Narrowband UVB Research Articles

Excimer Laser 308 nm

ABSTRACT The excimer laser delivers targeted ultraviolet radiation at 308 nm, useful for delivering targeted phototherapy. It can also be useful in treating difficult-to-reach treatment sites while minimizing radiation exposure to surrounding skin. The excimer laser has been FDA approved for treatment of inflammatory skin conditions. This review summarizes excimer laser applications and advantages over other narrowband UVB and other phototherapy treatments.

Vitiligo: Prevalence, Clinical Patterns, and Efficacy of Narrow Band Ultraviolet B Phototherapy

Background: Vitiligo denotes an acquired primary, usually progressive, melanocytopenia of unknown etiology, and clinically manifested by circumscribed achromic macules often associated with leukotrichia. Objective: The objective was to assess the prevalence and various clinical patterns of vitiligo and to study the efficacy of narrow-band ultraviolet B (NB-UVB) radiation. Materials and Methods: A prospective case series study was carried out at dermatology outpatient department (OPD), of tertiary care center in Central India on 50 patients of Vitiligo, who were diagnosed clinically, age ranging from 5 to 70 years of age. A thorough history and clinical examination as per institutional protocol was done for all the patients included in the study. Patients were exposed to NB-UVB rays in a phototherapy unit (Dermaindia Spiegel Series) with a standard protocol. Two scores designed for the assessment of vitiligo are Vitiligo Area Severity Index and Wallace Rule of Nines. Results: During the period of two years, 6638 patients were seen in dermatology OPD, out of which 129 patients were having vitiligo clinically. Thus, the prevalence of vitiligo was 1.9% in our study. The mean age in male was 40.4 years and that of female was 30.85 years. The female-to-male ratio was 2:3. 6% had a positive family history of vitiligo. The most common site affected was leg (pretibial region) (48%). Two patients (4%) were in Category– 0, 12 patients (24%) were in Category– I, 24 patients (48%) were in Category-II, and 12 patients (24%) were in Category– III, when graded according to their improvement. Forty-five patients (90%) had vitiligo vulgaris, two patients (4%) had segmental vitiligo, and one patient (2%) each of acrofacial vitiligo, lip-tip vitiligo, and focal vitiligo. On comparing the level of significance before treatment and after 2 months of treatment, after 4 and 6 months of treatment, and before treatment and at the end of treatment, it was found that the results were statistically highly significant. Thus, indicating that the improvement in the disease after NB-UVB therapy is statically significant. Conclusion: Our study found 1.9% prevalence of vitiligo among patients attending OPD. On comparing the level of significance, before treatment and at the end of treatment, it was found that the results were statistically highly significant with respect to improvement. Side effects were minimal in our participants. Thus, our study concludes that NB-UVB radiation is an effective and safe therapy for vitiligo.

Vitamin D Receptor Expression in Chronic Plaque Psoriasis Before and After Narrowband Ultraviolet B Phototherapy.

Psoriasis is a multifactorial disease. It is a combination of genetic, immunological, and environmental factors. Vitamin D receptor (VDR) is a nuclear receptor that regulates epidermal cell growth through the inhibition of proliferation and induction of keratinocytes terminal differentiation. Aim of the study was to investigate the effect of Narrow-band UVB (NB-UVB) therapy on VDR expression in the skin of psoriasis patients. Forty patients with different severities of psoriasis were assessed using the psoriasis area and severity index (PASI) score. Lesional and non-lesional skin biopsies were obtained from each patient before NB-UVB therapy, and then a third lesional biopsy was performed after completing 24 sessions of NB-UVB. Immunohistochemistry for VDR was performed on all specimens. There was a significant decrease in VDR expression in psoriatic lesions compared to that in non-lesional skin before treatment. A statistically negative correlation was detected between the degree of VDR expression before treatment and PASI score, family history, and duration of psoriasis. There was a significant increase in VDR expression at the sites of psoriasis lesions post-NB-UVB therapy compared to pretreatment lesional skin. VDR expression was down-regulated in psoriatic lesions compared to non-lesional skin, and NB-UVB therapy improved VDR expression in psoriasis skin lesions.

