UVA1 phototherapy is effective in darker skin: A review of 101 patients of Fitzpatrick skin types I-V

Background: Studies suggest ultraviolet (UV) A1 phototherapy is efficacious and safe in treating a variety of skin disorders. However, most reports evaluating the benefits of UVA1 phototherapy have been from Europe, focusing on a predominantly Caucasian population. Darker skin types have been evaluated only sparingly; none the less, it is widely held that these patients respond poorly to UVA1 phototherapy due to increased pigmentation. Objectives: We aim to compare efficacy (clinical improvement scores) of UVA1 phototherapy among Fitzpatrick skin types. Methods: A retrospective analysis of 101 patients receiving UVA1 treatment at the University of Texas Southwestern Medical Center in Dallas, TX was performed. Data on Fitzpatrick skin type and cumulative UVA1 doses were collected. Clinical improvement scores based on body surface area, erythema, induration, sclerosis, pigmentation, and symptoms of pain or pruritus were obtained. Results: In the population studied, with morphoea and scleroderma being the most frequent diagnoses, improvement scores from UVA1 phototherapy and mean cumulative UVA1 doses were not significantly different among the Fitzpatrick skin types evaluated. Furthermore, little or no correlation was found between improvement score and skin type. Conclusions: Data indicate skin pigmentation as graded by Fitzpatrick skin type does not significantly influence the efficacy of UVA1 phototherapy. Thus, UVA1 should be considered as a therapeutic option in more darkly pigmented patients.