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possible side effects and contraindications, so that the

procedure could be safely performed.

In all modalities of UVB phototherapy or PUVA, com-

plementary therapies such as topical vitamin D analogues,

corticosteroids and topical or oral retinoids may be associ-

ated for better control of psoriasis and other dermatoses.

1,7,8

One of the main indications of phototherapy is the

control of psoriasis. According to the Brazilian Consensus

of Psoriasis 2012, any form of phototherapy can be used

in this dermatosis. UVB is the first line for psoriasis, as it

is safer and more effective. It can be used in pregnant

women and children, and poses less risk of photoaging

and ophthalmological involvement, since it does not

require psoralens as adjuvants.

On the other hand, PUVA

is indicated as the best therapeutic option for extensive

areas of involvement, thick psoriatic patches and patients

with phototype III or greater.

1,5,9,10

In case 2, we chose

PUVA because the patient had extensive psoriasis and

thick plaques.

In vitiligo, repigmentation after treatment occurs due

to migration of melanocytes from the hair follicles to the

basal layer of the skin.

Phototherapy stimulates mela-

nogenesis and interferes with the inflammatory process

of the dermatosis.

In extensive vitiligo (as in the case

presented) PUVA with oral psoralen is the best therapeu-

tic option. Although many authors advocate UVB radia-

tion as the safest method, others indicate it only when

PUVA is contraindicated.

1,2

We opted for PUVA with oral

psoralen because of its effectiveness in extensive vitiligo.

The etiology of pityriasis alba is unknown but appears

to be related to xerosis and atopic eczema.

It mainly

affects the face, back and outer side of the arms, sometimes

posing a differential diagnosis with pityriasis versicolor.

11,12

The treatment of choice are emollients, sun protection

and the use of topical corticosteroids. Refractory cases

can be treated with PUVA.

The results of the sessions

exceeded expectations with the disappearance of most of

the lesions.

All three cases yielded excellent therapeutic results.

Good tolerance to phototherapy should be emphasized

without triggering relevant side effects. Thus, great psy-

chosocial impact and self-esteem was obtained, with im-

provement in patients’ quality of life.

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