TL01 Lamps – The UVB Narrow Band Source

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

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

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?

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

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.

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?

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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Vitamin D Production and UVB Narrowband

From a study entitled “The Effect of Narrowband UV-B Treatment for Psoriasis on Vitamin D Status During Wintertime in Ireland”

Caitriona Ryan, MB, BCh, BAO; Benvon Moran, MB, BCh, BAO; Malachi J. McKenna, MD; Barbara F. Murray, MSc; Jennifer Brady, PhD; Paul Collins, MD; Sarah Rogers, MD; Brian Kirby, MD

Psoriasis is a chronic skin condition that leaves up to 3 percent of the population with patches of thick, itchy and sometimes painful red skin. Abnormalities in vitamin D metabolism may be partly to blame for the development and worsening of psoriasis.

Many psoriasis sufferers seek light therapy, the standard of which is narrowband ultraviolet B (UVB) light therapy, which mimics the portion of the sun’s invisible light rays known to trigger the skin’s production of vitamin D.

Because previous research in people with psoriasis has shown that this treatment raises levels of vitamin D and improves the skin condition, Dr. Caitriona Ryan and her colleagues at St. Vincent’s University Hospital in Dublin, Ireland, wondered if these benefits might be linked.

To investigate, they followed 60 psoriasis patients during an Irish winter — between October 2008 and February 2009. Half were treated with UVB light therapy three times a week until their psoriasis cleared; the others received no light therapy. Vitamin D levels in the blood were measured along the way.

The researchers found that the average patient undergoing UVB light therapy more than doubled their blood levels of vitamin D by the end of the treatment period, which most completed in about 50 days. All of them reached vitamin D sufficient levels, the researchers report in the Archives of Dermatology.

As expected, psoriasis also significantly improved with UVB light therapy. Half the patients started out with psoriasis severity scores above 7.1, and by the end of treatment half had scores of 0.5 or below.

In contrast, three out of every four patients not receiving light therapy remained vitamin D insufficient at the end of the study. They also experienced no overall improvement in psoriasis severity.

When the researchers analyzed the levels of vitamin D and the extent of psoriasis relief, however, they could find no association between the two.

“The improvement in both vitamin D status and psoriasis may be contemporaneous, but unrelated, consequences” of UVB light therapy, Ryan told Reuters Health in an email.

This finding came as no surprise to Dr. Leon Kircik of Indiana University in Indianapolis.

“Any vitamin D in the blood is not going to help psoriasis. You need it on the skin,” he told Reuters Health, pointing to topical vitamin D as an effective psoriasis treatment.

Still, he noted that UVB light therapy is one of the best and safest options for combating psoriasis. So far, it has not been shown to increase the risk of skin cancer, he said, “and it’s been used for a long time, even for pregnant women.”

But Dr. Amra Osmancevic of the University of Gothenburg in Sweden cautions that UVB light therapy remains a known human carcinogen. Its intentional use in healthy people to only induce vitamin D production is not recommended, Osmancevic told Reuters Health in an email.

SOURCE: archderm.ama-assn.org/ Archives of Dermatology, online August 17, 2010

Arch Dermatol. 2010;146(8):836-842. doi:10.1001/archdermatol.2010.195

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Phototherapy with Narrowband vs Broadband UVB

Author: Berneburg M, Röcken M, Benedix F.
Department of Dermatology, Eberhard Karls University, DE-72076 Tuebingen, Germany. Mark.Berneburg@med.uni-tuebingen.de

Phototherapy with ultraviolet (UV) radiation of wavelengths between 280 and 320 nm (UVB) is a safe and effective treatment for a variety of diseases. In addition to standard broadband UVB (bUVB), narrowband phototherapy with fluorescent bulbs emitting near monochromatic UV around 311 nm (nUVB) has become an important treatment for diseases such as psoriasis, atopic dermatitis and vitiligo. In addition to these indications, the number of diseases for which nUVB phototherapy is reported to be effective is continuously growing. The differential effects of nUVB phototherapy in comparison to other UV wavelengths as well as established and new indications for this treatment modality are reviewed.
<See Entire Article – Click Here>

Another UVB BB vs NB Study (Japan 1999) Click Here

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Different, Just like me. A Vitiligo Story

Recently I received an email from Lori Mitchell whose daughter April Mitchell has had Vitiligo for many years. April’s one of the few who have come to grips with the challenge and embraced it.

See the Video >>

Cheryl and I have met April and Lori at several Vitiligo conferences over the years. Lori has written a book called “DIFFERENT -- Just Like Me

April and Lori are remakable people in an ever changing world.

Please watch the video!

Chris

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