Canadian Study discusses safety of UVB Narrow Band

Posted on May 17, 2012 by Chris Cane

Are narrow-band ultraviolet B home units a viable option for continuous or maintenance therapy of photoresponsive diseases?

Narrow-band ultraviolet B home phototherapy was found to be an effective form of maintenance therapy for photoresponsive diseases.

AUTHORS: Haykal KA, DesGroseilliers JP.
Division of Dermatology, University of Ottawa, Canada. khayk097@uottawa.ca

BACKGROUND: Phototherapy is an effective treatment for several photoresponsive diseases. Many patients are unable to attend hospital-based treatment and prefer home phototherapy.

OBJECTIVES: The purpose of this study is to survey patients who were prescribed home phototherapy to determine the viability of narrow-band ultraviolet B home units in the continuous or maintenance treatment of photoresponsive diseases.

METHODS: A patient questionnaire was prepared focusing on different areas of interest: the reason for choosing home therapy, appropriate teaching, previous medical treatment, present exposure therapy, improvement of the condition, side effects, regular dermatologic follow-ups, and the effectiveness of this approach. Twenty-seven patients who attended the photodermatology clinics at the Sisters of Charity of Ottawa Health Service at the Elisabeth Bruyère Health Centre in Ottawa and the Ottawa Hospital Civic Campus were contacted, and they completed a questionnaire by telephone or electronic mail.

RESULTS: Twenty-five patients completed the questionnaire. One refused to participate, and one was out of the country. The main reasons for choosing home phototherapy were time (40%), travel expenses (25%), difficulty with work schedule (17%), and recommendation by a physician (6%). Other reasons included loss of earnings, personal stress, knowledge that the disease recurs when phototherapy is discontinued, moving from the city, personal stress, and the convenience of being at home. Regarding the effectiveness of the home phototherapy, 24 patients (96%) viewed the home unit approach to be effective. All patients agreed that they would continue the treatment; they would repeat it, and they would recommend it. Few patients reported side effects, such as erythema (36%), blisters (1%), pruritus (8%), and dryness (1%). Fourteen patients (56%) reported not experiencing any side effects.

CONCLUSION: Narrow-band ultraviolet B home phototherapy was found to be an effective form of maintenance therapy for photoresponsive diseases. It is safe and presents few side effects when patients receive appropriate guidelines, teaching, and follow-ups.

PMID: 17234107 [PubMed - indexed for MEDLINE]
Article Source http://www.ncbi.nlm.nih.gov/pubmed/17234107
2006 Sep-Oct;10(5):234-40

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What is Ultraviolet Light?

Posted on February 28, 2012 by Chris Cane

What is Ultraviolet Light

The spectrum of light is broken up into several pieces such as UV (ultraviolet), IR (infrared) and of course visible light. UV and IR are not visible to the naked eye but each affects our skin and in the case of IR can be felt as heat on the human skin. UV light is not seen or felt but it can have profound and lasting effects on the skin in beneficial and sometimes harmful ways.uv-spectrum
Picture from http://www.electrobreezeaircleaners.ca/uvhelp.htm

In this blog we will concern ourselves with the UV portion of the spectrum, specifically UVB. UVB Narrowband is the a very specific spectrum at 311 nm (nano meters) or billionths of a meter.

uvbnb
Image from http://www.homephototherapy.com/nbc-narrowband.htm

Looking at the image above, one should notice that

1) The red line is our skin’s sensitivity to UV light
2) The blue line is what we call UVB Broad Band
3) The green line is UVB Narrow Band

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Guidelines for dosimetry and calibration in ultraviolet radiation therapy.

Posted on January 31, 2012 by Chris Cane

Guidelines for dosimetry and calibration in ultraviolet radiation therapy: a report of a British Photodermatology Group workshop.

The entire article can be seen by <Clicking Here>

uv_table_1

This report examines the dosimetry of ultraviolet (UV) radiation applied to dermatological treatments, and considers the definition of the radiation quantities and their measurement. Guidelines are offered for preferred measurement techniques and standard methods of dosimetry. The recommendations have been graded according to the American Joint Committee on Cancer classification of strength of recommendation and quality of evidence. Continue reading →

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TL01 Lamps – The UVB Narrow Band Source

Posted on August 2, 2011 by Chris Cane

Perhaps you’re wondering what a UVB Narrowband  Lamp is and how does it differ from a conventional fluorescent light bulb. Fluorescent lights are coated on the inside with a slurry of chemicals, binders and materials that fluoresce in the presence of an electrical field/plasma. UVB NB phosphors fluoresce at roughty 311 nanometers which we call UVB Narrow Band.

