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Psoriasis — SCE Dermatology MCQ

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ModeratePhotobiologyPsoriasisSCE Dermatology

A dermatologist is performing narrowband UVB phototherapy. A patient with psoriasis on Methotrexate asks whether phototherapy can be given concurrently. What is the recommended advice?

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Correct answer: C — NB-UVB can be given with Methotrexate but with enhanced erythema monitoring

NB-UVB phototherapy can be used concurrently with Methotrexate for psoriasis, but enhanced monitoring for erythema is advised as Methotrexate may theoretically increase photosensitivity (though significant interaction is uncommon). BAD phototherapy guidelines note that combining systemic therapies with phototherapy can improve outcomes in resistant disease. However, PUVA combined with Methotrexate carries a higher carcinogenic risk and requires more caution. Ciclosporin combined with PUVA is generally avoided due to cumulative immunosuppression and increased skin cancer risk.

Reference: BAD 2019 Phototherapy Guidelines