Oral PUVA Phototherapy

Transcription

1 Information for patients: Oral PUVA Phototherapy Brooke Building Phototherapy Unit All Rights Reserved Document for issue as handout.

2 This booklet aims to answer the most commonly asked question, but please feel free to ask your Nurse or Doctor if you are unsure of anything. What is PUVA? PUVA therapy is a treatment in which a medication called psoralen (P) is taken by mouth 2 hours before exposure of the skin to special wavelengths of light called UVA (Ultraviolet A). The number of tablets you will take depends on your weight and you will be given this medication from the Hospital Pharmacy. The psoralen reacts in the skin with the UVA to cause effects that help improve or clear a variety of skin conditions. It also makes your skin temporarily more sensitive to sunlight. Which conditions are treated with PUVA? Psoriasis, eczema, cutaneous T-cell lymphoma, granuloma annulare and many other skin conditions. Where do I have PUVA? UVA treatment is carried out in the Phototherapy Unit in the Brooke Building, near Ward M3 (Dermatology ward). Brooke Building You may attend here as an outpatient or inpatient for your treatment. The Unit staff includes Doctors, Nurses and Technicians. What happens when I get there? The phototherapy nurse will first go through the phototherapy do s and don ts, and consent procedure. You will then be shown around the Unit before starting the treatment. How long will I have PUVA treatment? This varies from person to person, but a course may last between 6-15 weeks. Treatments are usually given twice a week (Monday / Thursday, or Tuesday / Friday), for up to 30 sessions. Each individual session may last a few minutes with the total visit taking up to half an hour. The staff will assess you at each visit. If required a Doctor will see you. Do s and Don ts Do bring a list of your creams and medications at your first visit Do take the prescribed number of tablets 2 hours before attending for treatment. They should NOT be taken on an empty stomach but with a small amount of food; however, avoid any fatty food such as milk or butter as these inhibit absorption If you have been prescribed Acitretin tablets, do take it every day. You will still need to take oral psoralen tablets on the PUVA treatment days Do not wear any clothing during the treatment Male patients must wear a sock for genital protection Please bring a clean, dark sock for this purpose continued page 3 1 2

3 Do wear the close fitting goggles and faceshield provided while you are in the phototherapy cubicle (unless otherwise specified) Do inform the staff of any change in your medications (tablets and creams) as this may interfere with the treatment. If you are taking Warfarin this should be monitored closely during your course of treatment Do continue to use moisturisers during your course of treatment. If you use any other treatment creams the nursing staff will tell you if you should carry on using them If you are on Protopic ointment (Tacrolimus) or Elidel cream (Pimecrolimus), please stop using this two weeks before starting phototherapy On the day of treatment, do not use perfumed products such as cosmetics, perfumes or aftershaves as these can make your skin more sensitive to the light Do not use salicylic acid preparations or any moisturiser containing yellow soft paraffin before treatment as this can act like a sunscreen and stop the treatment working Do not use sunbeds or sunbathe throughout the course of treatment Avoid severe haircuts during your course of treatment Avoid eating or handling large quantities of celery, parsnips, carrots, citrus fruits, figs and parsley as they may make your skin more sensitive to the light Avoid alcohol prior to your treatment If you have a history of cold sores, do apply total sunblock to the affected area prior to each treatment Female patients should avoid pregnancy during PUVA treatment. If pregnancy does occur, do inform the staff Eye protection Psoralen tablets make both the skin and the eyes sensitive to light for some hours. It is therefore most important that protective glasses MUST be worn during daylight exposure for 24 hours after you take your tablets (not while sleeping or driving at night!) to avoid increasing the risk of cataracts. Suitable protection glasses may be clear or tinted (i.e. sunglasses). We can test your glasses or sunglasses to check if they are suitable. Sunglasses: You should look for sunglasses which are marked UV400. Boots the chemist, and many other retailers, will carry this. Glasses conforming with British Standard BS2724 is not necessarily adequate protection. Lenses should be large enough, being adequate to cover the whole eye, preferably with wrap-around side protection. Prescription Lenses: If you normally wear prescription spectacles with plastic lenses, you can have them coated with a clear material which is protective against UV light. You should ask your optician for a UV coating (approximately 10). You must also wear the protective goggles and faceshield provided during treatment unless otherwise stated by your doctor. Extra care should be taken throughout the course of PUVA treatment to protect the skin from sunlight. UVA light can penetrate through glass therefore care needs to be taken both indoors and while outside during daylight hours. 3 4

4 Unwanted side effects that can happen during a course of PUVA You may get a mild sunburn reaction during your course You may get a spotty, itchy rash during your course (about one in 10 people do) You may develop a dark tan Your skin may become dry You may get a prickling / painful sensation of the skin You may get queasiness/ indigestion due to the psoralen tablets If you develop any of these or any other side effects which you think may be PUVA-related, please discuss with the nursing staff. Unwanted side effects that can happen after a course of PUVA Skin Cancer People who have a lot of sunlight exposure have an increased risk of skin cancer. In Scotland, approximately one out of 10 will develop a skin cancer. (It is worth noting that 8 out of 10 Australians have a skin cancer at some time in their lives) If you have more than 200 PUVA treatments, you can expect to have 5 times the risk of developing a skin cancer Photoaging It is also possible if you need a lot of treatment that you will develop sunlight-induced skin changes with wrinkling and skin discolouration, similar to that of the ageing process or produced by cigarette smoking Important points Take your psoralen tablets 2 hours before each treatment. Wear protective glasses for 24 hours after taking psoralen tablets. Review: You will be asked to attend for a specific skin cancer review once you have received more than 200 PUVA treatments. Final points: Please inform staff if you are unable to attend Valuables are your responsibility If you have questions about any aspect of your treatment, please ask any member of staff while you are having your treatment For more information please contact: For new patient appointments To cancel / change subsequent appointments for-patients/outpatientinformation/cancelor-rebook-outpatientappointment/ For any queries / emergencies related to treatment: Monday-Saturday (07:30am - 16:00pm) Outside these hours: Ward M

5 G W. Design Services Salford Royal NHS Foundation Trust All Rights Reserved 2017 This document MUST NOT be photocopied Information Leaflet Control Policy: Unique Identifier: MED22(17) Review Date: June 2019 For further information on this leaflet, it s references and sources used, please contact Copies of this information are available in other languages and formats upon request. If you need this interpreting please telephone In accordance with the Equality Act we will make reasonable adjustments to enable individuals with disabilities, to access this treatment / service. InterpretationandTrans@srft.nhs.uk Salford Royal operates a smoke-free policy. For advice on stopping smoking contact the Hospital Specialist Stop Smoking Service on Salford Royal NHS Foundation Trust Stott Lane, Salford, Manchester, M6 8HD Telephone If you would like to become a Foundation Trust Member please visit: for-members If you have any suggestions as to how this document could be improved in the future then please visit: for-patients