ABSTRACT
Discolorations of the skin, such as vitiligo, were recognized thousands of years ago. White spots caused by vitiligo and other disorders have caused significant social opprobrium to those disfigured by these pigmentary disorders, throughout history and still in the present day. Treatments have been desperately sought with only partial success. Recent advances suggest that vitiligo and other pigmentary disorders might soon be curable.
Subject(s)
Adrenal Cortex Hormones/therapeutic use , Calcineurin Inhibitors/therapeutic use , PUVA Therapy/methods , Vitiligo/therapy , Administration, Cutaneous , Anthelmintics/therapeutic use , Antimalarials/therapeutic use , Antimetabolites, Antineoplastic/therapeutic use , Catalase/therapeutic use , Clofazimine/therapeutic use , Fluorouracil/therapeutic use , Folic Acid/therapeutic use , History, 16th Century , History, 17th Century , History, 18th Century , History, 19th Century , History, 20th Century , Humans , Khellin/therapeutic use , Leprostatic Agents/therapeutic use , Levamisole/therapeutic use , PUVA Therapy/history , Phenylalanine/therapeutic use , Vitiligo/historyABSTRACT
Psoralen photochemotherapy (PUVA) is the combined treatment of skin disorders with a photosensitizing drug (Psoralen) and UltraViolet A radiation. The introduction of PUVA therapy has arguably been the most important development in dermatology over the past 30 years and from the first days of the treatment being introduced in the UK, British medical physicists were an integral part of the effort to establish it. Medical physicists have contributed to this development in a number of ways, from designing irradiation units in the early days of the technique, through to collaborating with dermatologists in prosecuting clinical and experimental studies aimed at improving patient outcomes. That the dose of UVA radiation is administered quantitatively, and not qualitatively, has probably been the single most important contribution made by several medical physicists over this period. However, despite concerns that were expressed almost 30 years ago about the accuracy with which UVA doses are administered to patients, the medical physics community still has some way to go before we can be satisfied that statements about UVA irradiance and dose can be made with confidence.