This is from an article written by Damian McNamara of Skin and Allergy News in an article published in February of 2008.
TORONTO — Narrowband ultraviolet B treatment is effective for repigmentation of vitiligo lesions, according to ratings from 50 patients and their physicians. The technique was particularly successful for lesions on the face and body and less helpful on the hands and feet.
In a second study, 25 patients with photoresponsive conditions reported high satisfaction with use of narrow-band ultraviolet B (UVB) home units, Dr. Jean-Pierre DesGroseilliers said at the annual conference of the Canadian Dermatology Association.
He and his colleague, Kay-Anne Haykal, reviewed the charts of 50 consecutive patients who were treated with narrowband UVB. The mean age at the time of treatment was 41 years.
Effective repigmentation of the face and body and a high level of patient and physician satisfaction are among the advantages of narrowband UVB for vitiligo. An added benefit is a better safety profile than psoralen and UVA light (PUVA) therapy, said Dr. DesGroseilliers of the division of dermatology at the University of Ottawa and Ottawa General Hospital.
The researchers asked physicians and patients to rate the percentage of lesion repigmentation. Poor repigmentation was defined as 0%–33%; good was 34%–66%; and very good was 67%–100%. A total of 24% of physicians and 22% of patients reported good results. Another 48% of physicians and 50% of patients reported very good repigmentation with narrowband UVB.
Disadvantages include poor repigmentation of the hands and feet and a high rate of side effects. A majority of patients—90%—reported adverse events, including pruritus, pain, erythema, burns (particularly to the nipples), blistering of the lips, and/or a herpes simplex outbreak. The investigators said that the advantages of this therapy “far outweigh the drawbacks.”
In the second study presented at the meeting, the same investigators surveyed 25 patients via telephone or computer regarding use of home units of narrowband UVB for maintenance therapy of photoresponsive diseases (J. Cutan. Med. Surg. 2006;10:234–40).
“In a home setting, PUVA is not very practical. Similarly, with broadband UVB, the lower spectrum is more toxic versus narrowband,” said Dr. DesGroseilliers. “Narrowband UVB appears to be safest of the three.”
All patients had successful light treatment at the photodermatology clinic before beginning maintenance treatment at home. Duration of home therapy ranged from 2 weeks to 1.5 years, with a total of 10–200 treatments. Of the 25 patients in the study, 20 had psoriasis, 2 had vitiligo, 2 had mycosis fungoides, and 1 had atopic dermatitis.
All of the patients used Solarc/SolRx home phototherapy devices with Philips 311-nm bulbs. Of the devices, 18 were 1000 Series full-body panels (1760 UVB-NB and 1780 UVB-NB) and 7 were 500 Series hand/foot and spot devices (550 UVB-NB).
The researchers asked about insurance coverage for the home units. Three patients had full insurance coverage and six patients had partial insurance coverage, Dr. DesGroseilliers said.
Reasons reported for choosing a home device—patients could give more than one reason—included time (40%); fewer travel expenses (25%); a work schedule that made hospital treatment difficult (17%); and recommendation by a physician (6%).
“Satisfaction of the patients is very, very high,” he said. “One hundred percent agreed they would continue the treatment, repeat it, or recommend it.”
Adverse events included erythema in 36% of patients and pruritus in 8%. “NB-UVB home therapy is effective in comparison with hospital therapy. It is safe and presents few side effects,” said Dr. DesGroseilliers, who said he had no conflicts of interest to disclose regarding narrowband UVB devices.
