Narrowband UVB phototherapy in skin conditions beyond psoriasis.

Type:Uv phototherapy   Time:2017-09-11 14:38:18
Narrowband UVB phototherapy in skin conditions beyond psoriasis.
BACKGROUND:
Narrowband (NB) UVB phototherapy has been proven to be clearly more effective than broadband UVB and safer and/or more 
practicable than psoralen-UVA in the management of psoriasis. However, the role of NB UVB seems to be less clear in 
the management of skin conditions beyond psoriasis.
OBJECTIVES:
We sought to give an update on clinical experiences in NB UVB of nonpsoriatic skin conditions, and to establish its 
current position within the spectrum of competing photo(chemo)therapeutic options.
METHODS:
The computerized bibliographic database PubMed, without time limits, and other sources were screened for clinical 
trials on NB UVB. Included were research articles of randomized controlled trials, open prospective studies, and 
retrospective observations on NB UVB in skin disorders other than psoriasis.
RESULTS:
A total of 28 articles met our eligibility criteria including 6 randomized controlled studies, 16 open prospective 
studies, and 6 retrospective observations. NB UVB is effective in patients with chronic atopic dermatitis (AD) (n = 
719) and generalized vitiligo (n = 305) and appears to have some advantages over competing photo(chemo)therapeutic 
regimens. NB UVB also seems to be effective in patients with polymorphic light eruption (n = 25), early stages of 
cutaneous T-cell lymphoma (n = 108), chronic urticaria (n = 88), lichen planus (n = 15), pruritus associated with 
polycythemia vera (n = 10), seborrheic dermatitis (n = 18), actinic prurigo (n = 6), and acquired perforating 
dermatosis (n = 5). The quality of evidence determined for the aforementioned diagnoses ranged from high to moderate 
to very low.
CONCLUSIONS:
The best currently available data on NB UVB in nonpsoriatic conditions exist for AD and generalized vitiligo. In view 
of its efficacy, benefit/risk profile, and costs, NB UVB may be considered the first-line photo(chemo)therapeutic 
option for moderately severe AD and widespread vitiligo. In the treatment of most other nonpsoriatic conditions, NB 
UVB appears to be effective, but current data allow no definitive conclusions as to whether NB UVB should be preferred 
to competing photo(chemo)therapeutic options such as UVA1 and psoralen-UVA regimens. Because NB UVB may have a wider 
indication spectrum, including AD, vitiligo, and early-stage T-cell lymphoma, and appears to be equally effective or 
even more effective than broadband UVB, a switch from broadband UVB to NB UVB seems to be justified.
Gambichler T1, Breuckmann F, Boms S, Altmeyer P, Kreuter A.
www.kerneluvb.com----The leader manufacturer of UV Phototherapy.