The World of UV Phototherapy

Posts Tagged ‘UVBNB’

TITLE: A randomized controlled study of low-dose UVA1, medium-dose UVA1, and narrowband UVB phototherapy in the treatment of localized scleroderma.
Kreuter A, Hyun J, Stücker M, Sommer A, Altmeyer P, Gambichler T.

Department of Dermatology and Allergology, Ruhr-University Bochum, Bochum, Germany.

BACKGROUND: In previous trials, UV therapy has been demonstrated to be effective in the treatment of localized scleroderma (LS). To date, a randomized comparison study to evaluate the efficacy and safety of different, commonly used phototherapeutic modalities in LS is still outstanding.

OBJECTIVE: The aim of this study was to compare the safety and efficacy of

• low-dose (LD) UVA1,
• medium-dose (MD) UVA1, and
• narrowband (NB) UVB phototherapy in the treatment of LS.

METHODS: Sixty four patients with LS were consecutively included in a prospective, open, randomized controlled 3-arm study. Severity of LS was determined by means of a clinical score, and clinical improvement was also monitored by histopathologic analysis and 20-MHz ultrasound.

RESULTS: A total of 27 patients were treated with LD UVA1 (20 J/cm2), 18 patients received MD UVA1 (50 J/cm2), and 19 patients were treated with NB UVB dependent on their skin type. Phototherapy was performed 5 times weekly for 8 weeks. Two of the 64 patients included in this trial discontinued therapy. Skin status significantly improved in all patients who finished the treatment protocol, resulting in a reduction of the clinical score in all groups (LD UVA1, 7.6-5.0 [P < .001, 95% confidence interval 1.6-3.4]; MD UVA1, 11.1-6.6 [P < .001, 95% confidence interval 2.5-6.2]; NB UVB, 7.3-4.9 [P < .001, 95% confidence interval 1.6-3.2]). The reduction of the score was accompanied by an improvement of the visual analog scale for itching and tightness, histologic score, and 20-MHz ultrasound. MD UVA1 was significantly more effective than NB UVB (P < .05). There were no significant differences between LD UVA1 and NB UVB and the former and MD UVA1 (P > .05).

LIMITATIONS: We had a relatively small study sample and nonblinded assessment of primary outcome.

CONCLUSION: Phototherapy, as previously reported in several noncontrolled trials, is an effective therapeutic option in LS, with a favorable risk/benefit ratio. UVA1 phototherapy should be considered among the first approaches in the management of LS.

Link to PubMed Article:  << Click Here >>

NOTE: Amjo does offer UVA-1 Products at www.HomePhotoTherapy.com

Several times over the years, I’ve heard that Dead Sea Salt can help with the treatment of Psoriasis coupled with UVB Narrow Band. I decided to do some googling and learned some interesting stuff.

The interesting thing is that many folks go to the Dead Sea for the treatment of Psoriasis and this has caused the belief that the Dead Sea Salt is the contributor to the clearing of their Psoriasis, the conclusion that I draw based on the article below and others that I’ve read is that it’s not the salt but the sunlight which contains a reasonable proportion of UVB/UVB NB, possibly because of the filtering effect of the mists and atmosphere around the Dead Sea that contribute to the healing/clearing.

Of course the secondary my more mercenary conclusion says, don’t waste your money on a trip to the Dead Sea, just purchase a UVB Narrow Band system for your home or just head to your doctor’s UVB311/UVB NB Clinic and save lots of cash!

I’d be interested in your comments!

Here’s one article from the British Journal of Dermatology (ISSN 0007-0963 ) from 2005 that concluded “In this population the addition of pretreatment Dead Sea salt soaks to NB-UVB did not result in a clinically important improvement in clearance of psoriasis.”

Document title: A randomized controlled comparison of the efficacy of Dead Sea salt balneophototherapy vs. narrowband ultraviolet B monotherapy for chronic plaque psoriasis

Author(s): DAWE R. S. ; YULE S. ; CAMERON H. ; MOSELEY H. ; IBBOTSON S. H. ; FERGUSON J.
from the Photobiology Unit, Department of Dermatology, University of Dundee, Ninewells Hospital and Medical School, Dundee DD1 9SY, ROYAUME-UNI

Abstract: Background Dead Sea (DS) salt solution soaks are used in combination with narrowband ultraviolet B (NB-UVB) to treat psoriasis in many centres, particularly in continental Europe. No previously published controlled study has assessed DS salt + NB-UVB balneophototherapy.

Objectives: To compare DS salt balneophototherapy with NB-UVB monotherapy for chronic plaque psoriasis. Methods Sixty patients with chronic plaque psoriasis participated in this paired, controlled study, with pretreatment DS salt soaks randomly allocated to each participant’s right or left study limb. Psoriasis severity was assessed with a Scaling, Erythema and Induration score by a blinded observer. Assessments were weekly during the therapy course, and thereafter 8-weekly until relapse or for up to 1 year after clearance.

Results: The mean area under the psoriasis severity-time curves during treatment was not detectably lower with DS salt balneophototherapy than with NB-UVB monotherapy (P = 0.099). The psoriasis severity score fell slightly more from beginning to end of courses with DS salt balneophototherapy than with NB-UVB monotherapy (P = 0.019). There was no detectable difference in times to relapse.

Conclusion: In this population the addition of pretreatment DS salt soaks to NB-UVB did not result in a clinically important improvement in clearance of psoriasis.

Other reading

1. http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2678696
2. http://pt.wkhealth.com/pt/re/bjdr/abstract.00002300-200509000-00024.htm;jsessionid=K9QJPTxdckT2wddJJJx3CxndDt51Qyzryl6b0M110nXVB9LTPlst!331639832!181195628!8091!-1
3. http://www.ncbi.nlm.nih.gov/pubmed/10792225

I think you’ll draw the same conclusion or maybe not if you read the article at Click Here where the author says  “The ultraviolet radiation at the Dead Sea is attenuated relative to Beer Sheva as a result of the increased optical path length and consequent enhanced scattering. The UVB radiation is attenuated to a greater extent than UVA and the shorter erythema UVB spectral range decreased significantly compared with the longer therapeutic UVB wavelengths” - Life sure is complex!