Narrowband UVB Research Articles

Microneedling plus tacrolimus versus tacrolimus alone in conjunction with narrow band UVB in the treatment of vitiligo; A randomised control trial.

Objective: To compare the efficacy of microneedling plus Tacrolimus with narrow band UVB versus tacrolimus with narrow band UVB in the treatment of vitiligo. Study Design: Randomized Controlled Trial. Setting: Department of Dermatology, Madinah Teaching Hospital, Faisalabad. Period: 05-06-2023 to 5-12-23. Methods: Enrolled 28 patients with stable Vitiligo for the last 3 months, aged 15 to 60 years. Patients were assigned to group A and B, treated with microneedling plus topical tacrolimus 0.1% with narrow band UVB and tacrolimus ointment twice a day. The study focused on evaluating the repigmentation response during subsequent follow-up visits, using a comprehensive four-grade scale. The results were analyzed using SPSS 26. Results: The study involved 34 patients with face lesions. Six patients lost follow-up and were excluded. The study included 16 males and 12 females, with a mean age of 29.4 + 11 years. After the treatment, the first follow-up visit showed significant improvement in 17 of 28 patients (60.7%) in group A (microneedling pus Tacrolimus with narrow band UVB) compared to 32.1% in group B (Tacrolimus with narrow band UVB). The efficacy was categorized into five levels: 'excellent' in 25% cases in group A and 21.4% in group B, and very good' in 35.7 vs 10.7%. At 12 weeks, overall efficacy was seen in 71.4% in group A and 39.3% in group B. The study's findings suggest that microneedling plus tacrolimus with narrow band UVB may be a more effective treatment for vitiligo. Conclusion: Microneedling, a technique using delicate needles to puncture the dermis, has been shown to promote collagen synthesis and enhance the absorption of tacrolimus, a drug used for immunosuppression, potentially aiding in vitiligo repigmentation, but further localized studies are needed.

Phototherapy for the treatment of atopic dermatitis in Singaporean children and adolescents.

Phototherapy has emerged as a safe yet effective form of treatment of atopic dermatitis (AD). Few studies have been done to evaluate the efficacy of phototherapy in Asian children. The aim of this study was to review the phototherapy experience in a cohort of Asian pediatric patients with AD at a tertiary dermatologic center in Singapore. A retrospective study of patients 18 years and below with AD who had undergone phototherapy at KK Women's and Children's Hospital, Singapore, over a 4-year period was performed. Sixty-two patients were identified, between ages 4 and 16 years (mean age 11 years) at the time of commencement of phototherapy. Thirty-five (60%) patients were males and 23 (40%) were females. Most patients had moderate to severe disease, with 60.3% of the patients with an initial body surface area (BSA) involvement of 31%-60% and 13.8% of the patients with an initial BSA involvement of 61%-90%. For patients who had undergone narrowband ultraviolet B (NBUVB) and combined ultraviolet A (UVA) and NBUVB phototherapy, the mean reduction of the Eczema Area and Severity Index (EASI) scores were 11.4 and 7.9, respectively. Common side effects experienced include xerosis, pruritus, erythema, and pain. Other reasons for cessation of therapy in the NBUVB group included time commitment difficulty (9.3%), hyperactivity (2.3%), and claustrophobia (2.3%). Two patients that had photochemotherapy (psoralen + UVA) [PUVA] suffered from post-UVA burns requiring cessation of treatment. More than half of the patients (56.9%) treated with phototherapy experienced treatment success with improvement in Investigator Global Assessment and EASI scores. 86.2% of the patients had good compliance to the treatment regime, 12% had poor-compliance, and 3.4% were lost to follow-up. Phototherapy is a useful treatment adjunct for moderate to severe AD in Asian children.