Clinico-Epidemiological Profile of Vitiligo Patients Receiving Narrowband Ultraviolet-B (NB-UVB) Treatment

Background: Vitiligo is an idiopathic disease with a prevalence of 0.5-2% worldwide that causes the loss of melanocyte cells from parts of the body and is characterized by the appearance of well-defined white macules. The pathogenesis of vitiligo is suspected to originate from genetic, non-genetic, and autoimmune factors. Currently, Narrowband Ultraviolet-B (NB-UVB) is the first-line phototherapy treatment to treat vitiligo. Purpose: To evaluate the profile of vitiligo patients who were given phototherapy at the Dermatology and Venereology Outpatient Clinic, Dr. Soetomo General Academic Hospital for the period January-December 2019. Methods: This study used a retrospective descriptive research design with descriptive statistical methods. In this study, the medical records were evaluated by recording the patient's age, gender, occupation, history of illness, family history, and results of a physical examination. Result: This study obtained 31 samples that received phototherapy dominated by the age range of 17-25 years (29%) and male gender (55%), with a ratio of 1:0.82 to women. The majority work as others (68%). The most common trigger factor was emotional stress (29%). According to physical examination, the majority of patients had multiple lesions (81%), were not widely available (58%), and were of the generalized type (52%). Conclusion: It can be evaluated from the most data obtained: 17-25 years old (29%), male gender (55%), other occupations (68%), emotional stress triggers (29%), multiple lesions (81%), unavailable lesion area (58%), and generalized type (52%), describe the profile of vitiligo patients in Dr. Seotomo General Academic Hospital in 2019.

Vitamin D and narrowband ultraviolet B phototherapy for chronic kidney disease-associated pruritus.

In addition to improving the serum vitamin D balance, narrowband ultraviolet B (NB-UVB) phototherapy can effectively treat chronic kidney disease-associated pruritus (CKD-aP). We investigated the degree of CKD-aP amelioration according to changes in the serum vitamin D level after NB-UVB phototherapy. This was a before-after clinical study in patients with refractory CKD-aP on hemodialysis. NB-UVB phototherapy was administered thrice weekly for 12 weeks. The response of CKD-aP to NB-UVB phototherapy was assessed as the change in pruritus intensity over time. A rapid response was defined as a reduction in the visual analog scale (VAS) score of ≥50% within the first 6 weeks of NB-UVB phototherapy. We included 34 patients in this study. Although serum 25-hydroxy vitamin D [25(OH)D] concentrations increased significantly, by a median of 17.4 ng/mL, after the phototherapy course, other serologic parameters did not change. NB-UVB phototherapy reduced the VAS score for pruritus intensity over time significantly more in patients with Δ25(OH)D of >17.4 ng/mL than in patients with Δ25(OH)D of ≤17.4 ng/mL (p = 0.001). Ten patients were rapid responders. Multivariate logistic regression analysis showed that Δ25(OH)D was independently associated with rapid response (odds ratio, 1.29; 95% confidence interval, 1.02-1.63; p = 0.04). The effect of NB-UVB phototherapy on patients with CKD-aP correlated with their increase in serum vitamin D levels. Further well-designed clinical and experimental studies are needed to clarify the relationship between NB-UVB phototherapy and serum vitamin D levels in patients with CKD-aP.

Elucidating the NB-UVB mechanism by comparing transcriptome alteration on the edge and center of psoriatic plaques

Narrow band-ultraviolet B (NB-UVB) is an effective treatment for psoriasis. We aim to generate a potential mechanism of NB-UVB through comparing the transcriptomic profile before and after NB-UVB treatment between the peripheral edge of lesional skin (PE skin) and the center of lesional skin (CE skin) on the basis of molecular mechanisms of these two areas display different downstream functions. More than one-fourth of the NB-UVB-altered genes were found to be plaque-specific. Some of them were psoriasis signature genes that were downregulated by NB-UVB in, both, PE and CE skin (core alteration), such as IL36G, DEFB4A/B, S100A15, KRT16, and KRT6A. After NB-UVB treatment, the activity score of upstream cytokines, such as interferons, interleukin (IL)-6, IL-17, and IL-22 in pathogenesis decreased. In addition, NB-UVB could restore normal keratinization by upregulating LORICRIN and KRT2, particularly in the CE skin. Finally, we illustrated that NB-UVB is capable of suppressing molecules from the initiation to maintenance phase of plaque formation, thereby normalizing psoriatic plaques. This finding supports the usefulness of NB-UVB treatment in clinical practice and may help in the development of new treatment approaches in which NB-UVB treatment is included for patients with psoriasis or other inflammatory skin diseases.

