Phototherapy Guidelines for Indonesian Population

Initiation and Dosing of Phototherapy

For PUVA therapy in type IV skin, the American Academy of Dermatology recommends starting at 2.0 J/cm² with incremental increases 1
For PUVA therapy in type V skin, the American Academy of Dermatology recommends starting at 2.5 J/cm² with incremental increases 1
For NB-UVB therapy in type IV skin, the American Academy of Dermatology recommends starting at 330 mJ/cm² 1
For NB-UVB therapy in type V skin, the American Academy of Dermatology recommends starting at 350 mJ/cm² 1

Significant delayed tanning responses occur, especially with types III to VI, according to the Journal of the American Academy of Dermatology 2, 3
Nail changes (melanonychia) commonly develop during PUVA therapy in types IV to VI, as reported by the Journal of the American Academy of Dermatology 2, 3
Mottled hypo- and hyperpigmentation can appear as early as 4 weeks into phototherapy, according to the Journal of the American Academy of Dermatology 2, 3

Intense pulsed light (IPL) should be used with extreme caution in Indonesian patients, as skin types above Fitzpatrick IV have increased melanin that can attract more light, causing burns and pigmentation changes, as noted by the American Academy of Ophthalmology 4
Treatment intervals of at least 48-72 hours between phototherapy sessions are essential to assess for photoreactions, recommends the American Academy of Dermatology 1