3 E4
Latent period
6-12 hrs
6 hrs
3 hrs
Less than 24 hrs
Appearance
Mildly pink
Definite pink-red; blanches on pressure
Very red;does not blanches on pressure
Angry red
Approx. duration of erythema
2 days
3-5 days
A week
Skin edema
None
Some
Blisters

41. LEVELS OF UVR ERYTHEMA E1 E2 E3 E4 Skin discomfort None Hot& painful
Slight soreness; irritation
Hot& painful
Very painful
Desquamation
Powdery
In thin sheets
In thick sheets
Relation to dose causing E1 1
2.5 5 10

42. SELECTION OF DOSAGE LEVEL
FREQUENCY
1. E1 or Minimal Erythemal Dose may be given to total body area
Given daily
2. E2  up to 20% of total body area
Every second day
3. E3  up to 250 square cm of normal skin
Every third or fourth day
4. E4  up to 25 square cm of normal skin
Once a week or every forth night

43. CALCULATION OF UVR DOSAGE
Basis: determined by performing skin test to get MED or E1
Two units of measurements to consider:
a.) length of time (seconds)
b.) distance from the lamp (mm)

44. CALCULATION OF UVR DOSAGE
Levels of dosage intensity
a.) E1= determined by the skin test
b.) E2= 2.5 x E1
c.) E3= 5 x E1
d.) E4= 10 x E1

45. If the E1 of the patient is 50 s at a distance of 200 mm, find E3 at 200 mm.

46. CALCULATION OF UVR DOSAGE
Progression of dosage:
a.) E1 is progressed by 25% of the preceding dose
b.) E2 is progressed by 50% of the preceding dose
c.) E3 is progressed by 75% of the preceding dose

47. If E1 is 30 s at 200 mm, find the second progression (P2E1).

48. CALCULATION OF UVR DOSAGE
Alteration of intensity with distance
-guided by Law of Inverse Square which states that as the distance between the source and the patient increases, the intensity decreases in proportion to the square of the distance.
Formula: I = 1/ d2

49. nt= ot x nd2
od2

50. CALCULATION OF UVR DOSAGE
Using Kromayer lamp:
-use the levels of dosage for intensity since the distance is always at 25 mm.
Using air-cooled lamps:
-distance is from the burner of the lamp to the patient and follow the Inverse square law formula.

51. Using the kromayer, if the E1 of the patient is 2 s I/C, find the E1 at 100 mm.

52. Using the air cooled lamp, if the E1 at 400 mm is 30 s, find the E1 at 200 mm.

53. CALCULATION OF UVR DOSAGE
Using an applicator:
1.) Compute for coefficient of the applicator:
*Length of applicator in mm divided by 25
2.) Compute for applicator dose:
*in-contact dose (secs at mm) x coefficient of applicator (in mm)

55. THANK YOU!