Phototherapy, psoriasis, and the age of biologics


  • Elisabeth G. Richard,

    Corresponding author
    1. Dermatology Department, Johns Hopkins University, Baltimore, MD, USA
    • Correspondence:

      Dr Elisabeth G. Richard, M.D., Johns Hopkins University, 10755 Falls Road, Pavilion I, Suite 350, Johns Hopkins Dermatology at Green Spring Station, Lutherville, MD 21093, USA.

      Tel: +1 410 847 3767

      Fax: +1 410 847 3766


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  • Herbert Hönigsmann

    1. Dermatology Department, Medical University of Vienna, Vienna, Austria
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  • Conflicts of interest:

    None declared.


Over 10 years have passed since the first approval of a biologic agent for the treatment of psoriasis. No one can argue that the arrival of this entirely new, highly effective class of medications has not forever changed the therapeutic landscape for psoriasis. Traditional treatments such as phototherapy, however, remain both viable and effective therapies, both as standalone treatments and in combination with biologics. In general, synergistic effects are noted for combinations utilizing phototherapy; however, the long-term impact of these combinations on skin cancer development has yet to be fully determined. Increasing financial pressures for cost-effective therapies augment the appeal of phototherapy and other traditional treatments as compared with the more costly biologics. Phototherapy also remains strong outside the realm of psoriasis, in the management of atopic dermatitis, vitiligo, and cutaneous T-cell lymphoma, among other conditions. Phototherapy will remain a cornerstone in the management of psoriasis as well as nonpsoriatic skin conditions, as its efficacy is well known, its financial cost is reasonable, it is readily compatible with other therapeutics, and its utility is historically proven.