Psoralen–narrowband UVB phototherapy for the treatment of vitiligo in comparison to narrowband UVB alone

Abstract

The potential of psoralen-narrowband ultraviolet B (NBUVB) photochemotherapy has been investigated in vitiligo. The present study aims to evaluate the efficacy of psoralen-NBUVB (P-NBUVB) vs. NBUVB in vitiligo. In a randomized study, 45 Indian patients (age above 13 years) with vitiligo involving more than 5% body surface area were randomly allocated to receive either NBUVB or P-NBUVB treatment. Both groups received NBUVB exposure thrice weekly, with a total of 60 sessions. The extent of repigmentation achieved was calculated on the basis of Vitiligo Area Severity Index (VASI) scoring. Forty patients were available for analysis at the end of the study. The extent of repigmentation in the P-NBUVB group was statistically significantly greater in face and neck (P = 0.006, t-test) and hands (P = 0.007, t-test) in comparison with the NBUVB group (t-test). Percentage reduction in VASI scores was statistically significantly greater in the P-NBUVB group (29.2% vs. 21.7%, P = 0.043, t-test). The response to P-NBUVB therapy started earlier than the response to NBUVB. After excluding sunlight as a confounding factor, treatment response was also significantly better in the P-NBUVB group (P = 0.005). Addition of psoralen increased the extent of repigmentation due to NBUVB therapy in vitiligo. Further studies are required to determine the long-term efficacy and safety of P-NBUVB.