Here’s a brochure from Philips that I’m sure you’ll find interesting: <CLICK HERE>

A fluorescent lamp or fluorescent tube is a gas-discharge lamp that uses electricity to excite mercury vapor. The excited mercury atoms produce short-wave ultraviolet light that then causes a phosphor to fluoresce, producing visible light. Wikipedia does a much better job of describing fluorescent lights than I ever could. <<Click Here >>

Philips is the sole maker of UVB Narrow Band lamps at this time. Philips lamps with a “/01″ phosphor are the ones you’ll find in the UVB Narrow Band products we sell <<Click Here>>

UVB Narrowband Spectrum

UVB Narrowband Spectrum

In the graphic to the above, you’ll see two graphs, one depicting the UVB Broadband spectrum and the other is the UVB Narrowband spectrum which is a very narrow group of wavelengths centered around 311 nm, sometimes UVB NB or Narrow Band is called UVB311.

UVB NB or UVB Narrow Band has replaced PUVA and UVB Broadband in the majority of phototherapy applications today.

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Humana Medical Insurance for UV Phototherapy

Posted on May 27, 2011 by Chris Cane

Once gain we run into a wall with an insurance company, this time it’s Humana. It’s difficult to comprehend but Humana gave chosen to only cover certain sizes of UV Phototherapy Equipment for home use.

We (AMJO CORP) have never run into this before.

There are four HCPCS Codes that we typically file under, these are E0691, E0692, E0693 and E0694, all essentially defining the same equipment in different size ranges.

Description HCPCS Code
Ultraviolet light therapy system panel, includes bulbs/lamps, timer, and eye protection; treatment area 2 sq. ft. or less E0691 Covered
Ultraviolet light therapy system panel, includes bulbs/lamps, timer, and eye protection, 4 ft. panel E0692 Covered
Ultraviolet light therapy system panel, includes bulbs/lamps, timer, and eye protection, 6 ft. panel E0693 Covered
Ultraviolet multidirectional light therapy system in 6 ft. cabinet, includes bulbs/lamps, timer, and eye protection E0694 Not Covered

It seems insane to me that they do not cover all four codes. All the other insurance companies do, some have different allowable amounts for each class but to my knowledge, Humana is the only one that differentiates between the codes.

Medicare does cover E0694 for Psoriasis but not for other diseases.

Read Humana’s Policy (Click Here) (See Page 7 and 8)

Once again we are befuddled by an insurance company!

Although not tested yet, Humana’s policy does read “To qualify for home services, members must be confined to the home, or the condition is such that leaving the home for required services would require considerable effort, impose significant hardship, or expose the patient to undesirable risk.” This sentence may cause claims to be denied also.

Basically, If I had an option I would not choose Humana as an insurance company if I were expecting to benefit from insurance coverage for Ultraviolet UVB Narrow Band) Therapy.

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Handisol II UVB NB Panel – Available Now

Posted on February 14, 2011 by Chris Cane

Handisol II UVB Narrow Band Panel

We are introducing a new UVB Narrow Band panel suitable for the treatment of Psoriasis, Vitiligo, Eczema and a host of other skin challenges and diseases. Weighing in at sixteen pounds, this new panel is light, portable and will travel very well.

This new product will use the newest of the UVB Narrowband Lamps released by Philips, the world leader in UVB Lamps for phototherapy. The new PL-L-36W/01/4P lamp allows the construction of a highly energy efficient light weight phototherapy system. We are truly thankful to the folks at Philips for creating this new lamp. This lamp style (PL36) has been around for a while and the visible light (non UV) form of this bulb has been used for many years in products to treat Seasonal Affective Disorder. You can see many of these products at Amjo’s www.sadlight.com and www.lightenupshop.com websites. These remarkable lamps generate twice the power of the TL20W/01 lamps used in our two foot tall (nominal) systems.

The UV Output from this new Handisol II will be slightly higher than our eight lamp Panosol II UVB NB 2′ Panel! This will allow shorter treatment times and better penetration for Plantar and Palmar (Foot and Hand) Psoriasis.

Handisol II

The new Handisol II UVB NB panel  weighs in under 20 lbs. We fully expect that this unit will be one of our largest revenue producers in 2011.

You will need to contact Chris Cane (That’s me) to learn more. This Handisol II is priced agressively. Give me a call 513-942-2770. We will be adding this to our www.HomePhotoTherapy.com website in the very near future.

Effective home phototherapy treatment of psoriasis, vitiligo, and other skin diseases. Handisol II lets you treat the most difficult areas quickly and effectively.

  • Exclusive Controlled Prescription Timer® assures control of your treatment regimen
  • High output for quick, effective treatment
  • Large window and reflective backing behind lamps provides coverage area of over 2 square feet
  • Key lock to prevent unauthorized use
  • Slim, lightweight, and portable makes storage and setup easy
  • Clear acrylic shield for easy cleaning and optimum light energy
  • Shipped fully assembled, ready for immediate use.
Electrical Rating 115V – 60 Hz
1.2 A with Grounded Plug
Dimensions 25″ x 18″ x 3″
64 cm x 46cm x 8 cm)
Lamps 4 PL36 Style UVB 311
UVB Narrow Band Lamps
Weight 16 lbs (7 kg)
Shipping Weight is 22 lb or 10 kg
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Granuloma Annulare Can it be treated with Narrow Band UVB Therapy?

