BACKGROUND: Following the first investigational study on the use of extracorporeal photopheresis for the treatment of cutaneous T-cell lymphoma published in 1983, this technology has received continued use and further recognition for additional earlier as well as refractory forms. After the publication of the first guidelines for this technology in the JEADV in 2014, this technology has maintained additional promise in the treatment of other severe and refractory conditions in a multi-disciplinary setting. It has confirmed recognition in well-known documented conditions such as graft-versus-host disease after allogeneic bone marrow transplantation, systemic sclerosis, solid organ transplant rejection including lung, heart and liver and to a lesser extent inflammatory bowel disease. MATERIALS AND METHODS: In order to further provide recognized expert practical guidelines for the use of this technology for all indications, the European Dermatology Forum (EDF) again proceeded to address these questions in the hands of the recognized experts within and outside the field of dermatology. This was done using the recognized and approved guidelines of EDF for this task. All authors had the opportunity to review each contribution as it was added. RESULTS AND CONCLUSION: These updated 2020 guidelines provide at present the most comprehensive available expert recommendations for the use of extracorporeal photopheresis based on the available published literature and expert consensus opinion. The guidelines are divided in two parts: PART I covers cutaneous T-cell lymphoma, chronic graft-versus-host disease and acute graft-versus-host disease while PART II will cover scleroderma, solid organ transplantation, Crohn's disease, use of ECP in paediatrics practice, atopic dermatitis, type 1 diabetes, pemphigus, epidermolysis bullosa acquisita and erosive oral lichen planus.

3rd Faculty of Medicine Charles University Prague Czech Republic

Crown Princess Victoria Children's Hospital and Division of Pediatrics Department of Biomedical and Clinical Sciences University Hospital Linköping University Linköping Sweden

Department of Biomedical and Clinical Sciences Linköping University Linköping Sweden

Department of Cardiac Surgery Medical University of Vienna Vienna Austria

Department of Clinical Immunology and Transfusion Medicine Linköping University Linköping Sweden

Department of Dermatology and Venerology Helios Klinikum Krefeld Krefeld Germany

Department of Dermatology Lausanne University Hospital CHUV Lausanne Switzerland

Department of Dermatology Medical University of Graz Graz Austria

Department of Dermatology Medical University of Vienna Vienna Austria

Department of Dermatology University Clinics Schleswig Holstein Kiel Germany

Department of Dermatology University Hospital München Germany

Department of Dermatology Vanderbilt University Medical Center Nashville TN USA

Department of Thoracic Surgery Medical University Vienna Vienna Austria

Departments of Dermatology Venereology Allergology and Immunology Dessau Medical Center Brandenburg Medical School Theodor Fontane Dessau Germany

Dept Dermatology and Venereology Otto von Guericke University Magdeburg Germany

Dermatology Department University of Brescia Italy Brescia Italy

Division of Dermatology University of Alberta Edmonton AB Canada

Division of Haematology LKH Univ Klinikum Graz Medical University of Graz Graz Austria

Faculty of Biology and Medicine University of Lausanne Lausanne Switzerland

FRCP St John's Institution of Dermatology Guy's and St Thomas' NHS Foundation Trust London UK

FRCPath The Rotherham NHA Foundation Trust Rotherham UK

Hautklinik Städtisches Klinikum Karlsruhe Karlsruhe Germany

Hospital Saint Louis Université de Paris Paris France

National and Kapodistrian University of Athens Athens Greece

Onco Hematology Department Hautepierre Hospital Strasbourg France

Translational and Clinical Research Institute Newcastle University Great North Children's Hospital Newcastle upon Tyne Newcastle University Newcastle upon Tyne UK

University Clinic for Dermatology Johannes Wesling Medical Centre UKRUB University of Bochum Minden Germany

University Hospital Birmingham Birmingham UK

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