"Initiation burn" is a phenomenon in which the patient unexpectedly experiences burn very early in the course of phototherapy at a very low dose.1 This is especially common in patients with atopic dermatitis.2 Clinicians often conclude that the patient who suffers from initiation burn is not a candidate for phototherapy or has "failed" phototherapy, when in fact, the patient is able to tolerate ultraviolet (UV) light if dosimetry is adjusted and titrated skillfully.
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