Benefits of Tanning in Fibromyalgia Patients

Fibromyalgia is a common chronic disorder characterized by widespread pain and fatigue. It
occurs primarily in women, especially women of childbearing age. The effectiveness of
treatment for this disorder is limited, and alternative medical treatments are commonly used.

Ultraviolet (UV) light exposure gives a sense of relaxation. It is unknown whether UV
exposure has any effect on pain, particularly in patients with fibromyalgia. Through studies
performed with RO3 funding from the National Institute of Drug Abuse (NIDA), we demonstrated
that in frequent tanners, appearance is less important than UV-induced relaxation in
motivating tanning behavior. Moreover, we determined that UV light has reinforcing properties
apart from any psychosocial benefits of having a tan. One subject in our study reported low
back pain relief from the UV exposure condition.

This is a two-year proposal that is the beginning of a long-term plan to assess whether
indoor tanning ultraviolet light exposure has a therapeutic effect for patients with chronic
pain. To this end, we will determine the effect of UV light on fibromyalgia pain in a
controlled, double blind clinical trial of UV exposure. This approach is carefully designed
to separate the effects of UV exposure on pain from potential confounds associated with the
tanning procedure, including any perceived benefits of having a tan. The results of this
study will increase our understanding of the specific influence of UV light on persistence in
tanning behavior.

Inclusion Criteria:

- Fibromyalgia patients who meet the fibromyalgia criteria, and who have been diagnosed
with fibromyalgia by a board certified rheumatologist. The fibromyalgia criteria {as
defined by the American College of Rheumatology (ACR)} require the patient to have: at
least 3 months of widespread pain defined as: bilateral; above and below the waist,
including axial skeletal pain; and pain to palpation with 4kg of pressure at a minimum
of 11 out of 18 predefined tender points.

- Ideally, patients should not be taking medication for treatment of fibromyalgia, and
they should not be taking psychoactive medications on an as needed basis for treatment
of fibromyalgia. However, if patients are taking psychoactive or other medications for
the treatment of fibromyalgia, then they should be on a stable dose, defined as no
change in dosage in the 4 weeks prior to study enrollment.

- Patients must agree to not partake in tanning bed UV exposure during the study.

Exclusion Criteria:

- Fitzpatrick skin type 1 ("never tan, always burn")

- Past or present skin cancer

- Current use of photosensitizing drugs (current use of photosensitizing drugs will be
evaluated via a patient questionnaire at time of patient enrollment - see Appendix
1),, psychoactive medications (not a stable dose, defined as no change in dosage in
the 4 weeks prior to study enrollment), or illicit drugs

- Pregnant, planning to become pregnant, or breast feeding

- Significant visual discrimination of UV versus non-UV conditions

- Greater than 6 indoor tanning sessions over the past year

- Concurrent photosensitive disease, positive antinuclear antibody test, positive
anti-Smith antibody test, or positive anti-dsDNA test.