P035 Quantifying the mutation burden of a therapeutic course of narrowband ultraviolet B (UVB) to help inform on the carcinogenicity of narrowband UVB

P035 Quantifying the mutation burden of a therapeutic course of narrowband ultraviolet B (UVB) to help inform on the carcinogenicity of narrowband UVB

PD06 (P035) Quantifying the mutation burden of a therapeutic course of narrowband ultraviolet B (UVB) to help inform on the carcinogenicity of narrowband UVB

PD06 (P035) Quantifying the mutation burden of a therapeutic course of narrowband ultraviolet B (UVB) to help inform on the carcinogenicity of narrowband UVB

Evaluation the Efficacy of NB-UVB Treatment Alone in Comparison with Combination Therapy of NB-UVB and Oral Prednisolone in Treatment of Vitiligo

Background: The treatment landscape for vitiligo has witnessed diverse approaches yielding variable outcomes. Objective: To discern the optimal approach in terms of both tolerability and efficacy by comparing Narrow Band Ultraviolet B (NB-UVB) phototherapy with adjunctive oral mini pulse (OMP) prednisolone tablets. Patients and Methods: A total of eighty-seven individuals with progressive vitiligo were enrolled in a one-year study, with participants allocated randomly across three study groups through a continuous selection method. Group 1 received a combination of NB-UVB and OMP prednisolone tablets, group 2 underwent NB-UVB treatment only, and group 3 received OMP prednisolone tablets alone. Clinical assessments were conducted at three- and six-month intervals, and statistical analyses were performed utilizing descriptive and bivariate techniques, including the chi-square test, to gauge the significance of differences between the various groups. Results: In Group 1 (NB-UVB + OMP), substantial improvement was observed in 41.4%, accompanied by moderate improvement in 44.8% of patients. Group 2 (NB-UVB) demonstrated marked improvement in 31.0% and moderate improvement in 38.0%. In Group 3 (OMP), a lower proportion experienced marked (13.8%) or moderate (3.4%) improvement. Chi-square test findings indicated that the combination of NB-UVB and OMP correlated significantly with marked and moderate improvement in contrast to OMP alone, with respective values of χ² = 6.434 (p = 0.001) and χ² = 7.831 (p = 0.015) after a six-month follow-up. Conclusion: Through a comprehensive evaluation of three treatment modalities in vitiligo patients, it was established that the sole application of oral mini pulse steroids (OMP) held an adjunctive value, lacking substantial efficacy on its own. Remarkably, the amalgamation of Narrow Band UVB and OMP presented a clear advantage over either treatment administered independently. Keywords: Vitiligo, NB-UVB, OMP, Prednisolone.

Evaluation the efficacy of NB-UVB treatment alone in comparison with combination therapy of NB-UVB and oral prednisolone in treatment of vitiligo

Background: The treatment landscape for vitiligo has witnessed diverse approaches yielding variable outcomes. Objective: To discern the optimal approach in terms of both tolerability and efficacy by comparing Narrow Band Ultraviolet B (NB-UVB) phototherapy with adjunctive oral mini pulse (OMP) prednisolone tablets. Patients and Methods: A total of eighty-seven individuals with progressive vitiligo were enrolled in a one-year study, with participants allocated randomly across three study groups through a continuous selection method. Group 1 received a combination of NB-UVB and OMP prednisolone tablets, group 2 underwent NB-UVB treatment only, and group 3 received OMP prednisolone tablets alone. Clinical assessments were conducted at three- and six-month intervals, and statistical analyses were performed utilizing descriptive and bivariate techniques, including the chi-square test, to gauge the significance of differences between the various groups. Results: In Group 1 (NB-UVB + OMP), substantial improvement was observed in 41.4%, accompanied by moderate improvement in 44.8% of patients. Group 2 (NB-UVB) demonstrated marked improvement in 31.0% and moderate improvement in 38.0%. In Group 3 (OMP), a lower proportion experienced marked (13.8%) or moderate (3.4%) improvement. Chi-square test findings indicated that the combination of NB-UVB and OMP correlated significantly with marked and moderate improvement in contrast to OMP alone, with respective values of χ² = 6.434 (p = 0.001) and χ² = 7.831 (p = 0.015) after a six-month follow-up. Conclusion: Through a comprehensive evaluation of three treatment modalities in vitiligo patients, it was established that the sole application of oral mini pulse steroids (OMP) held an adjunctive value, lacking substantial efficacy on its own. Remarkably, the amalgamation of Narrow Band UVB and OMP presented a clear advantage over either treatment administered independently.