Narrow UVB-Emitted YBO3 Phosphor Activated by Bi3+ and Gd3+ Co-Doping.

Y0.9(GdxBi1-x)0.1BO3 phosphors (x = 0, 0.2, 0.4, 0.6, 0.8, and 1.0, YGB) were obtained via high-temperature solid-state synthesis. Differentiated phases and micro-morphologies were determined by adjusting the synthesis temperature and the activator content of Gd3+ ions, verifying the hexagonal phase with an average size of ~200 nm. Strong photon emissions were revealed under both ultraviolet and visible radiation, and the effectiveness of energy transfer from Bi3+ to Gd3+ ions was confirmed to improve the narrow-band ultraviolet-B (UVB) (6PJ→8S7/2) emission of Gd3+ ions. The optimal emission was obtained from Y0.9Gd0.08Bi0.02BO3 phosphor annealed at 800 °C, for which maximum quantum yields (QYs) can reach 24.75% and 1.33% under 273 nm and 532 nm excitations, respectively. The optimal QY from the Gd3+-Bi3+ co-doped YGB phosphor is 75 times the single Gd3+-doped one, illustrating that these UVB luminescent phosphors based on co-doped YBO3 orthoborates possess bright UVB emissions and good excitability under the excitation of different wavelengths. Efficient photon conversion and intense UVB emissions indicate that the multifunctional Gd3+-Bi3+ co-doped YBO3 orthoborate is a potential candidate for skin treatment.

Generalized purpuric lichen nitidus treated successfully with narrowband UVB therapy

AbstractA 66‐year‐old Finnish man suffered from asymptomatic, purpuric skin lesions extending from his ankles and dorsal feet to the trunk and forearms. Based on a skin punch biopsy and the clinical picture, the diagnosis of generalized purpuric lichen nitidus, which is an exceedingly rare form of lichen nitidus, was made. The condition responded well to narrowband UVB phototherapy.

Altered levels of lymphocyte enhancer-binding factor-1 modulates the pigmentation in acral and non-acral lesions of non-segmental vitiligo patients: a follow-up-based study in North India.

Lymphocyte enhancer-binding factor-1 (LEF1) is responsible for melanocyte proliferation, migration and differentiation and its downregulation may result in depigmentation in vitiligo. Narrowband UVB (NB-UVB) phototherapy is known to enhance melanocyte migration from hair follicles to lesional epidermis; hence, it may have a role in the upregulation of LEF1. We intended to assess the expression of LEF1 both before and after NB-UVB therapy and correlate it with the extent of re-pigmentation. In this prospective cohort study, 30 patients of unstable non-segmental vitiligo were administered NB-UVB phototherapy for 24weeks. Skin biopsies were obtained from acral and non-acral sites in all patients, both prior to initiation and after completion of phototherapy and LEF1 expression was measured. Amongst the 16 patients who completed the study, at 24weeks, all patients achieved > 50% re-pigmentation. However, > 75% re-pigmentation was achieved in only 11.1% of acral patches, whereas it was achieved in a significantly higher number of non-acral patches (66.6%) (p = 0.05). A significant increase was observed in the mean fluorescent intensity of the LEF1 gene in both acral as well as non-acral areas at 24weeks as compared to baseline (p = 0.0078), However, no difference was observed between acral and non-acral lesions in the LEF1 expression at 24weeks or the change in LEF1 expression from baseline. LEF1 expression modulates the re-pigmentation of vitiligo lesions after treatment with NBUVB phototherapy.

Assessment of soluble skin surface protein levels for monitoring psoriasis vulgaris in adult psoriasis patients using non-invasive transdermal analysis patch: A pilot study.

