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Journal of the American Academy of Dermatology
Volume 77, n° 5
pages 958-964 (novembre 2017)
Doi : 10.1016/j.jaad.2016.10.016
accepted : 7 October 2016
Reviews

Folate and phototherapy: What should we inform our patients?
 

Myron Zhang, MD a, Gregory Goyert, MD b, Henry W. Lim, MD a,
a Department of Dermatology, Henry Ford Hospital, Detroit, Michigan 
b Women's Health Services, Henry Ford Hospital, Detroit, Michigan 

Correspondence to: Henry W. Lim, MD, Department of Dermatology, Henry Ford Medical Center – New Center One, 3031 West Grand Blvd, Suite 800, Detroit, Michigan 48202, USA.Department of DermatologyHenry Ford Medical Center – New Center One3031 West Grand BlvdSuite 800DetroitMichigan48202USA
Abstract
Background

Ultraviolet (UV) degradation of folate has been studied in vitro and in vivo, but comprehensive reviews of the subject and recommendations for supplementing folate are lacking, especially for women of childbearing age, in whom decreases in folate predisposes newborns to neural tube defects.

Objective

We reviewed the effects of phototherapy on folate and provide a recommendation for women of childbearing age on phototherapy.

Methods

PubMed was searched for in vivo studies comparing folate levels before and after phototherapy.

Results

There is no evidence of decreased folate levels after UVA exposure. Decreased folate levels after sun exposure were limited to subjects taking folate supplements. Studies using narrowband UVB showed mixed results, potentially explained by dose-dependent degradation of folate; exposure >40 J/cm2 cumulatively and >2 J/cm2 per treatment were associated with 19%-27% decreases in serum folate levels, while lower doses did not affect folate levels.

Limitations

Extensive variability in results from studies and lack of considering confounders.

Conclusions

We recommend all women of childbearing age on phototherapy take 0.8 mg/day of folate supplements, as suggested by current guidelines for women of childbearing age, to reduce the risk of neural tube defects in unplanned pregnancy.

The full text of this article is available in PDF format.

Key words : folate, folic acid, narrowband ultraviolet B, neural tube defects, phototherapy, psoralen plus ultraviolet A, ultraviolet A1

Abbreviations used : 5MTHF, NB, NTD, PTB, PUVA, UV



 Funding source: None.
 Conflicts of interest: None declared.
 Reprints not available from the authors.



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