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NB-UVB phototherapy is the most commonly used light modality for vitiligo
Type:Uv phototherapy Time:2015-05-21 9:27:14Methods
A cross-sectional survey was distributed to all participants at a national general dermatology conference in Riyadh, Saudi Arabia, on November 9-13, 2008. Participants were general dermatologists. A questionnaire was distributed to all 140 dermatologists attending the conference. The questionnaire contained 25 questions, including basic demographic variables (gender, age, and years of practice). The dermatologists were also asked about the average weekly number of vitiligo patients with whom they used phototherapy and the percentages of different phototherapy modalities employed. The questions further addressed treatment options, dosages, and the management of adverse effects.
The dermatologists completed the questionnaires on site at the conference. A scale format (always, frequently, sometimes, rarely, never) was used to assess the dermatologists' practices regarding calculating cumulative doses and protecting body areas during phototherapy. Their preferences for different treatment modalities in vitiligo were explored. They were asked about the method they use most frequently to determine starting doses for PUVA and NB-UVB in vitiligo patients. Additionally, we requested that they indicate their first choice of phototherapy modality for treating the different types of vitiligo. Their views on the efficacy of PUVA vs NB-UVB were also probed. The percentage of vitiligo patients who suffered from side effects, such as burns, pruritus and PUVA lentigines, and the dermatologists' immediate treatment recommendations for side effects, were examined. All data were analyzed using the Statistical Package for Social Sciences (SPSS) software, version 16, and P values ¡Ü0.05 were considered statistically significant. Means, medians, and standard deviations were utilized to summarize the responses as measures of central tendency. Associations between baseline variables and outcomes were determined using Pearson's Chi-square test.
This study was approved by the Research Ethics Committee at King Saud University, Riyadh, Saudi Arabia.
Results
Demographic characteristics of the respondents
Among the 140 dermatologists attending the conference, 121 returned the questionnaires (response rate, 86.4%). Eleven questionnaires were excluded because they were more than 50% incomplete. A total of 110 questionnaires were analyzed. Of these, 108 (98.2%) indicated that they provided phototherapy to their vitiligo patients. The mean age of the respondents was 39.34 ¡À 9.7 years. Sixty-five percent (69/106) were males. Consultants comprised 43/108 (40%), while the rest of the respondents were specialists or residents in training (28.7% and 31.5%, respectively). University and government hospital-based practices employed 72.2% of the respondents, whereas 15.7% were private dermatologists. The mean number of years' experience in dermatology was 11.4 ¡À 8.4 years. The respondents had a mean of 18 ¡À 2.26 vitiligo patients undergoing phototherapy each week.
Preferred phototherapy modalities
Overall, NB-UVB was the most commonly used light modality for vitiligo (54%); 2.2% used broadband UVB (BB-UVB), 11% used oral PUVA, and 18% used topical (8-MOP) PUVA. Fifteen percent of the respondents had used excimer laser to treat vitiligo.
When asked about their first-choice phototherapy method for the treatment of focal vitiligo, nearly half of the respondents (52.8%, 47/89) preferred excimer laser, 6% used NB-UVB, and none used BB-UVB. For segmental vitiligo, 39.3% (33/84) preferred excimer laser, 28.6% used topical PUVA, and 27% used NB-UVB. The most common phototherapy modality used for generalized vitiligo was NB-UVB, which was selected by 83.7% of the respondents (87/104).