Phototherapy for Skin of Color in the Biologic Era: A Cross-Sectional Survey of Moroccan Dermatologists’ Knowledge and Practice

Background Phototherapy remains central to the treatment of inflammatory and pigmentary skin disease and is especially relevant in populations with darker skin phototypes. As biologic and targeted therapies expand, the place of phototherapy in resource-limited settings is uncertain. We assessed the knowledge, perceptions, and practice of Moroccan dermatologists regarding phototherapy and identified barriers to its use. Methods A cross-sectional, self-administered, web-based survey (34 items) was distributed to Moroccan dermatologists via the Moroccan Society of Dermatology network between October and November 2025, covering demographics, access, technical competency, knowledge, prescribing, attitudes toward biologic and targeted therapies, and training needs. Exploratory cross-tabulations (Fisher’s exact test) and 95% CIs (Clopper-Pearson method) were computed for the principal proportions. Results Of 53 respondents (91% female, 51% in private practice), 94% had ever prescribed phototherapy, but only 43% (95% CI: 30-58%) had access to a unit. Most respondents rated their knowledge of indications as sufficient or better; however, only 17% (95% CI: 8-30%) identified the guideline-based psoralen plus ultraviolet A risk-monitoring threshold, and 34% (95% CI: 22-48%) identified the recommended minimum age for narrowband ultraviolet B. Most (70%) considered phototherapy to retain a major role alongside biologic and targeted therapies, and a majority reported offering it before escalation in psoriasis (83%), vitiligo (76%), and atopic dermatitis (62%). Access to a phototherapy unit was strongly associated with public or university practice (p < 0.001) and with regular prescribing (p < 0.001). Logistical (79%), institutional (45%), and space-related (38%) barriers predominated; only 36% had received phototherapy training during residency. Conclusions Moroccan dermatologists express strong support for phototherapy and report offering it before biologic and targeted therapies across major indications, but deficits in equipment access, guideline-based knowledge, and postgraduate training represent barriers to optimal practice. These findings highlight the need for further research, including objective competency assessments and clinical outcome studies, to inform strategies for equipment deployment, structured training, and a national phototherapy network.