Treatment of oral graft-versus-host disease with intraoral nbUVB phototherapy.

There are limited treatment options available for hematopoietic stem-cell transplant patients (HSCT) with oral graft-versus-host disease (GVHD). Intraoral phototherapy is a novel, yet promising therapeutic regimen. To assess the safety and effectiveness of intraoral narrowband UVB (nbUVB) phototherapy in the treatment of oral GVHD. This case series evaluated 10 patients with refractory oral GVHD, who were treated at Northwestern Memorial Hospital with nbUVB between July 2019 and October 2023. Primary outcomes were to evaluate the safety and efficacy of phototherapy. Efficacy was measured by objective improvement in symptom scores and subjective improvement in patient reported symptoms. Safety was determined by the withdrawal due to adverse events. Total nbUVB exposure, number of treatments, and change in systemic immunosuppressive medications were also examined. The study cohort comprised 10 patients who developed oral GVHD at a median of 9.5months after HSCT. The total median dose of nbUVB was 36J/cm2, and the median number of sessions was 55. All 10 patients demonstrated some degree of improvement in symptoms. Notably, there was a reduction in the number of patients who reported symptoms of oral pain (83%), bleeding (67%), xerostomia (50%), and oral sensitivity (78%) after initiating phototherapy. There was also a statistically significant decrease in the levels of pain, erythema, and edema (p ≤ 0.001, < 0.001, 0.01, respectively). Most patients tolerated phototherapy well, but 1 patient withdrew from treatment due to adverse effects. Seventy-five percent of patients who were on immunosuppressive medications were able to decrease or stop these medications. This case series suggests that nbUVB phototherapy is well tolerated and efficacious in patients with oral GVHD.

A prospective observational study of oral abrocitinib and narrow-band ultraviolet-B in refractory progressive vitiligo

A prospective observational study of oral abrocitinib and narrow-band ultraviolet-B in refractory progressive vitiligo

Clinical Applications of Phototherapy in Treating Skin Disorders

Introduction and Purpose: Phototherapy, involving the therapeutic use of ultraviolet and visible light, has been a cornerstone in dermatology for treating various skin disorders. This review aims to consolidate current knowledge on the mechanisms of action and clinical applications of phototherapy, with a focus on enhancing understanding among clinicians and researchers.State of Knowledge: Phototherapy is particularly effective for chronic conditions such as psoriasis, vitiligo, and atopic dermatitis, where traditional therapies might not suffice. The mechanism involves modulation of immune response and inhibition of cellular proliferation, achieved through various wavelengths, including UVA and UVB. Recent advancements have introduced narrow-band UVB, which offers targeted therapy with fewer side effects compared to broad-band UVB. Moreover, the review explores innovations such as LED-based therapies and photodynamic therapy, expanding the spectrum of phototherapeutic options.Summary: Phototherapy remains a vital and evolving treatment modality in dermatology, offering safe and effective management for multiple skin disorders. Its success hinges on precise application and adherence to treatment protocols. Future research should aim to optimize treatment regimens, reduce side effects, and enhance patient compliance to improve outcomes. By advancing our understanding and application of phototherapy, we can better tailor treatments to meet individual patient needs, thereby improving the quality of life for those afflicted with chronic skin conditions.

Effectiveness of narrowband ultraviolet B monotherapy versus combination therapy with systemic agents in patients with early-stage mycosis fungoides and the association with plaque lesions.

