Narrowband UVB phototherapy psoriasis treatment

Cutis. 2001 Nov;68(5):345-7.

Barbagallo J, Spann CT, Tutrone WD, Weinberg JM.

Department of Dermatology, St. Luke's-Roosevelt Hospital Centre, New York, New York 10025, USA.

What is the safest form of ultra violet (UV) phototherapy?

An advance in UVB-based phototherapy has been the introduction of fluorescent light bulbs (Philips TL-01) that deliver monochromatic light at 311-nm UVB, a narrowband wavelength that seems to maximize clearing of plaques relative to its erythrogenic potential. Narrowband UVB phototherapy has considerable advantages over traditional treatment options such as broadband UVB and psoralen plus UVA (PUVA). It is clearly more effective than broadband UVB, safer than PUVA, and well tolerated by patients when taken at suberythemogenic doses. Narrowband UVB represents an important new therapy for psoriasis.

PMID: 11766120 [pubMed - indexed for MEDLINE]

Skin cancer begins when cells that make up the skin grow out of control and take over healthy cells. There are three common types of skin cancer and are named after the type of skin cell; cell carcinoma, squamous cell carcinoma and malignant melanoma .

PUVA, UVB, psoriasis and non-melanoma skin cancer

J Am Acad Dermatol. 1993 Dec;29(6):1013-22.

Studniberg HM, Weller p.

Skin & Cancer Foundation, Darlinghurst NSW, Australia.

This article reviews the English-language literature on the risk of nonmelanoma skin cancer from phototherapy (UVB) or photochemotherapy (PUVA) in the treatment of psoriasis. The evolution of the debate on the carcinogenic potential of these treatment is discussed, particularly with reference to PUVA. Available data indicate that therapeutic UVB has a low risk of producing cutaneous cancers, with the possible exception of those on male genital skin. However, there is a definite cutaneous carcinogenic risk from oral PUVA. The major associated risk factors are reviewed. We provide recommendations for the assessment and treatment of patients to minimize this risk.

pMID: 8245237 [pubMed - indexed for MEDLINE]

The risk for psoriasis patients on a life long UVB treatment will probably be of the same order of magnitude as for outdoor workers. In comparison with other every day risks, the risk of dying from a skin cancer seems to be negligible. Regular check-ups by a dermatologist can reduce this risk close to zero.

#1 UVB phototherapy and skin cancer: a review of the literature. E. Lee, MD, J. Koo, MD, and T. Berger, MD. The International Journal of Dermatology Vol 44, 355-360. 2004

Study reviewed all prospective and retrospective studies from 1966 to 2002 that attempted to quantify or qualify and additional skin cancer risk from UVB phototherapy. 3400 participants were involved.

CONCLUSION: UVB phototherapy is a common treatment modality for psoriasis and other skin conditions. All studies showed no increased skin cancer risk with UVB phototherapy.

#2 No Evidence for Increased Skin Cancer Risk in Psoriasis patients Treated with Broadband or Narrowband UVB Phototherapy: A First Retrospective Study. M. Weischer, A. Blum, F. Eberhard, M. Rochen, and M. Berneburg. Acta Derm Venereol Vol 84; 370-374. 2004.

Followed 195 patients receiving broadband UVB or narrowband UVB over period from 1994 to 2000 to assess skin cancer risk.

CONCLUSION: Phototherapy of skin diseases such as psoriasis is an effective and safe treatment modality. No evidence for an increased skin cancer risk for patients treated with either broadband or narrowband UVB phototherapy was found.

#3 Treatment of Generalized Vitiligo in Children with Narrow-Band (TL-01) UVB Radiation Therapy. M. D. Njoo, MD, PhD and W. Westerhof, MD, PhD. Journal of American Academy of Dermatology. Vol 42, Number 2, Part 1. February 2000

Studied efficacy and safety of UVB (311 nm) therapy in children with generalized vitiligo. 51 Children were treated twice a week for one year. Psychosocial impact of disease and treatment were carefully evaluated before and after. 75% overall repigmentation in 53% of patients and a stabilization of the disease in 80%.

CONCLUSION: Narrow-band UVB therapy is effective and safe in childhood vitiligo; it may also significantly improve the quality of life.