CA2205041A1 - Light therapy treatment arrangement and use thereof - Google Patents

Abstract

The invention concerns the simultaneous use of fluorescent lamps of different monochromatic radiation each having maximum radiation and high radiance in a treatment arrangement for various illnesses and for cosmetic purposes. The treatment arrangement can also be used in combination with a prior application of a light-sensitizing ointment.

Description

CA 0220~041 1997-0~-09 LIGHT THERAPY TREATMENT ARRANGEMENT AND USE THEREOF

Description The invention is directed to a universal treatment arrangement for treating diverse illnesses, especially also hyperproliferative, malignant and inflammatory skin diseases, psoriasis, and other diseases and/or for cosmetic skin treatment and to the use of such an arrangement for diagnostic procedures.
An electrical all-purpose discharge lamp with a light bulb which is transparent to light, a pair of electrodes which can be connected to a power source, an ionizable filling, and a luminescent material coating applied to the inner wall of the bulb has already been proposed in DE-AS 17 64 685. This lamp generates an output of 6 to 50 ,uW per lumen of visible light in the wavelength range above 290 nm, in particular for middle ultraviolet radiation, and an output of 150 to 170 ,uW per lumen of visible light for the near ultraviolet range, wherein the output is configured in both ranges in a ratio of 1 :8 to 1 :40. In addition, it is specified that the total radiation per lumen has roughly the same proportion as natural daylight of corresponding color temperature.
Apart from the fact that the output comparison between lumens and watts is misleading and that here invisible light is put in a ratio with visible light, calculations show that a maximum output of 1.5 mW is emitted for the total range from 290 to 320 nm and a maximum output of 42 mW is emitted for the range of 320 to 380 nm.
There is no reference to surface area.

CA 0220~041 1997-0~-09 It is further disclosed that lamps of this kind can have different maxima up to the range of 700 nm, e.g., between 570 and 595 or between 595 and 625 nm. On the whole, the reference also discusses prior art concerned with fluorescent lamps of special wavelength which, unlike daylight, can have a sharp maximum at different wavelengths. Suitable mixtures of luminescent material are indicated for this purpose, wherein characteristic metal compounds are listed for various color temperatures. In addition to the special ratios mentioned above in the ultraviolet light range, the different outputs of natural light compared with selected artificial lamps are shown for lamps with a power rating of 40 W and a light output of 2100 to 2300 Im.
The aim of the invention is to propose a lamp which prevents unwanted reddening of the skin (analogous to sun burn) during the 8-hour work day, but which nevertheless has a desired color reproducing effect. Various biological effects are also mentioned in tabular form, in particular the effect of light on eye color material, the effect on pineal glands and gonads of irradiation within a wavelength range of 380 to 700 nm, and the bactericidal effect of ultraviolet light at a wavelength of 254 nm. The formation of vitamins, deactivation of microorganisms, and cosmetic effect are mentioned in connection with the ultraviolet range. Reference is also made to the fact that ultraviolet radiation can bring about quantitative changes in skin melanin;
however, this effect is attributed especially to the effect of light at wavelengths from 290 to 320 nm and it is stressed for this reason that a lower radiation of the all-purpose lamps according to this invention with natural daylight spectrum is to be provided for this range.

CA 0220~041 1997-0~-09 Similarly, DE 23 39 181 C2 proposes a relatively homogeneous energy distribution over the individual spectral ranges in the visible spectral range from 300 to 800 nm with indicated individual ranges and intermediate ranges. A lamp of this kind is intended for use in plant breeding by imitating natural sunlight.
DE 31 21 689 C2 proposes a fluorescent lamp which has a filtering effect in the UVC and UVB ranges by means of glass bulbs. A maximum above 350 nm with a spectral width of approximately 320 to 400 nm is specified in particular for the UVA
range and, in addition, a pronounced radiation emission in the orange-red region at approximately 650 nm is provided by means of a second luminescent material. The result, according to this reference, is that fluorescent lamps conventionally used in solaria for tanning or for treating psoriasis (DE-OS 26 28 091) will not produce any side-effects such as fatigue or decreased energy. According to the reference, the orange range produces a one-sided influence on nerve tone and a dilation of blood vessels to eliminate fatigue. However, it is indicated that a lamp of this kind has an e,nission maximum typical of mercury in the range from 404 to 437 nm (blue) and H
is therefore impossible to filter out the blue range as is desired according to the descri,ulio".
DE-OS 34 31 692 proposes a fluorescent lamp similar to sunlight having five energy maxima at approximately 320, 380, 450, 550 and 650 nm which are to be achieved by lamps suitably doped with the indicated mixed luminescent materials. It is noted that in the UVA range cell damage is reparable and a regeneration of the eyes is made possible, whereas in the range below 320 nm the long-wave UVB

