Home UVB phototherapy for psoriasisBMJ 2009; 338 doi: https://doi.org/10.1136/bmj.b607 (Published 07 May 2009) Cite this as: BMJ 2009;338:b607
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No man in his later fifties should have to acknowledge that he looks
magnificent, if a little Rococo around the middle, in a dental floss
thong. Nonetheless, I must concede that the phrase ‘body of a young Greek
god’ barely does justice to the magnificence that has lately been on show
at the phototherapy department RVI in Newcastle upon Tyne.
Whilst I am sincerely grateful for the kind attention that I received
at the RVI it must be appreciated that, including the initial OPA, test
dose, thirty treatment sessions and one FU OPA, the total mileage involved
has been over two thousand. I have an exotic foreign mid-engined two seat
convertible (a Smart) that does about 50mpg but even so, it’s a time
consuming and carbon heavy commitment.
Until twenty years ago my psoriasis did not really require any
intervention beyond emollients but when further measures were required
then narrow band UVB fitted the bill perfectly. Most impressive of all was
the relief from itch.
So impressed was I that, fifteen years ago, I spent some of the
savings from Fundholding on a narrow band UVB machine for the practice –
my practice being thirty plus miles from Newcastle and covering 750 square
miles of largely empty countryside. In consultation with the local
consultant I worked out treatment schedules and patient leaflets and then
awaited a steady flood of referrals of local psoriatics. Almost none
appeared and this seemed to be a reflection of surprise that GPs should
offer the service and/or ignorance of its existence and reluctance to let
go of the therapeutic reins.
For the avoidance of doubt, I should add that I did not treat myself
unless instructed to do so by a consultant.
The narrow band UVB cubicles used by hospitals are vastly more
effective than the one-side-at-a-time panel that fundholding could afford
but, looking to the future, I am sure that a federation of GPs could
operate a cubicle between them to the great benefit of their patients and,
importantly, the reduction of a very heavy workload at the regional
On a slight tangent; what provision is to be made for those with
visible skin disease working in environments where ‘bare below the elbow’
regulations are in force?
I am a psoriatic of more than three decades experience.
Competing interests: No competing interests