Phototherapy (Radiant light energy)

Phototherapy(light therapy) represents exposure to

light more intense than the light of the bulb, but not the same as
intense sunlight. For light therapy it does not
I use: ultraviolet light, lamps that emit heat or
tanning lamps.
Light therapy can be useful in treatmentof depressionsyes
can influence (reset) the 'biological clock' (rhythm
circadian), which regulates sleep and wakefulness.
Phototherapy typically consists of placing the person in front of
a high-intensity fluorescent lamp, in each
morning for 30 minutes to 2 hours.

Radiant light energy can be:

Natural

Artificial

Artificial heat is given by the irradiation of heated bodies.

The physical properties of phototherapy

1. The propagation of energy occurs according to 2 theories:

Quantum emission theory

Electromagnetic theory.

The speed of propagation in a vacuum is 300,000 m/sec.

3. Light reflex represents the return from the environment.

the source from which it comes, the reflected ray being in the same plane as the ray

incident such that the angle of reflection is equal to the angle

of the incident.

4. Light refraction represents the deviation undergone by the ray.

luminous at the passage through the surface between 2 media with
different densities.

The refracted ray is not in the same plane as the incident ray.
so that the angle of refraction is different from the angle of
incident.

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 5. Lack of reciprocal disturbance is observed in cases of
intersection of 2 rays propagating between them
independent.

6. Interference - it is the phenomenon of wave superposition.

luminous with the same direction of propagation resulting in bands
luminous and dark.

7. Diffraction - the phenomenon of bending the light trajectory

in the region of the geometric shadow.

8. Polarization represents the dependence of the intensity of the rays on

reflected light with respect to the orientation of the incidence plane.

Propagation of light
It is carried out according to 2 theories:

1. Quantum or photonic theory - which asserts that light is

emission is absorbed in discontinuous quantities of energy.

2. Electromagnetic theory - according to which light is a

transverse sinusoidal vibration propagating in a vacuum at 300
mii m/sec., in this space the radiations form a field
electric and a magnetic field are perpendicular to each other
the other one in the direction of propagation.

Electromagnetic radiations are characterized by:

Wavelength,

Frequency represented by the number of vibrations per second.

Time period,

Number of where per cm.

The luminous radiations used within

phototherapy

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 1. Infrared or thermal radiations that have a length of
Under 760-50 millimicrons, they do not exert pressure.
the eye, are emitted by the same sources as visual rays that is
from incandescent bodies electric discharges in gases.

It can be highlighted through photographs or through methods

photoelectric and thermal.

2. Visible radiation - is light waves that have wavelength

included 770-390 millimicrons with all 7 bands
form the colors.

3. Ultraviolet radiation - which has a wavelength of 400-10 millimicrons

they can themselves be of 3 kinds:

a) Ultraviolet A or I are also called long wave

400-315 millimicron constitutes the most abundant spectrum.
in the sunlight.

b) Ultraviolet B or II are also called simedisi aulanda

315-280 millimicrons are emitted by lamps with
mercur.

c) Ultraviolet C or IIIse are also called short with landa

sub280 milli microns that are produced by discharges
electric in mercury vapors.

Radiation with 250 millimicrons is the most penetrating.

The biological effects of ultraviolet rays

These are explained by the mechanisms produced in the cells

epidermic at the level of sensory nerve endings and at
the level of blood vessels of the chorion.

Actinic or ultraviolet erythema

It is a photochemical phenomenon that occurs after exposure to
ultraviolet is followed by pigmentation then by removal and
exfoliation of the skin.

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 The erythema produced by short ultraviolet rays appears within the first 6 hours.
after exposure, it reaches a maximum intensity after a few
it is removed, in 2 to 4 days the pigmentation is a little
intense, the bronzing lasts 2-4 weeks and then follows a
the weak are despised.

The erythema produced by ultraviolet rays appears after 4-8 hours of

the exposure reaches a maximum after 3-4 days, the pigmentation is
The intense treatment lasts 8-10 days.

Based on the intensity of the erythema, we can have several degrees:

Grade I appears on a small skin surface, it

produces lent after 4-6 hours, has a pinkish hue is slightly or
completely non-purging, disappears in 1-3 days, peeling is slight
highlighted and leaves no traces.

Grade II appears after a period of 4-6 hours after exposure,

the reddening is highlighted with a bright red hue, it gives a sensation
more pronounced pain depending on the exposed area. Yes
a moderate itching, redness persists for 3-4 days, peeling
cured after 1-2 weeks.