Narrowband ultraviolet B (NB-UVB) has been recommended as first-line therapy for early-stage mycosis fungoides (MF) in international guidelines. NB-UVB can be used as monotherapy or part of a multimodality treatment regimen. There is limited evidence on the effectiveness and optimal patients of NB-UVB in combination with systemic therapies in MF. We aimed to assess the effectiveness of the combination versus NB-UVB monotherapy in early-stage MF and if plaque lesion status was related to these effects. This observational cohort study included 247 early-stage MF patients who had received NB-UVB combined with systemic therapies vs. NB-UVB monotherapy from 2009 to 2021. The primary outcome was partial or complete response. Overall response rate and median time to response were calculated. Hazard ratios (HRs) were estimated using the Cox model. In 139 plaque-stage patients, the response rate for combination therapy group was higher than that of monotherapy group (79.0%vs. 54.3%, p=0.006). The adjusted HR for combination therapy compared with NB-UVB monotherapy was 3.11 (95% CI 1.72-5.63). The combination therapy group also showed shorter time to response (4vs. 6 months, p=0.002). In 108 patch-stage patients, the response rate and time to response in two treatment groups showed no significant difference. There was therefore an observed interaction with patients' plaque lesion status for the effect size of NB-UVB combination therapy. No serious adverse events were observed. Adding systemic treatments to NB-UVB did not improve the treatment outcome of patch-stage patients, but it surpassed NB-UVB monotherapy for early-stage patients with plaques.

Combination of total glucosides of paeony, narrow-band ultraviolet B, and oral corticosteroid mini-pulse therapy for nonsegmental vitiligo: A retrospective study.

The total glucoside of paeony (TGP) is recognized for its immunomodulatory properties and anti-inflammatory effects. This study evaluates the efficacy of TGP combined with oral mini-pulse therapy (OMP) and narrow-band ultraviolet B (NB-UVB) in treating active nonsegmental vitiligo (NSV). The combination therapy was contrasted against those from a group treated solely with OMP and NB-UVB. Data from 62 patients undergoing TGP combination treatment and 55 without were analyzed over a 3-month period. After 6 months, the differences in recurrence rate were investigated by follow-up. The findings indicate that integrating TGP may yield superior outcomes compared to OMP + NB-UVB alone. Moreover, the patient's oxidative stress makers were significantly reduced after the treatment. The majority of patients in the TGP cohort exhibited enhanced skin pigmentation over the duration. Notably, no increase in side effects or recurrence was observed in this group. Especially, patients with vitiligo on their head and neck experienced pronounced improvements. The efficacy of the combination treatment group was better than that of the control group at 2 and 3 months, and there was no difference in recurrence rate and side effects, suggesting that TGP may continue to show efficacy in NSV for a longer period of time by reducing the level of oxidative stress, and is especially suitable for patients with head and neck lesions.

P07 Mutagenicity of narrowband ultraviolet B

Abstract Introduction and aims Exposure to ultraviolet (UV) radiation causes DNA mutations in skin and development of skin cancer. Despite this, UV radiation in the form of narrowband UVB is commonly used by dermatologists to treat skin diseases such as psoriasis. However, the mutagenicity of narrowband UVB in human skin is unknown. In this study, we investigated the mutation burden resulting from a course of narrowband UVB in patients with psoriasis. Methods Skin biopsies were taken from uninvolved skin of sixteen patients with psoriasis before and after a treatment course of narrowband UVB. Following microdissection, DNA was extracted from the epidermis and sequenced using nanorate sequencing (NanoSeq), which detects mutations in single molecules of DNA with an error rate of fewer than five errors per billion base pairs. Whole-genome sequencing of blood DNA was employed as germline control. Comparison of mutations in prenarrowband UVB and postnarrowband UVB skin samples allowed quantification of mutation burden and mutational signatures owing to narrowband UVB. Results There was a significant increase in the mutation burden in skin following the narrowband UVB treatment course, with UV radiation signatures SBS7a, SBS7b and DBS1 documented in both nonsun-exposed skin and frequently sun-exposed skin samples. Comparison of the magnitude of the mutation burden resulting from narrowband UVB to that in keratinocyte cancers provided insight into the mutagenicity of narrowband UVB in relation to the potential numbers of narrowband UVB courses over a lifetime that might lead to skin cancer development. Conclusions Narrowband UVB treatment for psoriasis Results in significant numbers of UV-radiation-induced mutations in human skin.