Posted on January 22, 2011 by Chris Cane

Today I received a phone call from a woman in Florida with granuloma annulare. Her dermatologist has recommended that she try UVB Narrow Band as a potential treatment. She had PUVA treatment in the mid nineties with some success but the return to PUVA with its inherent risks is a route she would prefer not to take.

I decided to do some web surfing and have learned that she might be on the right track.

Elsewhere in this blog at http://www.uvbnarrowband.com/index.php/2010/01/uva1-phototherapy-is-it-effective I did write about UVA-1 and its apparent success with Granuloma Annulare.

First a little reading about the disease.

A little reading from several sites provided this information.
For some images of the disease; See http://tinyurl.com/granuloma-annulare

Overview

Granuloma annulare is a long-term (chronic) skin disease consisting of a rash with reddish bumps arranged in a circle or ring.

Causes
Granuloma annulare most often affects children and young adults. It is slightly more common in girls. The condition is usually seen in otherwise healthy people. Occasionally, it may be associated with diabetes or thyroid disease. Its cause is unknown.

Symptoms
Granuloma annulare usually causes no other symptoms, but the rash may be slightly itchy. Patients usually notice a ring of small, firm bumps (papules) over the backs of the forearms, hands, or feet. Occasionally, multiple rings may be found. Rarely, granuloma annulare may appear as a firm nodule under the skin of the arms or legs.

Treatment
I did find an article at http://tinyurl.com/4phduov discussing the use of UVB Narrow Band with Granuloma Annulare and this study concluded that:

“Thereafter, no recurrences were observed during maintenance therapy with Narrow-band UVB. Narrow-band UVB phototherapy is easy to use, since, in contrast to PUVA, there is no need for the intake of photosensitizers and for photoprotection of skin and eyes on treatment days.”
The challenge at this moment is to find more information about the treatment of Granuloma Annulare using ultraviolet technology. I did find that PUVA has been used with some success and typically we see that eventually when dermatologists use UVB NB (TL-01) UVB 311 technology that it provides similar or better efficacy than PUVA with much lower risk of skin cancers and liver damage.

I welcome any comments from readers with experience in this area.

Links

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Are you itching to try UVB Narrow Band – UVB311

Posted on December 3, 2010 by Chris Cane

We’ve learned that Itch Centers may be coming. Recently I was reading Skin and Allergy News Online and came across an article about pruritus (itching) and UVB Narrow Band.

LAS VEGAS – Improved understanding of itching and best practices in management of the condition may lead to U.S. medical centers specializing in treating pruritus.

A recent gathering of experts convened by the National Institutes of Health (NIH) may be the first step in this direction, Dr. Timothy G. Berger said at a dermatology seminar sponsored by Skin Disease Education Foundation.

Dr. Timothy G. Berger Continue reading →

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Narrowband UVB phototherapy in children – A New Zealand experience.

Posted on October 14, 2010 by Chris Cane

Typical UVB Narrowband Cabinet

We’ve seen a few reports out of New Zealand with respect to the use of ultraviolet light. Here’s one I added to our blog in July: < click here > 

Recently (12 October) another article was posted about the use of UVB and kids. The study involed  116 children. Here’s the essence of the article.

Background:  Continue reading →

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How does UVB Narrowband compare to sunlight?

Posted on August 25, 2010 by Chris Cane

Sunlight? How does UVB Narrowband differ? The first thing to discuss is wavelength. The sun produces virtually all wavelengths of visible, infrared and ultraviolet radiation as well as many other parts of the spectrum including radio waves, gamma rays and a bunch of others. Our atmosphere absorbs much of the radiation from the sun so we are protected from some of the most harmful rays including much of UVC and UVB and shorter wavelengths.

The part of the sun’s spectrum that we concern ourselves with is the Ultraviolet portion which is by definition 200 nM to 400 nM (nM is nano meter or a billionth of a meter). The UV Spectrum is broken up (by definition) into three bands, UVA, UVB and UVC. Science has arbitrarily defined these as

  • UVA – Long Wavelength             320 to 400 nm
  • UVB – Medium Wavelength       290 to 320 nm
  • UVC – Short Wavelength            200 to 290 nm (Sometimes called ‘Germicidal Light’)

UVB Narrow Band is a small slice of the UVB Spectrum at 311 nM and is identified as that part of the UV Spectrum that seems to provide the optimal therapeutic effect with the lowest risks including lower risk of cancer, lower risk of sunburn and very low risk of contributing to premature skin aging.

OK I’m rambling a bit. People ask, how does UVB NB equate to sunlight? This is an impossible question to answer.

This question is impossible to answer as the sun’s measurable output varies depending on:

  • Our Latitude.
  • The time of day.
  • The season.
  • The time of year.
  • Cloud cover.
  • Relative humidity.
  • One’s elevation.

Suffice it to say, one of the advantages of UV Phototherapy is the constancy that one can achieve in one’s treatment from day to day.

Sunlight presents a ‘full spectrum’ of UV light whose energy level arriving on the surface of our planet is dependent on all of the above factors and perhaps others.

Hope this helps?

Do you have any suggestions?

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Posted in Medical Articles, UVGuy's Ramblings | 3 Comments