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Background The aim of this retrospective study was to compare the efficacy and safety of different phototherapeutic modalities in the treatment of cutaneous lichen planus (LP). Methods We retrospectively analyzed the chart data of 53 patients with generalized LP who had been subjected to narrowband UVB (NB-UVB) or photochemotherapy (PUVA) between January 1997 and April 2020. Of these, 30 patients had received NB-UVB, 18 patients oral PUVA and 5 patients bath PUVA. Results Fifty patients completed a full treatment course. The percentage of patients with a complete (>90% clearing) or good (51%-90% clearing) response was similar for NB-UVB versus PUVA (86.2% vs. 90.5%; P = 1.00). The number of exposures required for obtaining a complete or good response was also comparable for both treatment groups (NB-UVB: 28.9 ± 12.3 vs. PUVA: 25.4 ± 10.1; P = .209). Adverse events, in particular gastrointestinal upsets, were recorded in 26.1% of patients treated with oral PUVA while none were observed with NB-UVB. Conclusion The therapeutic outcome and the number of treatments required for achieving a complete or good response were comparable for NB-UVB and PUVA; however, PUVA therapy was associated with a substantially higher rate of moderate adverse events.

Vitiligo is an acquired chronic skin disease, characterised by progressing, usually symmetric, depigmented areas in human skin. Vitiligo affects 0.5% of the human population, however, optimal treatment combination real clinical practice has yet to be found. The aim of the study was to assess whether combined therapy with ultraviolet B (UVB) therapy and calcineurin inhibitors (CNI) provides superior response in vitiligo patients, compared with phototherapy or topical CNI monotherapy. We performed a retrospective cohort study of children treated for vitiligo from January 2016 to December 2019. Primary outcome measures include clinical efficacy defined by area of repigmentation — good clinical efficacy (re-pigmentation of ≥ 50% of lesion surface area), positive clinical efficacy and poor clinical efficacy (re-pigmentation of < 15% of lesion surface area). Secondary outcome measures included reduction of lesion size and tolerability of therapy. A total of 114 patients were recruited in the study, 46 allocated to the topical CNI therapy group, 36 to the narrow band (Nb-UVB), and 32 to the combined therapy group. All treatments statistically significantly decreased lesion surface area compared to the baseline (mean, SD). Local therapy reduced lesions from 8.5 (5.7) to 5.3 (4.2) by 37.3% (p < 0.0001), phototherapy reduced lesions from 9.8 (5.4) to 5.7 (3.92) by 42.3% (p < 0.0001), and combined therapy reduced lesions from 14.2 (4.8) to 6.58 (3.5) by 53.6% (p < 0.0001), with combined therapy showing superior numerical efficacy. Clinical efficacy for CNI monotherapy was 67.4%, for phototherapy — 80.5%, and for combined therapy 93.7%. The safety profile of therapies was consistent with other studies. Our results support the use of combined therapy in vitiligo patients.

Ultraviolet (UV) therapy is an effective and well tolerated therapeutic method for various dermatologic conditions due to its antiproliferative and immunosuppressive effects. Contemporary phototherapy (PhT) includes broadband UVB, narrowband UVB, UVA1, PUVA and excimer laser therapy. The coronavirus disease 2019 (COVID-19) pandemic has resulted in the closure of many patient care facilities including phototherapy units world-wide. Home phototherapy, thalassotherapy, another UV-therapy modalities are an alternative for many patients with chronic dermatoses. We have highlighted possible interactions of UV-therapy effects and the COVID-19 pandemic and have focused on organization and measures against transmission of infections in phototherapy units. Dermatology departments have reopened their units, assessing the risks and benefits for patients, optimizing safety regulations, and adhering to the rules for disinfection.

