Phototherapy dosimetry errors lead to burns, missed treatment windows, and long-term skin cancer risk. Clinit tracks cumulative MED, session schedules, and lifetime dose thresholds automatically.
The Dosimetry Challenge
Narrowband UVB (NB-UVB) and PUVA phototherapy are highly effective for psoriasis, vitiligo, atopic dermatitis, and mycosis fungoides — but they carry dose-dependent risks. Under-dosing produces no response; over-dosing causes phototoxic burns. Long-term cumulative dose is associated with an increased risk of squamous cell carcinoma, particularly with PUVA.
Managing this with a paper log — tracking cumulative J/cm², adjusting for missed sessions, recording adverse events, and flagging lifetime dose thresholds — is error-prone and difficult to audit.
What Clinit's Phototherapy Module Tracks
Per Session:
- Date and time of treatment
- Body regions treated (total body, limbs, scalp)
- Dose delivered (J/cm² for NB-UVB; joules for PUVA)
- Cumulative dose to date (auto-calculated)
- MED multiplier applied (e.g., 70% MED for first session, increasing by 10–20% per session)
- Adverse events: erythema grade, blistering, phototoxic reaction
Missed Session Adjustment:
When a patient misses sessions, the protocol mandates a dose rollback. Clinit flags missed sessions and auto-calculates the correct reduced starting dose for the next session based on days elapsed.
Lifetime Dose Thresholds:
- NB-UVB: Alert at 1,000 treatments (cumulative lifetime; risk-benefit discussion recommended)
- PUVA: Alert at 150 J/cm² total cumulative (standard threshold for significantly elevated SCC risk)
The alerts are visible in the phototherapy session header — not buried in settings.
Treatment Response Tracking
PASI or VASI scores are recorded at baseline and every 4 weeks of treatment. The phototherapy module displays the response curve alongside the cumulative dose curve — allowing the clinician to assess whether the response is proportional to dose and make a go/no-go decision.
Consent and Documentation
A phototherapy-specific consent form is stored at baseline. Annual photo documentation (body map photographs) is prompted by the system and stored against the patient's dermatology record.
