Background/aims: Confident diagnosis of photosensitivity in patients with light dermatoses requires skin exposure to well determined ultraviolet (UV) light doses, most often from a solar simulator. The traditional test procedure results in a rough classification of skin sensitivity based on the minimal erythema dose (MED) found for each patient. The limited number of constant irradiance doses used during phototesting decreases the precision of the MED value. In the present study we aimed at developing the technical system for the determination of MED by using a single, centrifugally attenuating, UVB provocation.
Methods: A divergent UV beam was achieved with the help of an optic lens. To investigate the irradiance profile, an irradiance acquisition system was built that produced three-dimensional intensity maps. In addition, a laser Doppler perfusion imaging (LDPI) system was introduced in the evaluation of the skin response along with visual readings of the same exposed areas, in order to add a quantitative aspect to the assessment of erythema. The procedure was used on one test subject.
Results: The divergent UV beam showed the desired profile. With the current setup 20 different UV-dose levels could be discriminated. Relevant UV-dose levels were determined and tested on a subject, which in practice gave results in the form of visual assessment as well as LDPI-images. The visual or LDPI diameter gave the MED. Within the skin reaction, irradiance and the laser Doppler values could be compared mm for mm.
Conclusions: A more accurate MED determination with a single UV exposure seems to be feasible by using the proposed method. Though further investigation is required, the technique appears to offer new possibilities for the association of dose to response. In addition LDPI is possibly a useful complement to the visual readings of the skin responses, since the method gives a quantification of the grade of erythema, as opposed to visual (+, ++, +++) readings that are subjective and at best semiquantitative.
1999. Vol. 5, no 4, 255-259 p.