CA 0220~041 1997-0~-09 -radiation causes formation of vitamin D3 and calcium resorption, stimulation of metabolism and increased performance with respect to muscular system and circulatory organs. According to the reference, a sunburn effect only comes about in wavelength ranges below 300 nm. Approximately similar spectral emissions as those in the above-cited DE-AS 17 64 685 are indicated for the 300 - 400 nm range.
A number of references indicate dopant metals suitable for the various radiation ranges, e.g., for red to dark-red (US-PS 3,287,586) or for the blue range (DE-OS 19 22 416). Special lamps (DD 201 207 and DD 221 374) have been designed for therapeutic windows at a wavelength of around 325 nm. A phosphor dopant for an optimized emission at 340 - 400 nm has been suggested in DE-OS 32 39 417 for the treatment of skin ailments.
DE 29 10 468 A1 proposes an ultraviolet luminescent material radiation source for photobiological and photochemical purposes, in particular for tanning irradiation, in which the bulb of the radiation source contacts a liquid layer, preferably a water layer or a water bath. Such a water bath can also be designed as a water bed with a recliner or lounger, wherein the projection surface is a flexible transparent covering of the water bed and the water temperature is to be adjusted to 30 to 50~, preferably 35 to 40~. More particularly, an arrangement of the individual radiation sources is proposed in which the radiation sources are arranged in channel-like water containers enclosing the fluorescent tubes. These channel-like elements are to be provided with reflectors on the side remote of the irradiated object so as to enable light to be reflected from this cooling device in the direction of the projection surface. For this CA 0220~041 1997-0~-09 purpose, it is suggested to use ultraviolet fluorescent lamps in the 300-430 nm spectrum with luminescent materials which cannot be highly loaded thermally; other substances may be added to the cooling water, if necessary, to influence the spectral transmittance and/or to reduce electrical conductivity. The achievable radiation output with pigmentation effect, i.e., irradiation output in the aforementioned ultraviolet range, should be approximately 140 W/m2. It is noted that this irradiation device is also suitable optionally for medical application (diagnosis and therapy), in particular also for treatment of skin diseases and skin damage.
The device did not gain acceptance because its main purpose, tanning, can be achieved more cheaply in conventional solaria and the device was too complicated and too expensive for medical practice. A principal reason may consist in that the lamps were very highly stressed, since a surface temperature of the lamp amounting to 35 to 40~C, in particular at a relatively high power rating of 115 W, reduced the life of the lamps.
It has already been suggested (DE 40 33 958 A1) for infrared high-output radiators in hyperthermia therapy to provide a cooling and filtering device which comprises a coaxial sheathing tube around the radiator, water being guided along the surface of the radiator through this sheathing tube. The water can contain dye for absorption of determined radiations, in this case particularly visible radiation, in order to avoid blinding the patient. Antibacterial agents can also be added to this cooling liquid.

