Narrowband ultraviolet B phototherapy in pediatric vitiligo: A retrospective study

Abstract

To the Editor: Narrowband UV-B phototherapy (nbUV-B) is a first-line treatment for vitiligo management. 1 Mohammad T.F. Al-Jamal M. Hamzavi I.H. et al. The vitiligo working group recommendations for narrowband ultraviolet B light phototherapy treatment of vitiligo. J Am Acad Dermatol. 2017; 76: 879-888 Abstract Full Text Full Text PDF PubMed Scopus (64) Google Scholar Previous small studies have suggested that children can acquire repigmentation comparable to that of adults. 2 Magdaleno-Tapial J. Ortiz-Salvador J.M. Valenzuela-Oñate C. Marí-Cornejo P. Esteve-Martínez A. Pérez-Ferriols A. Comparison of phototherapy in pediatric and adult patients. Actas Dermosifiliogr. 2020; 111: 41-46 Crossref PubMed Scopus (3) Google Scholar Nevertheless, concerns regarding safety, practicality, and insurance coverage arise. 3 Blundell A. Sachar M. Gabel C.K. Bercovitch L.G. The scope of health insurance coverage of vitiligo treatments in the United States: implications for health care outcomes and disparities in children of color. Pediatr Dermatol. 2021; 38: 79-85 Crossref PubMed Scopus (2) Google Scholar To assess the prevalence, efficacy, and safety of nbUV-B, we conducted a retrospective chart review of pediatric patients with vitiligo seen by our department from January 1, 2009 to December 31, 2020. In 324 identified patients, 50% were male, median age at first visit was 8.7 years (SD, 4.3 years), and median follow-up was 20 months (IQR, 8-39 months). Clinical management included nbUV-B in 126 patients (38.9%) for a mean duration of 18 months (SD 13, Table I). The youngest patient that received nbUV-B treatment was aged 3 years, and 58 (46%) patients used home nbUV-B, which is typically an out-of-pocket cost. Table IManagement of Pediatric Vitiligo Treatment n % None 28 8.6 Topical calcineurin inhibitor 284 88 Topical steroid 188 58 Oral steroid 47 15 Outdoor sun exposure 21 6.5 Topical JAK inhibitor 9 2.8 Oral JAK inhibitor 2 0.62 Topical calcipotriene 6 1.9 MKTP 13 4.0 Excimer 32 9.9 Other 14 4.3 nbUV-B phototherapy (including home) 126 39 Phototherapy characteristics Home phototherapy 58 46 Occurrence of sunburn 33 29 Occurrence of blistering 4 3.5 Occurrence of scarring 0 0 Reported skin cancer 0 0 Duration of phototherapy (n = 108), mos ∗ Twice or 3 times a week. 18 † Mean. 13 ‡ SD. JAK, Janus kinase; MKTP, melanocyte-keratinocyte transplant procedure; nbUV-B, narrowband UVB. ∗ Twice or 3 times a week. † Mean. ‡ SD. Open table in a new tab JAK, Janus kinase; MKTP, melanocyte-keratinocyte transplant procedure; nbUV-B, narrowband UVB.