Degree III - the erythema exceeds far beyond the exposed surface.
are a dark red towards violet, with a burned appearance and
It hurts. There is a painful itch, contact with clothing is
unbearable, may appear in 2 hours and persist for several days.

Pigmentation appears on the 4th day in the form of reddish-brown spots.

it extends and lasts for several weeks. Exfoliation is
marked and massive appears on the 15th day and is followed by
formation of crusts.

Grade IV - the production of pronounced edema and exudate and

the production of blisters. Blisters break easily and require
protect with a bandage. It has a blue-red color,
the skin is swollen and painful. Peeling is
massive if it occurs after 20 days. The pigmentation is
inhibited showing depigmented areas surrounded by a halo
pigment

Methods of producing actinic erythema

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 Five hypotheses are known:

[Link] radiation causes the release of some

Vasoactive substances such as: histamine and acetylcholine produce
vasodilation and consequently the increase in absorption power of
ultraviolet rays causing actinic erythema.

[Link] radiation causes the release into

the membrane of some lipid peroxides that are responsible for
the production of erythema.

3. Ultraviolet rays act on the skin releasing

steroids with vasoactive action and consequently production
of the erythema.

Ultraviolet rays act on the skin

determining the release of some cutaneous prostaglandins and in
the consequence of forming different glands from erythema.

Ultraviolet rays engage some neuro-vegetative reflexes

hypothalamic stimulation induces vasodilation
nice and with the production of erythema due to increased absorption
of ultraviolet.

The histological changes in erythema

actinic

1. Increase of the horny layer at the level of the skin.

2. Edema intra- and extracellular in the epidermis.

3. Due to the increased sanguine flow, it also causes a

capillary lability with leukocyte migration.

4. Degenerative modifications of the cells in the layer occur.

basal skin layer and the progressive replacement of cells
alters through the proliferation of the stratum corneum and through thickening
epidermal layer.

5. Epidermal regeneration is accompanied by pigmentation.

with the increase of melanin pigment content the cells
Malpighi.

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 Melanocytic pigmentation occurs naturally after
exposure to the sun, to artificial ultraviolet rays, to infrared and
it occurs by transforming the propigments into pigments.

The activity of pigmentation under the influence of natural light can

rapid through ultraviolet irradiation directly or a pigmentation
late when it appears after actinic erythema.

There can be pathological natural pigmentation (in the disease

adverse drug-induced pigmentation.

The absence of melanin pigment is found in albinism and vitiligo.

The biological role of melanin pigment

Produce hypertrophy of the stratum corneum having a protective role for the face.
of tissue overheating.

Stimulates hair growth.

They are thermoregulators by triggering sweating.

Stimulates skin activity.

They have anti-inflammatory roles especially against staphylococci.

The physiological effects of ultraviolet rays

I. Effects on metabolism:

It enhances the oxidative processes in the body - metabolism.

Initially it rises and then falls, reaching a balance.
This metabolism decreases in the person who dominates the sympathetic action and increases in
the action of vagueness.

2. The dido-basic balance causes acidosis after which appears

the elongated alcove.

3. Carbohydrate metabolism - initial blood sugar and glycosuria decrease.

proportional to the intensity of irradiation for both individuals

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 normal as well as in diabetics then increase but without reaching
initial values.

Increased glycogen deposition in the liver and muscle tissue

with an important role in improving sports performance.

4. Protein metabolism is stimulated by catabolism after

where the elimination of N, P, and S increases.

5. Mineral metabolism - we particularly emphasize vitamin

Increases calcium and phosphate levels.

Calcium removal decreases. Absorption is improved.

calcium in tissues and at the intestinal level.

The increased blood levels of Ca and P promote deposition.

cartilage in the bone epiphyses.

The formation of vitamin D is obtained from inactive provitamins D.

it is activated under the action of ultraviolet rays. There are more
many provitamin D:

Provitamin D3 or 7-dehydrocholesterol comes from cholesterol.

and is formed in the greatest quantity being
deposited in the skin.

Provitamin D4 comes from dehydrated cholesterol.

Provitamin D comes from endosterol.

The source of vitamin D formation is the horny layer. The role of vitamin D is important in
rickets, tetany, spasmodic syndrome, lactation and dental change.

II. Action on sanctioning elements.

Ultraviolet rays play a role in the hematopoiesis process. It increases

the number the leuco-cytos and the formula is improved
leukocyte.

It is influenced: blood coagulation, processes

immunological and decreases the concentration of blood cholesterol.

III. Action on circulation.

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 This influences both the superficial circulation through action
directly to heats as well as deep circulation through mechanisms
neurovegetative
During the erythematous state, the pulse increases and the blood pressure decreases.
the arterial pressure increases and cardiac output increases by 10%.

