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Long-term treatments for chronic diseases such as vitiligo need to be evaluated for their clinical efficacy. Assessment of the quality of life (QOL), however, may provide the most relevant information on the actual benefit for these patients. In this study we evaluated QOL after long-term narrowband ultraviolet (UV) B for the treatment of vitiligo. All patients, with long-term stable vitiligo vulgaris, who were treated at our clinic during the last 4 years received specifically for this study a designed QOL questionnaire, which included questions about general well-being, camouflage and psychosocial aspects; 71.4% of the patients responded. Most patients indicated an improvement on a psychological level, but an increase in camouflaging. The present study shows that, after long-term narrowband UVB phototherapy, skin appearance does not play a major role in the life of vitiligo patients, while well being only improved in a minority of patients. [ABSTRACT FROM AUTHOR]

Tjioe M, Smits T, van de Kerkhof PCM, Gerritsen MJP. The differential effect of broad band vs. narrow band UVB with respect to photodamage and cutaneous inflammation. Since Fischer reported on the superiority of 313 nm UVB compared with broad band UVB in the treatment of psoriasis, narrow band UVB has become the main phototherapeutical modality in several countries. There is some discussion about the safety and photobiological effects of narrow band UVB. In the present study, narrow and broad band UVB have been compared with respect to parameters for photodamage and inflammation. Fourteen healthy volunteers were randomized in two groups. Both groups were irradiated with three minimal erythema doses (MED) of narrow or broad band UVB, respectively. Before and 4, 24 and 48 h after irradiation, 6 mm biopsies were taken for immunohistochemical analysis of p53, apoptosis and p16 (photodamage parameters) and T-cells, polymorphonuclear leukocytes (PMN) and Langerhans' cells (inflammatory cells). Mean MED for narrow band UVB was 8.125 times higher than broad band UVB. Significant changes in expression were seen for all parameters except for p16. P53, apoptosis, T-cells and PMN increased, while Langerhans' cell count decreased significantly. No significant differences were seen between the narrow and broad band UVB. In conclusion, following irradiation of three MED narrow band UVB and broad band UVB safety parameters for carcinogenesis and inflammation were induced to the same extent. As narrow band UVB is more effective than broad band UVB, the present study suggests superiority of narrow band UVB as a treatment with a better benefit risk ratio. [ABSTRACT FROM AUTHOR]

Abstract: TNF-α is known to play an important role in UV-induced immunomodulation and photodamage. It plays a role in UVB-mediated induction of apoptosis and is a strong inducer of the c-Jun N-terminal kinase (JNK) pathway, which eventually leads to the loss of dermal collagen and elastin content. Recently chimeric anti-TNF-α has been introduced as a therapy for rheumatoid arthritis. The aim of the present study was to investigate the effect of anti-TNF-α treatment on UV-induced DNA damage, apoptosis, and induction of matrix metallo proteinases. Twelve patients with rheumatoid arthritis were included and irradiated with 2 MED broadband UVB before and after administration of 0.5 mg/kg anti-TNF-α monoclonal antibody. Twenty-four hours after irradiation biopsies were taken. Frozen and paraffin sections were stained for p53, c-Jun, phosphorylated c-Jun, sunburn cells and MMP-1. No significant changes were observed in the expression of p53 and sunburn cells and MMP-1 content after treatment with anti-TNF-alpha, whereas a slight but significant decrease in c-Jun and phosphorylated c-Jun expression was noted (P = 0.0250 and P = 0.0431, respectively). Our results showed no influence of anti-TNF-α on UV response at therapeutic doses in patients with rheumatoid arthritis. [ABSTRACT FROM AUTHOR]