Ultraviolet Radiaton: Made Hendra Satria Nugraha, S.FT., M.Fis
Ultraviolet Radiaton: Made Hendra Satria Nugraha, S.FT., M.Fis
E1 = 2,5 X MED
E2 = 5 X MED
E3 = 10 X MED
Clinical Application for Ultraviolet
Psoriasis
PUVA Therapy
Disturbances of Calcium and Phosphorus Absorption
Pressure Sores
Sterilization
Diagnosis
Dosymetry for the Treatment of Psoriasis
with UVR
Using UVB
E1 dose increase 10% to 40% each treatment treatment is
given once or twice a day
Using PUVA
Oral psoralens 2 hours after ingestion of the drug
When the psoralent is delivered topically, the UVR exposure is
provided immediately after the patient has soaked in a bath of weak
psoralen solution for 15 minutes.
PUVA treatment are usually given 2 or 3 times a week to allow time
for the erythema of one treatment to resolve before the next
treatment is applied.
The treatment is generally applied to the whole body, and is usually
started at 40% to 70% of the MED and increased by 10% to 40%
each week in order to maintain the response. Evaluate in 6 weeks!
(Ex. Hypopigmentation post inflammation)
Adverse effect of PUVA
Short-term nausea and vomiting, which last for 1 – 4
hours after ingestion of the psoralen.
Prolonged high dose PUVA therapy can also result in skin
damage, including hyperpigmented and nonmalignant
lessions.
Increase epithelial cell turn over
Epidermal cell hyperplasia
Granulation tissue formation
Increasing blood flow
Killing bacteria
Increase vitamin D by the skin
Contraindication and Precaution
Contraindication Precautions
Irradiation of the eyes Photosensitizing
Skin cancer medication use
Pulmonary tuberculosis Photosensitivity
Cardiac, kidney, and liver disease Recent x-ray therapy
Systemic lupus erythematosus No dose of UVR should
Fever be repeated until the
effects of the previous
dose have disappeared.
References:
Prentice, WE. 2002. Therapeutic Modalities for Physical
Therapists. McGraw-Hill: USA
Cameron, MH. 2003. Physical Agents in Rehabilitation:
From Research to Practise. Elsevier: USA
Nussbaum, EL. et al. 2013. Ultraviolet-C Irradiation in The
Management of Pressure Ulcers in People With Spinal
Cord Injury: A Randomized, Placebo-Controlled Trial.
Physical Medicine and Rehabilitation Journal: USA