CA 0220~041 1997-0~-09 Psoriasis is a disease affecting the whole body. The most modern and effective treatment is photochemotherapy. It is based on the fact that Psoralen (administered orally prior to the treatment) under the influence of ultraviolet light (UVA, 365 nm) binds to the DNA of the epidermal cells to form photoadducts with crosslinking of the double-strand and thus prevents cell division. A further known idea consists in carrying out irradiation in general with UVB light in which rapidly dividing cells are destroyed. Psoriasis cells divide approximately five times faster than healthy normal cells so that irradiation is very effective. The disadvantage in each concept is the increased risk of cancer, especially with prolonged use due to irradiation with ultraviolet light.
In order to avoid these disadvantages, it has already been suggested to create photosensitive cells in another region of the~spectrum, namely, in the noncarcinogenic region, by means of photosensitizers. US-PS 4,753,958 suggests the use of hematoporphyrins. These substances accumulate in hyperproliferative tissue, e.g., in tumorous or inflamed tissue. These "Prodrugs" convert into porphyrin in the cell.
When the tissue region which is dyed in this way is sufficiently exposed, the dye undergoes photolysis. The photolysis leads to an intracellular release of cell toxins.
The affected clise~secl cell tissue is thus deliberately targeted by the irradiation and destroyed by simple exposure.
The irradiation is usually carried out with high-power incandescent lamps in which the unwanted spectral regions are filtered out by means of red filters. In spite of high power consumption, the lamps are characterized by only a limited effective CA 0220~041 1997-0~-09 output accompanied by a very high heat development. This makes the treatment relatively cost-intensive and also unpleasant for the patient. Moreover, it limits the possible duration of exposure. Also, treatment of the whole body is practically out of the question without exercising a "grill"-like effect on the patient due to the high heat generation.
According to DD 251 707, the insufficient radiation intensity of ultraviolet lamps is compensated for by making use of waste heat in that the latter is directed to the skin as a flow of warm air by means of fans. Patients seldom consider this pleasant due to the noise and current of air.
Alternatively, high-power dye lasers have also already been used. However, the cost of acquiring these dye lasers is extremely high; further, they only illuminate small areas. The use of 5-~-aminolevulinic acid in combination with laser therapy of this kind at a wavelength of 635 nm has occasionally been suggested, as well.
Proceeding from this prior art, the problem posed by the present invention is that of proposing an i"adialion arrangement which is appreciably more economical and simpler, but which can be used universally with many illnesses, and use thereof for specific light treatment.
This problem is solved by the features indicated in claims 1, 14 and 15.
Further developments of the invention are indicated in the subclaims.
This solution enables the reali7~tion of an economical irradiation arrangement for psoriasis patients and a multiplicity of other known therapies. The radiation arrangement can further be re~li7e-i for diseases affecting the whole body as well as CA 0220~041 1997-0~-09 _, for partial irradiation. The device can be designed for horizontal or vertical operation or can be suspended or directed to specific parts of the body. In devices which allow the patient to stand or sit, the resting arrangement for the patient can also be constructed so as to be rotatable in front of the irradiation device.
In particular, the invention can be used to treat hyperproliferative epithelial diseases distinguished by epidermal cell proliferation and incomplete cell differentiation, including acne, psoriasis, premalignant and malignant epithelial changes, e.g., dysplasia, herpes simplex, warts, ichthyosis, keratosis induced by exposure to the sun, benign keratosis, squamous epithelial-cell carcinoma, basal-cell carcinoma, and melanoma. Further, neurodermatitis, atopic dermatitis, contact dermatitis, and vitiligo can be treated.
For this purpose, the invention makes use of the advantages of the very large number of known versions of light therapy and improves the therapy variants while avoiding the known shortcomings.
Fluorescent lamps are relative economical. Moreover, in contrast to incandescent lamps, it is not required to screen out determined spectral regions by means of filters (and to convert them into heat); rather, appropriate doping is used to shift the spectral range of radiation to be given off into the desired range, e.g., in this case into the visible spectrum between 400 nm and 800 nm or, preferably from UVA
1 to the blue range.
Fluorescent lamps with amalgam-indium filling and doping with magnesium fluorogermanate or yttrium vanadate or cer-terbium magnesium aluminate or lithium CA 0220~041 1997-0~-09 metal aluminate have proven particularly suitable for this purpose. These dopants give off a radiation in the desired principal spectral range which can be configured within a narrow band by alternative compositions. An appropriate doping of the fluorescent tubes with these materials also falls within the affordable range, particularly in relation to the costs incurred in conventional installations. Doping materials for determined spectral ranges which are known per se can also be used.
Further, in the targeted spectral selection range, the fluorescent lamps preferably emit a specific light output of more than 700 W/m2, of which approximately 500 W/m2 reaches the irradiated object. This relatively high output can appreciably shorten the duration of an individual treatment and is also tolerated by the patent undergoing treatment in contrast to the conventional treatment with broad-band ultraviolet light, since practically exclusively the affected diseased parts of the skin react to the radiation, that is, they are destroyed by photolysis. Naturally, it is important to shield the eyes in so doing.
An increase in output for a specific output acting on the irradiated object is achieved by means of a reflecting device, e.g., a foil or refection damping layer, which is applied in or on the wall of the lamp.
In principle, lamps with a very small diameter, e.g., 12 mm or 6 mm, are used.
The lamps are inserted into the module at a slight distance from one another and bathed by a directed flow of coolant. The lamps are outfitted with helices which are overdimensioned in relation to their diameters so that the lamps can be loaded by higher current. Electronic ballast devices are used which operate at 25 kHz instead CA 0220~041 1997-0~-09 of at 50 Hz as has been conventional heretofore. The idling power or reactive power is accordingly minimized.
Output can be adapted in a continuous manner to the respective use, e.g., when changing from an adult patient to a child, with a current divider or voltage divider similar to a dimmer.
As a result of all of the steps in combination with an aimed for surface cooling, the emission output can be multiplied in the ranges which are important for irradiation in accordance with the invention to approximately 700 W/cm2 and greater. In this connection, the radiation output is calculated at the standardized wavelength of 555 nm. Tests made in an Ulbricht sphere and with additional measuring apparatus have confirmed the anticipated results.