To improve the care of patients with chronic inflammatory skin conditions, such as psoriasis, there is a need for diagnostic methods that can facilitate personalized medicine. This exploratory pilot study aimed to determine whether non-invasive measurements of inflammation-related proteins from psoriatic skin can be sampled using the FibroTx Transdermal Analysis Patch (TAP) to assess disease severity and monitor pharmacodynamic changes. Ten healthy volunteers and 44 psoriasis vulgaris patients were enrolled in the exploratory pilot study. Skin surface protein measurements for healthy and lesional skin were performed using TAP. Patients' scores of psoriasis activity and severity (PASI) were documented, and differences in the thickness of skin layers were determined using sonography. The study assessed the skin surface protein levels of psoriasis patients undergoing whole-body treatment with narrow-band UVB to evaluate whether the levels of the skin surface proteins IL-1α, IL-1RA CXCL-1/2, and hBD-1 were associated with the disease activity and severity measurements. Using TAP technology, it was observed that there were clear differences in levels of IL-1α, IL-1RA, CXCL-1/2, and hBD-1 between psoriasis lesional and non-lesional skin. In addition, a positive correlation between CXCL-1/2 and desquamation, and between CXCL-1/2 and SLEB thickness was observed. During UVB treatment, the TAP measurements revealed a clear reduction of IL-1RA, CXCL 1/2, and hBD-1 on lesional skin. Further, skin surface measurements of IL-1RA and CXCL-1/2 displayed a different profile than those achieved by visual scoring of local inflammation, thus indicating that measuring the 'molecular root' of inflammation appears to have value as an objective, non-invasive biomarker measurement for scoring disease severity.

Anti-inflammatory effects of Derris scandens extract on narrowband-ultraviolet B exposed HaCaT human keratinocytes

Narrowband-ultraviolet B (NB-UVB) has been used to treat skin diseases such as psoriasis. Chronic use of NB-UVB might cause skin inflammation and lead to skin cancer. In Thailand, Derris Scandens (Roxb.) Benth. is used as an alternative medicine to nonsteroidal anti-inflammatory drugs (NSAIDs) for low back pain and osteoarthritis. Therefore, this study aimed to evaluate the potential anti-inflammatory effect of Derris scandens extract (DSE) on pre- and post exposed NB-UVB human keratinocytes (HaCaT). The results indicated that DSE could not protect HaCaT from cell morphology changes or DNA fragmentation and could not recover cell proliferation ability from the NB-UVB effects. DSE treatment reduced the expression of genes related to inflammation, collagen degradation, and carcinogenesis, such as IL-1α, IL-1β, IL-6, iNOS, COX-2, MMP-1, MMP-9, and Bax. These results indicated the potential use of DSE as a topical preparation against NB-UVB-induced inflammation, anti-aging, and prevention of skin cancer from phototherapy.

Contributions of NR1H3 genetic polymorphisms to susceptibility and effects of narrowband UVB phototherapy to nonsegmental vitiligo

Vitiligo is the most common depigmenting disorder to which both genetic and environmental factors contribute. The aim of the current work was to evaluate the relationship between polymorphisms of the gene nuclear receptor subfamily 1 Group H member 3 (NR1H3) and the risk of vitiligo and phototherapy effects in the Chinese Han population. Two independent samples were enrolled to form the discovery set (comprised of 1668 nonsegmental vitiligo [NSV] patients and 2542 controls) and the validation set (comprised of 745 NSV patients and 1492 controls). A total of 13 tag single nucleotide polymorphisms (SNPs) were genotyped in the samples from the discovery stage. SNPs that achieved nominal significance were validated in another independent sample set. The serum level of NR1H3 protein was assayed using enzyme-linked immunosorbent assay kits in the validation set. Genetic association analysis was carried out at allelic and genotypic levels. The therapeutic effects of significant SNPs were examined in the validation set. The SNP rs3758672 was significantly associated with NSV. The A allele was correlated with NSV risk and poorer therapeutic effects. The A allele was strongly correlated with the increased level of serum NR1H3 in both controls and patients. In summary, SNP rs3758672 in NR1H3 was significantly associated with both disease susceptibility and individualized therapeutic effects of NSV in study participants with Han Chinese ancestry.