Two-dimensional Keitz method for the radiant power measurement of planar ultraviolet excilamps

Planar XeBr∗ and XeCl∗ excilamps emitting noncoherent narrowband UVB light (280–315 nm) are now widely used to cure psoriasis and vitiligo as well as to improve vitamin D synthesis. The two-dimensional integral formula has been deducted in this study, which is a good method and has great practical significance to calculate the total radiant power and assess the energy efficiency of a planar UV lamp. The measured radiant power of planar white LED lamps through a two-dimensional Keitz formula has been compared to that of gonio-photometer, verifying the applicability of the formula. The optimum measurement distance is dependent on the lamp length (1.5L≤D≤3.5L) for which the derivation from the two methods can be controlled within 10%. The planar XeBr∗ excilamps have been measured and compared to coaxial excilamps, which show similar patterns of change for the radiant characteristics. Since the planar radiant power formula only needs to measure normal illuminance at a certain distance from the symmetric center of the lamp, it is more convenient to use and is a low-cost method to promote the development of large-sized planar ultraviolet lamps.

Photoprotective, Immunomodulatory and Eco-Friendly: On the road to the Holy Grail of Sunscreen Development

Phototherapy, utilizing Narrow band UVB, PUVA, UVA-1 or natural sunlight has long been used by dermatologists in the management of a range of dermatological conditions but is accompanied by the potential hazards associated with ultraviolet light exposure to the skin. A therapeutic sunscreen, a preparation which offers ultraviolet light protection, whilst permissive of the benefits of ultraviolet light therapy without the need for expensive medical equipment is an attractive concept.

Combination of Fractional Carbon Di Oxide Laser with Narrow Band Ultravoilet B Therapy to induce repigmentation in stable resistant vitiligo- A split-lesional study

Context: Resistant vitiligo is challenging to treat and needs new therapeutic approaches such as combining fractional carbon dioxide (CO2) laser and narrow-band ultraviolet B (NB-UVB) therapy. Aims: The study aimed to determine the efficacy and safety of combining fractional CO2 laser and NB-UVB therapy to induce repigmentation in resistant localized vitiligo patches. Materials and Methods: In this open, prospective, split-lesional study, 40 stable resistant vitiligo patches in 30 patients were included and assessed. After an initial assessment, a few resistant patches of vitiligo were identified, and a symmetrical half of it was given two sessions of fractional CO2 laser 1 month apart, followed by NB-UVB sessions to both sides thrice weekly for 3 months. Photographs were taken at baseline and 12 weeks, and repigmentation responses were assessed by calculating the mean percentage of improvement and mean grade of pigmentation on the fractional CO2 laser with NB-UVB site (test) and the only NB-UVB site (control) and then compared using Wilcoxon signed-rank test, with significance determined by P value &lt;0.05. Results: The mean grade of pigmentation (1.8±0.88) and mean surface area improvement (8.40 ± 6.82 cm2) on the fractional CO2 laser with NB-UVB site (test) were statistically better than the mean grade of pigmentation (1.27 ± 0.71) and mean surface area improvement (5.37 ± 6.76 cm2) on the NB-UVB site. A better grade of pigmentation was noted over sun-protected areas with fractional CO2 and NB-UVB therapy, while NB-UVB therapy fared better in sun-exposed areas. Conclusions: Fractional CO2 laser with NB-UVB therapy is an effective treatment in resistant vitiligo patches, especially for sun-protected areas.

The effect of narrowband ultraviolet B on tissue level of interleukin-15 and interleukin-15 receptor alpha subunit in active nonsegmental vitiligo cases: an interventional cohort study