Cooling the fluorescent lamps has a number of advantages. On the one hand, it carries off the dissipated power from the fluorescent dye and the glass of the fluorescent lamp so that an increased radiant power is achieved at moderate temperatures in all parts of the fluorescent lamp. On the other hand, the cooling protects the patient from long-wave heat radiation.
By providing a temperature control for the cooling liquid, the radiation data can be optimized and/or the l,ansrer of heat between the patient and the surrounding can be improved with the aim of increasing the patient's feeling of well-being. For this purpose, the ambient temperature of the lamp is first adjusted to the optimum temperature range of 8 to 20~C for maximum output with a spread width of a maximum of 5 to 30~C. At least the area of contact with the patient in the resting CA 0220~041 1997-0~-09 device is then heated to a higher temperature. The cooling of the fluorescent lamp can be effected directly or indirectly.
Direct cooling means that the fluorescent lamp is operated while completely immersed in the coolant with the exception of the area of its electrical connections.
For this purpose the irradiation device can be constructed in the manner of a tub so that the useful radiation is radiated upward by the surface of the coolant liquid. In this case, the patient lies on a transparent or perforated cloth above the coolant bath.
The supporting cloth can also be constructed as a textile net.
Alternatively, the irradiation device can also be constructed in such a way that its radiating surface is sealed with a liquid-tight transparent cover, e.g., of glass. The interior of the irradiation device is then completely filled with the coolant so that it is possible to irradiate in any desired lamp direction.
Indirect cooling is also possible. In this case, the fluorescent lamps are not submerged in the cooling liquid, but rather the heat is guided off by radiation, heat conduction and convection to lamp cooling means through which coolant flows or which has a cooling surface for giving off heat to the atmosphere. In addition, the fluorescent lamp, in the region of its electrodes, can be built into a cooling body or heat sink made of material with good heat conductivity which intimately contacts the fluorescent lamp along a large portion of its circumference and guides off the absorbed heat toward the lamp cooler.
To prevent the patient from being irradiated with long-wave heat radiation, a special radiation cooler can be arranged between the fluorescent lamp and the CA 0220~041 1997-0~-09 patient. This radiation cooler is formed of two parallel plates of glass or another material which allows the useful radiation to pass. Coolant, e.g., special gases or an aqueous fluid, flows through the intermediate space between the above-mentioned plates of glass and this intermediate space is provided, in addition, with suitable sealing, support, and inlet and outlet openings.
Of the irradiance or irradiation densities which can be achieved in accordance with the invention, the red spectral range (600- 700 nm), green spectral range (500 -570 nm), and the spectral range below UVA-1/blue (360-460 nm) are advantageous for the treatment of psoriasis and skin tumors, preferably in combination with a synthetic increase in naturally produced porphyrin by surface treatment with amino-~-levulinic acid, including its ester and/or glucose, including its ester and/or iron compounds administered orally or as a suitable ointrnent.
Of the achievable irradiation densities, the blue (400- 500 nm) and green (500 to 600 nm) spectral ranges are advantageous for the treatment of pruritus, e.g., with hyperbilirubinemia and renal insufficiency.
In particular, in neonatal icterus, the useful output in the green range can be elevated, since an increase in the dose output is limited by possible harmful effects only in blue tails of the spectral region.
Of the irradiation densities according to the invention, the spectral range from blue to ultraviolet, particularly UVA-1, offers advantages for the treatment of acne, bronchial asthma, lupus erythematosus, neurodelmalilis and psoriasis. Endogenous porphyrin (synthesized by bacteria) is found in acne, and the photolysis of these CA 0220~041 1997-0~-09 porphyrins influences bacterial growth so that the whole ultraviolet spectral region is not available for phototherapy as was previously the case.
At very high irradiation intensities, preferably in the green range between 500 and 600 nm (up to 700 J/cm2), it is possible to exert a considerable influence on immunization functions which have an advantageous effect on the illnesses mentioned above.
The achievable irradiation densities in the range of 600 to 800 nm are advantageous for treatment of hypertonia and blood circulation problems.
High-intensity white light as well as blue and green light have proven effective for treatment of depression, preferably seasonally dependent illnesses (winter depression) and schizophrenia, problems resulting from changes in work shifts, delayed sleep phase syndrome, jet lag, premenstrual syndrome, and alcohol withdrawal syndrome. The positive effects are increased by simultaneous action of a magnetic field.
Since photobiological effects are subject to a nonlinear action function, the described positive effects can be triggered in the patient only by irradiation at a sufficiently high intensity and not by a conesponding increase in the duration of irradiation with the low intensity available at the time.
It is particularly preferable when a photosensitizing of the skin is effected, e.g., with an ointment based on 5-~-aminolevulinic acid. This substance has proven to be especially advantageous precisely in this connection. In general, systemically or topically applicable photosensitizers which are effective in the nonmutagenic spectral CA 0220~041 1997-0~-09 range above 400 nm are preferred in the invention. The use of an ethyl or methyl ester derivative of the substance is still more preferable. Tests have shown that these ester derivatives of the substance - without penetration enhancing agents -bring about a considerably improved tissue penetration depth (increased lipophilia) and are therefore more suitable as sensitizers on surfaces than the original substance. Accordingly, even a curative irradiation of skin carcinoma, even prophylactically under certain circumstances, is conceivable.
The use of fluorescent lamps emitting above the ultraviolet range for treating hyperproliferative, malignant and/or inflammatory skin dise~ses, e.g., psoriasis, has never before even been considered. The considerable improvement in irradiation possibilities, especially the appreciable reduction in the risk of cancer with simultaneous prevention of the detrimental effects caused by heat generation show the importance of the substantial advantages of this invention precisely with regard to a common skin ailment which is incurable per se, apart from the possibilities of the invention in relation to health economics.
Since substances such as amino-~-levulinic acid and its derivatives in ester are not themselves photosensitive, they can be put to very good use as ointments because no "sunburn" or similar effects can occur in spite of the massive irradiation.
All effects occur only in the unconverted substance reaching the cells, namely the protoporphyrin IX produced naturally by the body.

