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The details of UV phototherapy practices for vitiligo
Type:Uv phototherapy Time:2015-05-21 9:22:24Background: The details of phototherapy practices for vitiligo have been rarely studied. Objective: To explore the details of phototherapy practices for vitiligo among dermatologists. Methods: A self-administered questionnaire about the details of phototherapy practices for vitiligo was distributed to all dermatologists attending a national general dermatology conference in Riyadh, Saudi Arabia, in 2008. Results: Questionnaires were returned by 121 of 140 participants (response rate = 86.4%). The mean age of the respondents was 39.34 9.7 years, and 65% were males. One hundred eight of 110 (98.2%) respondents provided phototherapy to their vitiligo patients. The mean number of vitiligo patients who underwent phototherapy each week per dermatologist's office was 18 2.26. Narrowband ultraviolet B (NB-UVB) was the most common modality chosen to treat generalized vitiligo (84%). Excimer laser was the most common modality used to treat focal and segmental vitiligo (53% and 39%, respectively). Sixty-eight percent of dermatologists administered a fixed starting dose of NB-UVB to all patients, whereas 31% used the minimal erythema dose as a guide. Fifty percent reported that NB-UVB resulted in better color matching with the surrounding skin. Thirty-seven percent favored NB-UVB over psoralen + ultraviolet A for a faster response, and 31% preferred NB-UVB for a pigmentation that is more durable. Forty-seven percent (50/106) of the respondents limited the number of phototherapy sessions to reduce the risks of skin cancer. However, no respondent reported any skin cancer incidence in phototherapy-treated vitiligo patients. Conclusion: There is a need for phototherapy guidelines for the treatment of vitiligo in patients with skin of color.
Vitiligo is an acquired cutaneous depigmentation disorder that affects approximately 1 to 2% of the world's population, with no predilection for age, gender, or ethnic background. Vitiligo is difficult to treat, although various nonsurgical and surgical treatment modalities have been mentioned in the literature. The progressive depigmentation of the skin that characterizes vitiligo is associated with a loss of melanocytes from the basal layer of the epidermis.
Narrowband ultraviolet B (NB-UVB) therapy is now a well-established and recommended phototherapy for generalized vitiligo, even in pregnant women and children, because of its high safety profile. As with many other treatments, psoralen + ultraviolet A (PUVA) and NB-UVB therapies generally result in good repigmentation on the trunk and proximal aspects of limbs but less frequently improve pigmentation on the hands and feet.
We sought to explore the details of current practice in phototherapy treatment for vitiligo among dermatologists in Saudi Arabia. No regional or worldwide study has been conducted to explore the details of phototherapy use in the management of vitiligo. Previous surveys either evaluated phototherapy for vitiligo in general as a part of the overall management of vitiligo, or examined phototherapy practices for skin disorders in general.