I have itching that spreads. Should I stop UV therapy?

Question

Hello doctor,

I have started UV light therapy for a skin condition that is waiting to be confirmed as mycosis fungoides or psoriasis. The itching and affected areas keep getting so much worse and spreading out to new areas.

So, my concerns are:

How much worse is it supposed to get before there is concern?
Should I stop UV therapy?

Kindly give your suggestions.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

Thank you so much for reaching out. What you are describing is not something to ignore, especially when you are undergoing phototherapy before your diagnosis of mycosis fungoides or psoriasis has been confirmed.

Phototherapy is a standard and effective first-line treatment for early-stage mycosis fungoides (MF) and as add-on therapy in psoriasis, and does not typically worsen the condition; however, in psoriasis, as per research and my experience, the patients are sometimes sensitive to it.

Phototherapy can cause mild itching, redness, pigmentation, and sometimes a slight blister if the dose is high, but it does not cause the formation of new lesions.

Psoriasis can be worsened with normal sunlight, and hence changes in its severity in some patients are seen with phototherapy as well.

In either case, it should not cause itching or the formation of new lesions. This will put you at risk of developing an unstable form of the disease.

You do not need to panic, but it is important to pause your UV (ultraviolet) therapy until your dermatologist reviews whether you are developing unstable psoriasis or photosensitivity.

As your itching is getting worse and the lesions are spreading to new areas, you should let your doctor know right away. Simply explain that your symptoms have been increasing since starting phototherapy and ask if the treatment can be paused until the diagnosis is confirmed or the dose is readjusted.

Meanwhile, for relief, you can follow the suggestions below:

Use moisturizers that contain petroleum jelly and petrolatum.
Try to avoid anything that can further irritate your skin, such as heat, hot showers, or scratching, since these can worsen inflammation and itching.
It is also best to stay away from lotions that contain fragrance or menthol, as these ingredients can trigger more irritation and make your symptoms feel more uncomfortable.

I hope it helped with your query, and get well soon. For more queries, reach out to me anytime.

Thank you.