CA 0220~04l l997-0~-09 Methylene blue (Pyoktonin) and related phenothiazine dyes are likewise suitable as photosensitizers for external use on the skin.
Medications and ointments containing iron compounds include a large number of trivalent complex compounds such as ferric sulfate, ferric chlorate or iron-sorbite-citrate complex. Iron compounds which can be protected against oxidation by the addition of ascorbic acid are preferred. Resorption can be promoted by the use of iron salts of organic acids such as aspartate, fumarate, succinate and the like.
Surface application of heme iron of myoglobin from flesh or blood is also advantageous, since the heme iron of epithelial cells is absorbed as an intact molecule and the iron is released in the cell.
Sugar containing compounds also include sugar alcohols and their esters, glucose, fructose, sorbite in simple and esterified form, saccharides, sugar acids, sugar phosphates and complex solution mixtures thereof.
The external application of the photosensitizing active ingredients mentioned above in the form of finished preparations is made possible by means of suitable foundations (carrier substances), combinations thereof and additives (active ingredients) which are incorporated in the foundations. Such foundations include eucerinum anhydricum, petrolatum, lanolin, and lard, as well as synthetic fats such as Carbowax and polyethylene glycol. With an applied fat layer, an artificial space is created between the fat layer and the skin so that the active ingredients are better distributed and penetrate more deeply. The addition of emulsifiers allows the water-repelling foundation materials to absorb water. Depending on skin type, applications CA 0220~041 1997-0~-09 can be carried out in the form of emulsions (creams with water in the internal phase or water in the external phase). Further, water-soluble ointment foundations of polyethyelene glycol or swelling colloids in glycerin water are used. Skin treated with this preparation reacts favorably to the applied irradiation in a specific spectral range with the fluorescent lamps of the type according to the invention.
In contrast to the punctiform light sources occurring chiefly with laser light, a very much more uniform spatial light distribution is to be expected as a result of irradiation with the fluorescent lamps over a large surface area. Therefore, when used appropriately, it would also be possible to diagnose only suspected tumorous porphyrin accumulations.
A further embodiment form according to the invention makes use of a plurality of fluorescent lamps with different spectral ranges, e.g., red and/or green and/or blue, for a special purpose. The individual colors are switched alternately at approximately 100 Hz. In conjunction with red-filter spectacles with LCD shutters, it would then be possible for the treating physician to effect a simultaneous display at 50 Hz per eye with excitation wavelengths of different tissue pe"el~alion depth. This would make it possible to see the depth to which skin changes extend for diagnostic use.
Irradiation arrangements according to the invention are very practical for cosmetic treatments; they can also be used in tanning salons for deliberate temporary tanning of different parts of the body by changing modules. The invention makes it possible for the first time to purposely irradiate the whole body without risky side-effects. The use of fluorescent lamps results in an accelerated clearing up of the CA 0220~041 1997-0~-09 -unwanted skin change and accordingly brings about a significant positive cosmetic effect.
Embodiment examples of the invention are explained more fully with reference to the drawing.

