Psoriasis and daily low emission phototherapy; effects on disease and vitamin D level

Psoriasis vulgaris is a common, cosmetically debilitating disease of the skin.
It is associated with arthritis and recently has been linked to higher risk for
developing metabolic syndrome. Patients are treated in different manners, i.e.
local corticosteroids, systemic immunosuppressants and phototherapy. This last
therapy is usually given during relapses as higher dose of UV is given to
patients. The effect of low dose continual UV-therapy is however not yet
elucidated. With the introduction of SunshowerMedical Helios on the Dutch
market, daily low dose, home phototherapy has become an practical and realistic
option.
As vitamin D is stimulated by UV exposure and this vitamin is possibly also
linked to metabolic syndrome, monitoring the parameters for metabolic syndrome
might prove interesting.

Assessing the value of SunshowerMedical Helios as a at home maintenance
treatment for patients with psoriasis vulgaris.

open, controlled (randomised) intervention study

Psoriasis patients will be randomised in a control group or for daily use of a
home UV-device, the Sunshower medical. Patients will be monitored in their
PASI-score, quality of life, vitamin D status, blood pressure and UV damage
caused by this device.

A group of 7 patients undergoing conventional TL01 UVB light therapy (group C)
will also be asked permission to retrieve two skin biopsies to assess the
amount of `normal` DNA damage caused by conventional UV-therapy. These patients
will not participate in other aspects of the study and no extra out-patient
clinic visits will be needed.

Patient visits: 3 after informed consent
Questionnaires: 3x 2 questionnaires (total 40 questions)
Physical examinations : 4x (skin only), 2x weight assessment, 2x blood pressure
Venapunction: 3x 1 blood sample for half of included patients
Skin biopsy 3mm: 2x for 12.5% of patients, usually heals without scarring + 7
patients (group C) undergoing conventional phototherapy (higher dose) and in no
other way will be asked to participate in this study.

The risk associated with participation is negligible as the amount of UV that
is used in this study is significantly lower than daily, maximum advised dose.
It is already good clinical practice to treat (psoriasis) patient with
UV-devices with a much higher dose.
For the patients in group C, a minimal risk of scarring is associated with skin
biopsies.