Background Vitiligo is an acquired depigmenting skin disorder in which CD8 effector and memory T-cells contribute to its pathogenesis and recurrence. Interleukin (IL)-15 contributes to CD8 effector T-cell cytotoxicity and CD8 memory T-cell survival and maturation. Objective To evaluate the effect of total narrowband ultraviolet B (NB-UVB) on tissue levels of IL-15 and IL-15 receptor alpha (IL-15Ra) in active nonsegmental vitiligo. Patients and methods The patients were assessed clinically for vitiligo extent and activity before and after treatment. Perilesional skin biopsies were taken from 30 vitiligo patients before and after 48 sessions of NB-UVB and from 30 healthy controls. Tissue levels of IL-15 and IL-15 Ra were evaluated by enzyme-linked immunosorbent assay before and after treatment to evaluate the effect of NB-UVB on them. Results Before NB-UVB treatment, the tissue levels of both IL-15 and IL-15Ra were significantly higher in vitiligo patients than controls; moreover, they were significantly higher than those after NB-UVB treatment. In contrast, after NB-UVB treatment, no statistically significant difference was detected between the patients and controls. The levels of IL-15 and IL-15Ra were significantly correlated, whereas they were not correlated with either vitiligo activity or extent. Conclusion IL-15 and IL-15Ra were higher in vitiligo patients than controls before treatment. However, their tissue levels were normalized after treatment with NB-UVB, emphasizing its therapeutic potential.

Level of long noncoding RNA taurine upregulated gene 1 after narrow band-ultraviolet B phototherapy in vitiligo

Background Vitiligo is a skin disease that is characterized by depigmenting lesions as a result of melanocytes destruction. Long noncoding Taurine upregulated gene 1 (lnc TUG-1) is one of the long noncoding RNA (lnc RNA) family members. The role of lncRNA TUG1 in melanogenesis has been investigated in recent studies. Objective To investigate the impact of narrow-band ultraviolet B (NB-UVB) on lncTUG-1 expression in vitiligo. Patients and methods The first step of this work was a case control study that included thirty vitiligo patients and thirty healthy controls. four mm skin biopsies were taken from normal skin in healthy controls and from depigmenting lesions in vitiligo patients. The second step was a prospective single-arm interventional study in which patients were subjected to 12 weeks of NB-UVB phototherapy and biopsies were taken from repigmenting areas. Biopsies were kept frozen at −80°C till by real-time polymerase chain reaction was conducted to evaluate the lnc TUG-1 expression. Results The mean lnc TUG-1 expression in skin tissue biopsies of the vitiligo patients was significantly lower compared with control skin biopsies (0.307±0.202 ng/mg vs 1.03±0.063 pg/mg, respectively, P&lt;0.001). Although the level of lnc TUG-1 was not normalized, the mean value of lnc TUG-1 significantly increased after 12 weeks treatment with NB-UVB compared with its value before phototherapy (0.0687 ng/mg vs. 0.307 ng/mg, respectively, P&lt;0.001). Conclusion The lnc TUG-1 could be a possible player in the pathogenesis of vitiligo and repigmentation of vitiligo after NB-UVB phototherapy.

A novel reverse perilesional home phototherapy can promote the repigmentation of vitiligo patches with complete leukotrichia: A 12-week, open-label, double-arm, multicenter, randomized clinical trial.

Existing phototherapies are ineffective for treating patients with vitiligo with complete leukotrichia. We compared the efficacy of reverse perilesional irradiation, during which only the lesional areas are covered, with conventional narrowband ultraviolet B (NB-UVB) home phototherapy for repigmentation of non-segmental vitiligo in patients with complete leukotrichia. This was a 12-week, open-label, double-arm, multicenter clinical trial, with a total of 121 patients with non-segmental vitiligo who were randomly divided into two groups (both received topical tacrolimus): the conventional NB-UVB irradiation (CI) and reverse perilesional NB-UVB irradiation (RI) groups. A statistically significant difference in improvement from baseline was observed in the RI group compared with the findings in the CI group (-30.8% ± 11.8% vs. -25.5% ± 11.05%, respectively [p = .010]; pair-wise comparison p = .900 at week 4, p = .104 at week 8, and p = .010 at week 12). At week 12, the average percentage change from baseline of leukotrichia in the irradiation area significantly decreased from 100% to 82.2% ± 13.65% in the RI group, and from 100% to 88.7% ± 9.64% in the CI group (p = .027). Adverse events were minor, including desquamation, dryness, erythema, and blisters. No severe or lasting side effects were observed during the study. RI mediated better repigmentation of vitiligo with complete leukotrichia than CI.