Figs. 1, 1a, 1b show a suspended treatment arrangement in detail from the side and in partial section;

Fig. 2 shows a second construction of a suspended arrangement according to the invention;

Fig. 3 shows a floor version of the arrangement according to the invention.

In the following, identical reference numbers are used to designate identical parts or parts having the same function.

Fluorescent lamps 9, 29 are arranged in a module frame 21 which is not shown in correct scale. The doping of the fluorescent lamps 9, 29 is so adjusted that the lamp 9 has a maximum output at 370 nm and lamp 29 has its maximum output at 410 nm. Both lamp bulbs have a diameter of 12 mm and a connection power of 60 W; their radiant power at the surface is 710 W/m2.
The electronic ballast device, not shown, which can be regulated with respect to frequency is provided with a dimmer by means of which the radiant power and/or CA 0220~041 1997-0~-09 the current consumption can be regulated in a continuous manner. In an alternative constructional form (Fig. 1b), the voltage can also be regulated within certain limits.
This arrangement affords the possibility in practice of reducing the voltage by up to 10% when necessary, which, although it results in a slight decline in output, increases the life of the lamp by 60%. The entire electric supply component 6 is encapsulated so as to be watertight and is conductively coupled with a heat sink 12 to carry off heat. Another heat sink 10 is coupled to the side of the lamp surface remote of the patient 1, where the lamp surface has a reflector in addition and keeps the lamp temperature at 8~C.
The emitted radiation 2 is directed through a radiation cooler 11 which is acted upon by water 7 and has a transparent cover 4, so that the emitted radiation 2 can be used as useful radiation 3 for skin treatment. Figures 1a and 1b show different constructions of the heat sinks 12 in partial section; the heat sinks 12 can be fastened to the module.
Fig. 2 shows a cooling housing 18 for coolant 17 . The lamps 19 with seals 15 are immersed and surrounded by the coolant 17. The entirety is formed as an exchangeable module which is connectable to a power supply by plug-in contacts 16.
The useful radiation 13 must penetrate a transparent shield 14 before it reaches the patient 1.
Fig. 3 shows a standing device or floor device analogous to that shown in Fig.

2. In this case, the patient lies on one of the flexible mats 20 which are transparent to radiation and are similar to the suspended mat.

