Photodermatology PDF

Preface

Within the past 30 years photomedicine has developed from empiricism into one of the most exciting fields in biomedical research. Studies on the effects of visible and ultraviolet radiation on skin have led to a fruitful collaboration between basic scientists and clinicians. The successful use of the new ultraviolet techniques for the treatment of skin disease, along with a rapidly increasing understanding of the pathogenesis of photodermatoses, thereby markedly improving their treatment, have been the driving force for the development of a new subspecialty of photodermatology. This now encompasses the diagnosis and treatment of sunlight-induced disorders; all aspects of phototherapy, including the use of such new modalities as photodynamic therapy for skin tumors and other diseases; as well as photoprotection, which continues to evolve with the development of new generations of ultraviolet filters. In the past decade, therefore, very significant advances have occurred throughout this novel subspecialty, particularly in photoimmunology, molecular biology, and genetics. In more detail, these include better recognition and understanding of:

• Acute and chronic effects of ultraviolet radiation on the skin: in vitro studies, animal models, photoaging, and epidemiology of skin cancers;

• Clinical manifestation of photodermatoses: actinic prurigo, pin-head papule form of polymorphous light eruption, novel genetic mutations in porphyrias, and so on;

• Pathophysiology and treatment of photodermatoses: polymorphous light eruption, actinic prurigo, chronic actinic dermatitis, xeroderma pigmentatosum, photo-exacerbated dermatoses, and so on;

• The science of photoprotection: new ultraviolet filters, photoprotection by clothing, photoprotection by oral agents, and so on;

• Phototherapy: narrowband ultraviolet B, ultraviolet A1, visible light;

• Topical photodynamic therapy;

• Medical and cosmetic applications of laser and similar radiation sources; and

• New insight on the use of laser and radiation sources on people of color.

In planning for this book, our vision as editors was to create a book that is comprehensive and up-to-date, yet is user-friendly to its intended readers who are busy, practicing dermatologists, photodermatologists, and trainees in dermatology. The editors are pleased that recognized experts from many parts of the world willingly put in the effort and contributed most informative chapters for this book.

The book consists of six sections. Section I is on history and basic principles, followed by the effects of ultraviolet radiation on normal skin in Section II. Section III covers all the photodermatoses, while Section IV and V discuss photoprotection and ultraviolet and visible radiation therapy. Section VI is a practical description of testing methods used in photodermatology and guidelines of setting up a phototherapy and laser center.

The three of us work in the United States, Europe, and the United Kingdom. We have taken great care to make sure that materials covered in this book reflect an international point of view. For example, international coverage is done on actinic prurigo (commonly seen in Central and South America), photoprotection (different ultraviolet filters available in different parts of the world), light sources and laser, and many other topics. It is our hope that the readers will find that this book provides a good perspective on the worldwide scope of photodermatology.

On a personal note, the three of us have been colleagues and friends for many years; all of us have separately published books in photodermatology in the early and late 1990s. It has been a real pleasure to combine our experience and to work on editing this book together. We do hope that the readers will enjoy this book as much as we have enjoyed writing and editing it.