Risk of Skin Cancer in Patients with Psoriasis: Single-Center Retrospective Study Comparing Anti-TNFα and Phototherapy.

Background: The risk of developing non-melanoma skin cancers (NMSCs) in patients with psoriasis is highly debated, and, to date, there is no unambiguous consensus opinion. Psoriasis is known to be related to an increased likelihood of other comorbidities such as psoriatic arthritis, obesity, metabolic syndrome, depression, and cardiovascular disease. Regarding cancer risk, previous studies have reported a greater tendency for the development of cutaneous T-lymphomas and colon, breast, kidney, and lung cancers. Furthermore, data from network meta-analyses have shown that patients with psoriasis have a higher risk of developing squamous cell carcinomas (SCCs) and/or basal cell carcinomas (BCCs). Multiple factors may contribute to the development of NMSCs in psoriatic patients, ranging from immunosuppression induced by biologic agents to previous phototherapy. However, the extent to which each factor may impact this risk has not been entirely assessed. The aim of this study was to evaluate the risk of developing NMSCs in patients with psoriasis observed for at least 5 years, by directly comparing patients only treated with phototherapy and patients treated with anti-tumor necrosis factor α (TNFα) agents, naive to other systemic treatments or phototherapy. Methods: We conducted a single-center retrospective study at Siena University Hospital, Italy, on 200 adult patients with psoriasis divided into two groups: (i) group 1, including 100 patients treated with narrow-band UVB phototherapy (nb-UVB), and (ii) group 2, including 100 patients treated with anti-TNFα. The patients included in group 2 had to be naive to cDMARDs and biologics and treated with anti-TNFα continuously for 5 years without loss of efficacy. All patients were observed for 5 years and underwent annual dermatologic examinations to assess for the occurrence of BCC or SCC. Results: A total of 34 out of 100 patients treated with phototherapy had one BCC or one SCC and 10 out of 34 developed two skin cancers. In particular, five had both types (one BCC and one SCC), and five had two BCCs. Conclusions: The results of our study highlight how the risk of developing NMSCs is greater in patients undergoing phototherapy compared to those treated with anti-TNFα. It also draws attention to the consideration that patients with scalp psoriasis might need closer follow-up as they could be more at risk of developing NMSCs.

Serum neopterin level in psoriatic patients treated with acitretin or narrowband ultraviolet B or both

Background A biological indicator of cellular immunity is neopterin. In certain studies, psoriasis patients had higher serum, and urine neopterin levels, which were reduced following therapy. Aims To evaluate the effect of acitretin versus narrowband ultraviolet B (NB-UVB) and combinations of them on psoriasis vulgaris and correlate it with neopterin level Patients and methods In this case-control research, a total of 120 respondents (30 healthy volunteers) served as the control group, in addition to 90 psoriasis patients randomly allocated into three equal groups: group (I): 30 patients received Acitretin for 3 months. Group (II): 30 patients were treated with NB-UVB. Group (III): 30 patients received Acitretin and NB-UVB (3 sessions/week) for 3 months. Serum neopterin levels were measured pre- and post-treatment. All patients were clinically and photographically evaluated using the Psoriasis Area and Severity Index (PASI) score. The study was registered at clinicaltrial.com. Approval numbers: NCT05401006 and date of registration: 1/6/2022. Results In this study, statistically significant higher serum neopterin levels have been found in psoriatic patients than healthy controls. We found a significant decrease in PASI scores in all groups. The relative reduction percentage in the PASI score was substantially different between groups (P&lt;0.001). The highest decrease percentage in PASI score was reported in group III compared with group II (NB-UVB) and group I (Acitretin group), (P&lt;0.001). The median s. neopterin levels after treatment varied substantially among the three groups (P&lt;0.001). Conclusion When compared with healthy controls, serum neopterin levels in psoriatic patients were substantially greater (P&lt;0.05).