Spontaneous Reversal of Vitiligo, a Rare Phenomenon Reported in a Case in Saudi Arabia with an Insight into Metabolic Biochemical Derangements

Background and Objectives: Vitiligo is a skin disorder characterized by hypopigmented macules occurring due to melanocyte destruction. An interplay of several biochemical mechanisms has been proposed to explain the etiopathogenesis of vitiligo, such as genetic, autoimmune responses, generation of inflammatory mediators, oxidative stress, and melanocyte detachment mechanisms. There is no cure for vitiligo; however, pharmacological treatment measures (cosmetic camouflage creams, steroids, psoralen and ultraviolet A (PUVA) therapy, narrowband UVB) are available, but they could have certain side effects. We reported an interesting case of vitiligo in Saudi Arabia that showed reversal of vitiligo, which is an extremely rare phenomenon, with the objective of probing the probable reasons for this reversal. To the best of our knowledge, there is no study on vitiligo that has reported spontaneous reversal of vitiligo in Saudi Arabia so far. Materials and Method: The patient presented to the Family Medicine clinic with a history of restoration of melanin pigment in his lesions after 3 years of the onset of vitiligo. Patients history was taken carefully along with clinical examination, carried out necessary biomedical lab investigations and compiled the data. The data at the time of pigment restoration were compared to the previous data when he developed the lesions. Result: The probable reasons for vitiligo reversal could be markedly decreased psychological stress, regular consumption of an antioxidant-rich herbal drink made of curcumin and honey, and dietary switchover to vegetarianism and an alcohol-free lifestyle. Conclusions: Curcumin-based herbal remedies could be an alternative option to treat vitiligo. These methods must be further explored through clinical trials as they are safer, easily available, and more affordable.

Burden of vitiligo on Chinese patients: an online survey.

Burden of vitiligo on Chinese patients: an online survey.

Narrowband ultraviolet B phototherapy in pediatric vitiligo: A retrospective study

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.

Eruptive papules on axillary folds of an adolescent.

Eruptive papules on axillary folds of an adolescent.

Acceleration of melanocyte senescence by the proinflammatory cytokines IFNγ and TNFα impairs the repigmentation response of vitiligo patients to narrowband ultraviolet B (NBUVB) phototherapy

Vitiligo is a chronic autoimmune disease characterized by the T helper 1 (Th1) cytokine-driven immune destruction of melanocytes (MCs). Although narrowband ultraviolet B (NBUVB) phototherapy has been proven to be an effective therapeutic option, the repigmentation response to that phototherapy varies greatly in different vitiligo patients. Here, we demonstrate that there is an increase of NBUVB-induced cellular senescence in vitiligo MCs exposed to Th1 cytokine interferon γ (IFNγ) and/or tumor necrosis factor α (TNFα) in lesional vitiligo skin from poor responders who had undergone NBUVB phototherapy. Supplementation with exogenous recombinant human stem cell factor (rhSCF) in the culture medium as well as the lentiviral vector–mediated overexpression of cKIT could prevent the MCs from the IFNγ/TNFα-accelerated cellular senescence. Mechanistic studies indicated that the reduced ratio of membrane-bound KIT (mKIT) to the soluble form of KIT (sKIT) is directly related to the cellular senescence of vitiligo MCs following exposure to IFNγ and TNFα. Furthermore, the matrix metalloprotease 9 (MMP9) inhibitor GM6001 attenuates the production of sKIT via the suppression of cKIT ectodomain shedding. Altogether, our study indicates that the presence of Th1 cytokines IFNγ and/or TNFα in the epidermal milieu might impair the repigmentation response of vitiligo patients to NBUVB phototherapy.