IV. Action on respiration.

Gas exchanges are influenced by increasing the quantities.

of absorbed oxygen and through reflex pathways the respiratory movements
they become more ample and rarer.

[Link] on the digestive system.

The secretion of gastric acid increases, the salivary secretion also increases and
Pancreatic, it increases gastric and intestinal motility.

VI. Action on the endocrine glands.

The stimulation of the parathyroid glands plays a role in metabolism.

calcium increases the activity of the endocrine pancreas with a role in
stabilization of glycemia and functional changes occur in
adrenal gland, pituitary, gonad and thymus.

VII. Action on the nervous system.

Especially on the autonomic nervous system through reduction

sympathetic tone and increased parasympathetic.

In general, the color red has a stimulating effect on patients.

depressants and the color blue has a sedative effect on
hyperexcitatory illnesses

Ultraviolet devices
In medical practice, they are used as a source for
ultraviolet

Arc electric

Mercury lamps

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 The arc lamps operate on the principle of production
ultraviolet rays.

Between 2 carbon or metallic poles of an electric circuit.

situated at a certain distance from each other and forming a
electric discharge in the form of a shining arc.

This is born as a result of electron bombardment of

the positive pole that becomes incandescent thus emitting
radiant light. The proportion of ultraviolet in these lamps
this is small.

Mineralized carbon electrodes can be used which are

obtained from retort coal covered with a powder
metallic.
The flame between the electrodes accounts for 85% of the total radiation. It is obtained

spectrum of the radiation of the metals used.

The arc lamps are replaced with mercury lamps.

they are less expensive and easier to handle.
I divide into 3 groups based on mercury pressure.

Medium pressure lamps that emit mercury radiation.

High or very high pressure lamps - which emit radiation.

of the mercury and other radiations. The greater the pressure is,
so many other emissions are more.

Low-pressure lamps that emit ultraviolet with pressure

of 230 million microns.

The media are the most used, lamps can also be found.
with hydrogen, xenon, cadmium and tungsten.

Technique for the application of ultraviolet light

therapeutic

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 The sensitivity to ultraviolet rays varies from person to person.
the region of the body, by age, by various other conditions
coexisting if the individual's sensitivity of the patient.
The application of ultraviolet light can be:

General

Locala.

Methods of measuring ultraviolet radiation can be:

1. Physical-chemical - what physical units of another type of energy are used

in which radiant energy is transformed.

2. Biological - in which the erythema dose or biodose is assessed.

Biodoza represents the minimum required for the appearance of the one
I have actinic erythema in a certain patient and it goes away.
after 24h using a certain lamp applied at a distance
fixed at 50 cm.

Devices are used for determining the biodose.

dosimeters equipped with openings that are discovered
successively during exposure to ultraviolet at an interval of
one minute each.

With the help of the biodosimeter, high doses can be avoided that
produces burns or the small ones that are ineffective.

The indications of ultraviolet rays

I. Dermatology: psoriasis, acne, alopecia, scar

keloid
lupus vulgaris, cutaneous ulcers, cutaneous mycoses
pyodermatitis.

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 II. Pediatrics: rickets, spasmodic cough, respiratory distress
(asthma bronciale), physical debilitation, craniotabes.

III. Rheumatology: rheumatoid arthritis, osteoarthritis,

periarthritis, neuralgia the syndromealgoneurodystrophic
abarticular rheumatism,

IV. Other conditions:

Neurovegetative syndromes: hypersympathetic atonia, syndromes

visceral spasticity;

Some disorders endocrine hyperthyroidismlight,

menopause, some types of obesity.

Some conditions in the ENT field: pharyngotonsillitis, rhinitis, otitis

external;

Dental disorders: periodontitis, stomatitis, gingivitis;

Ailments in the obstetric-gynecological sphere: vaginitis, fissures

mammillary, vulvar edema postpartum, amenorrhea;

General condition affectations: in patients exhausted after illnesses

infectious consumptive diseases, nutritional deficiencies, in patients
anemic, lacking appetite, with weight loss, some cases of
insomnia.

Contraindications of ultraviolet rays

Active pulmonary tuberculosis, neoplasms, cachexias of

any cause and malnutrition, decompensated cardiopathies,
heart failure, advanced-stage atherosclerosis
insufficient liver and kidney, chronic and severe nephritis,
thrombophlebitis, hyperthyroidism, diabetes mellitus, patients
nervous and irritable, pregnancy, pigmentation disorders,
consecutive arterial hypertension of pigmentation.

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