Phototesting for a variety of skin conditions before narrowband (TL-01) Ultraviolet-B

Abstract

Background: For the majority of photo responsive skin disorders, narrowband ultraviolet-B (NBUV-B) phototherapy is currently regarded as the preferred option. The initial dosage of NBUV-B phototherapy is determined as a percentage of the minimal erythema dose (MED) at the majority of dermatology centers that offer phototherapy. This will shorten the time of therapy and lower the chance of burning while optimizing the therapeutic effect. Three times a week is the usual dosage for NBUV-B phototherapy treatment, which takes 18 to 30 sessions on average to clear the condition. For these types of treatment plans, a precise evaluation of the MED is necessary before starting treatment in order to prevent NBUV-B overdoses or underdoses. Aim: The objective of this study is to investigate the MED of 311nm NBUV-B phototherapy in a group of Libyan patients. Methods: For this prospective study, 150 patients with a range of skin conditions who saw the phototherapy unit at Bir Usta Melad Hospital of Dermatology and Venereology in Tripoli, Libya over an 8-month period were enrolled. Skin conditions include vitiligo, atopic dermatitis, and psoriasis are among those being researched. Using Fitzpatrick's questionnaire, skin types were assigned to each patient. Using a MED tester instrument (Dermalight® 80), 311 nm NBUV-B was applied to the right forearm. The test findings were recorded 24 hours later. Results: Of the patients studied, 82 (54.7%) were female and 68 (45.3%) were male. Their ages ranged from 10 to 60 years, with 30% of the sample falling between the ages of 31 and 40. The patients were clinically diagnosed with the following conditions: vitiligo 65(43.3%), psoriasis 61(40.7%), eczema 8(5.3%), pruritus 6(4%), and alopecia areata and lichen planus 5(3.3%) each. According to Fitzpatrick's categorization, the skin prototypes in the included series were 15(10%) patients of skin type III, 118(78.7%) patients of skin type IV, and 17(11.3%) patients of skin type V. Among the enrolled participants, the minimum necessary dose to elicit an erythema for NBUV-B ranged between 300 mJ/cm2 and 750 mJ/cm2, with the mean dosage was 484.7 ± 82.2 mJ/cm2. Conclusions: The average MED to 311nm NBUV-B in Libyan patients was around 500 mJ/cm2, which can be utilized to determine the initial dose and treatment regimen of phototherapy for various skin conditions.