Claims (17)

Patent Claims

1. Treatment arrangement for phototherapy on patients comprising a patient resting arrangement (20), a power supply, a light irradiation device, and a cooling arrangement (10, 12, 14, 15, 17, 18) for the light irradiation device, wherein the light irradiation device is substantially formed of fluorescent lamps (9, 19, 29) which are arranged parallel to one another and radiate in a virtually monochromatic wavelength range, characterized in that at least two differently radiating lamp types (9, 19, 29) are arranged in the irradiation device which radiate in different wavelength ranges in the spectrum from rough 290 to 850 nm, and a specific radiant power of greater than 50 mW per cm2 is generated at a projection surface to be irradiated, wherein the main component of the radiant power is produced in the selected wavelength ranges.

2. Arrangement according to claim 1, characterized in that the fluorescent lamps (9, 19, 29) of the selected wavelength ranges are arranged alternately in the radiation arrangement.

3. Arrangement according to claim 1 or 2, characterized in that the fluorescent lamps (9) are arranged in exchangeable modules (21), each with a plurality of parallel lamps (9), and an irradiation device is formed by one or more modules (21).

4. Arrangement according to one of claims 1 to 3, characterized in that each individual module (21) of a plurality of modules (21) of an irradiation device is outfitted with lamps (9) which radiate in the same wavelength range.

5. Arrangement according to one of claims 1 to 4, characterized in that the fluorescent lamps (9, 19, 21) are designed as inductive low-pressure gas discharge lamps with a filling containing amalgam compounds and are doped, as is known per se, corresponding to the selected wavelength ranges.

6. Arrangement according to one of claims 1 to 5, characterized in that the emitting surface of the irradiation device is dimensioned to at least 75% of the projection surface.

7. Arrangement according to one of claims 1 to 6, characterized in that the fluorescent lamps (9, 19, 29) have at their surface a reflection arrangement directing the radiation.

8. Arrangement according to one of claims 1 to 7, characterized in that a filter device (4, 7, 11 or 14, 17) for spectral ranges above 850 nm and/or below 290 nm is arranged between the projection surface and the fluorescent lamps (9 and 19).

9. Arrangement according to claim 8, characterized in that water (7, 17) is used as a filter for infrared radiation.

10. Arrangement according to one of claims 1 to 9, characterized in that the cooling arrangement (10, 12, 14, 15, 17, 18) is designed for a temperature keeping the surface of the fluorescent lamps (9, 29) at approximately 5 to 30°C, preferably 8 to 20°C.

11. Arrangement according to one of claims 1 to 10, characterized in that the heat guided off by the cooling arrangement (10, 12, 14, 15, 17, 18) is used to adjust at least portions of the patient resting arrangement (20) to optimum temperatures for treatment of the patient (1).

12. Arrangement according to one of claims 1 to 11, characterized in that fluorescent lamps (9, 19, 29) are used within a module (21) in the following combinations:
a) 311 nm and 370 nm b) 380 nm and 620 nm c) 460 nm and 530 nm d) 300 nm and 350 nm e) 300 nm and 350 nm and 380 nm f) 410 nm and 635 nm g) 370 nm and 410 nm

13. Arrangement according to one of claims 1 to 12, characterized in that the fluorescent lamps (9, 19, 29) can be operated by means of selectable impact ionization at frequencies of 50 Hz to 200 kHz.

14. Combined use of materials selected from the group comprising sugar-containing and/or iron-containing compounds, methylene blue, and related phenothiazine dyes, and 5-.delta.-aminolevulinic acid for the production of a medication, preferably an ointment, and a large-surface irradiation with monochromatic cold light of two fluorescent lamps of different spectral ranges for influencing diseased skin cells.

15. Use of a treatment arrangement according to one of claims 1 to 13 for distinguishing diseased layers of skin cells close to the surface and deeper layers of skin cells in conjunction with shutter spectacles, wherein two types of fluorescent lamps of different spectral ranges emit pulses at a frequency which can be predetermined for simultaneous display of the skin layers.

16. Arrangement for treating illnesses, characterized by individual or all novel features or combinations of the disclosed features.

17. Use of the arrangement for treating illnesses, characterized by individual or all novel features or combinations of the disclosed features.