Expert Committee Provides Advice on Phototherapy Operations During Pandemic

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Phototherapy booth. Dermatologist setting up an ultraviolet B phototherapy booth.
Balancing risks and benefits for patients and optimizing safety for staff were guiding principles in developing the recommendations for phototherapy practice during COVID-19.

During the coronavirus-19 (COVID-19) era, phototherapy units that see patients with skin disorders have closed their doors to help slow the spread of the disease caused by the severe acute respiratory syndrome coronavirus 2. Although no guidance has been put into place regarding the management of phototherapy services or resumption of these services during the pandemic, phototherapy supervisors across the United States have published recommendations for phototherapy services in a letter to the editor of the Journal of the American Academy Dermatology.

The new recommendations state that local public health recommendations should be used to guide the reopening of phototherapy locations. In medical center-based phototherapy units, however, the decision to reopen these units needs to also be made in conjunction with advice from the institution’s infection control unit.

The phototherapy supervisors who released these recommendations have also provided recommendations based on consensus opinion of members of the dermatology expert committee from the Light Treatment Effectiveness (LITE) study, which examined the use of home vs office narrowband ultraviolet-B (UVB) phototherapy in 1050 patients across multiple US sites.

The consensus recommends screening all patients who enter a phototherapy unit for COVID-19 symptoms, as dictated by local guidelines. It is recommended that a clinician see the patient alone and without a family member, friend, or caregiver. Only 1 guardian is allowed to enter the medical unit with a minor. The guardian in this case would be required to wear a mask, apply hand sanitizer, and practice social distancing measures. The patient is recommended to wear a homemade cotton mask except when undergoing total body phototherapy.

In addition, the LITE dermatology expert committee recommends that staff should schedule patients no more than every 30 minutes and should arrange the waiting areas with seating 6 feet apart. All staff should wear a mask and should apply hand sanitizer before and after each patient encounter. The fan of the phototherapy unit should not be used if at all possible; instead, the committee recommends fractionated treatment to avoid the build-up of heat in the unit. All high-touch surfaces should be disinfected between each patient.”

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“Once the public health authority has given the permission to resume unrestricted daily activity,” the authors wrote, “practice performed prior to the pandemic can then be done.”

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Lim HW, Feldman SR, Van Voorhees AS, Gelfand JM. Recommendations for phototherapy during the COVID-19 pandemic [published online April 24, 2020]. J Am Acad Dermatol. doi: 10.1016/j.jaad.2020.04.091