Improving vitamin D content in pork meat by UVB biofortification

Vitamin D deficiency is prevalent worldwide and identification of alternative food-based strategies are urgently warranted. In two studies, 12-week old crossbred pigs (Duroc x (Large White x Landrace)) were exposed daily to narrowband UVB radiation for ∼10 weeks or control (no UVB exposure) until slaughter. In Study 1 (n = 48), pigs were exposed to UVB for 2 min and in Study 2 (n = 20), this duration was tripled to 6 min. All pigs were fed the maximum permitted 2000 IU vitamin D3/kg feed. Loin meat was cooked prior to vitamin D LC-MS/MS analysis. In Study 1, pork loin vitamin D3 did not differ between groups. Study 2 provided longer UVB exposure time and resulted in significantly higher loin vitamin D3 (11.97 vs. 6.03 μg/kg), 25(OH)D3 (2.09 vs. 1.65 μg/kg) and total vitamin D activity (22.88 vs. 14.50 μg/kg) concentrations, compared to control (P < 0.05). Pigs remained healthy during both studies and developed no signs of erythema. Biofortification by UVB radiation provides an effective strategy to further safely increase the naturally occurring vitamin D content of pork loin, alongside feed supplementation.

The correlation between patient satisfaction treatment of narrowband ultraviolet B phototherapy and the improvement of psoriasis severity index

Background: Psoriasis is a chronic inflammatory disease of the skin affecting patients of all ages, both males and females. Currently, the psoriasis area and severity index (PASI) method is the gold standard in assessing the severity of psoriasis. Phototherapy narrowband ultraviolet B (NBUVB) is one of the modalities of psoriasis therapy which is relatively safe and effective for repairing psoriasis lesions. Patient satisfaction with phototherapy, which can be assessed using a questionnaire, serves to determine the patient's motivation in carrying out routine therapy. &#x0D; Objective: This study was designed to determine the correlation between the level of NBUVB phototherapy satisfaction with PASI improvement.&#x0D; Method: The study subjects were 22 plaque-type psoriasis vulgaris patients who underwent NBUVB phototherapy from May 2018 to October 2018 in the dermatovenereology outpatient clinic of Dr. Moewardi Hospital Surakarta. Subjects filled in the Treatment Satisfaction Questionnaire for Medication (TSQM) included questions about satisfaction with NBUVB phototherapy, and PASI scores were measured before and after NBUVB phototherapy. &#x0D; Results: The data were analyzed with the Pearson correlation test with a significance value of p &lt;0.05. There are significant differences between PASI before and after giving 24 times phototherapy with a value of p&lt;0.05. &#x0D; Conclusion: There was a significant correlation between the degree of PASI improvement and the global patient satisfaction with NBUVB phototherapy

Ultraviolet A Combined with Narrow‐Band Ultraviolet B is an Effective Treatment Modality for Early Folliculotropic Mycosis Fungoides and Early Mycosis Fungoides Refractory to Narrow‐Band Ultraviolet B: A Retrospective Cohort Study

Background. Psoralen plus ultraviolet A (PUVA) is the preferred phototherapeutic modality for early‐stage folliculotropic mycosis fungoides (FMF), and for early‐stage non‐FMF refractory to narrow‐band ultraviolet B (NBUVB). However, PUVA has a problematic safety profile. Literature on the treatment with the combination of UVA and NBUVB for MF is sparse. Objective. To evaluate the effectiveness of UVA combined with NBUVB for early‐stage MF, specifically for FMF and NBUVB‐refractory non‐FMF, in adult and pediatric patients. Methods. A retrospective analysis was conducted for patients treated with UVA combined with NBUVB at our center, during 1/2008–8/2022. Results. The cohort included 51 patients: 35 adults and 16 pediatric patients. The overall response rate (ORR) of 39 patients with early‐FMF (25 adults and 14 children) was 95%, and the complete response (CR) was 62%. No significant differences in ORR/CR rates were noted between adult and pediatric patients. Of 12 patients with non‐FMF (10 adults and 2 children), the ORR was 83% and the CR was 50%. In 17 patients (8 FMF and 9 non‐FMF), prior NBUVB therapy resulted in partial response/stable disease; yet, UVA + NBUVB led to CR in 9 patients (4 FMF and 5 non‐FMF). Side effects were minimal. Conclusion. Combined UVA and NBUVB is a good alternative to PUVA for adult or pediatric patients with early‐stage MF , with FMF or non‐FMF refractory to NBUVB.