Joanna Narbutt,1 Janusz Krzyścin,2 Piotr Sobolewski,2 Małgorzata Skibińska,1 Marcin Noweta,1 Witold Owczarek,3 Bonawentura Rajewska-Więch,2 Aleksandra Lesiak1 1Department of Dermatology, Pediatric Dermatology and Oncology, Medical University of Łódź, Łódź, Poland; 2Institute of Geophysics, Polish Academy of Sciences, Warsaw, Poland; 3Department of Dermatology, Military Institute of Medicine, Warsaw, PolandCorrespondence: Janusz KrzyścinInstitute of Geophysics, Polish Academy of Sciences, Warsaw, 01-452, PolandTel +48-2269-15950Email jkrzys@igf.edu.plBackground: Nowadays, patients with moderate-to-severe psoriasis are treated with conventional immunosuppressants or with new biological agents. Phototherapy is the first-line treatment for patients in whom topical therapy is insufficient. Although numerous studies have been carried out, it is still difficult to predict the outcome of phototherapy in individual patients.Methods: Prior to standard narrow band (NB) ultraviolet B (UVB) phototherapy, the patients filled out a questionnaire about personal life and health status. Several standard blood tests, including selected cytokine levels, were performed before and after a course of 20 NB-UVB treatments. The questionnaire answers, results of the blood tests, and treatment outcomes were analyzed using an artificial intelligence approach—the random forest (RF) classification tool.Results: A total of 82 participants with moderate-to-severe psoriasis were enrolled. Prior to starting phototherapy, the patients with expected good outcome from the phototherapy, shorter remission, and quitting a possible second course of the NB-UVB treatment could be identified by the RF classifier with sensitivity over 84%, and accuracy of 75%, 85%, and 79%, respectively. The inclusion of cytokine data did not improve the performance of the RF classifier.Conclusion: This approach offers help in making clinical decisions by identifying psoriatic patients in whom phototherapy will significantly improve their skin, or those in whom other therapies should be recommended beforehand.Keywords: psoriasis, phototherapy, outcome prediction, artificial intelligence

Narrow band ultraviolet B (NB UVB) radiation doses are administered during phototherapy for various dermatological ailments. Precise quantification of these doses is vital because the absorbed irradiation can cause adverse photochemical reactions which can lead to potential phototherapeutic side effects. The paper presents development of diacetylene based dosimeter for the determination of therapeutic NB UVB doses during phototherapy. The amide terminated diacetylene analogues have been synthesized by tailoring them with different functional groups. The synthesized diacetylene monomers have been introduced in a polyvinyl alcohol binder solution to obtain a film dosimeter. The influence of different headgroups on the colorimetric response to UV radiation has been studied. Among all the synthesized diacetylene analogues, the naphthylamine substituted diacetylene exhibited excellent color transition from white to blue color at 100 mJ cm−2 NB UVB radiation dose. The developed amide films can be easily pasted on multiple sites of the patient’s skin to monitor doses during phototherapy simultaneously at different anatomical regions. The digital image processing of the scanned images of the irradiated films facilitates rapid dose measurement which enables facile implementation of the developed film dosimeters and promising application in routine clinical dosimetry.

Psoriasis is a heterogeneous disease characterized by a wide range of clinical manifestations. Patients with psoriasis and psoriatic arthritis have an increased risk of developing comorbid conditions, therefore, when prescribing therapy, it is necessary to take into account aspects of polypharmacy and the risks of developing infections. Apremilast is effective for the treatment of patients with psoriasis and comorbid comorbidity. To increase the effectiveness of apremilast therapy (achieving PASI 90 and PASI 100), it is possible to use a combination with narrow-band medium-wave phototherapy. The combined method allows achieving clear or almost clear skin in the vast majority of patients and is highly safe, as evidenced by the absence of severe side effects. The method is safe when used in patients with impaired glucose tolerance, diabetes mellitus, increased body weight and the risk of infections.

Introduction: PUVA (psoralen + UV-A) has been used since long time ago in psoriatic patients, which has some adverse effects. Phototherapy in form of Narrowband UVB is advancement in the treatment of psoriasis and it has been found to be same efficacious and having lesser side effects than PUVA. Aim: The study was aimed to compare NBUVB and PUVA in chronic plaque psoriasis in terms of their efficacy and adverse effects. Methods: The study included 43 cases of chronic plaque psoriasis which were randomly divided into two groups. Patients were examined for body surface area involvement and PASI scoring. Narrow-band UV-B phototherapy was given to one group and the other group received PUVA therapy thrice-weekly for a duration of 3 months. Then they were compared for clearance of lesions and side effects. Results: Both groups showed decrease in the PASI scoring by at least 75%. It was observed that lesser number of treatment sessions and fewer days were required for clearance of the lesions in PUVA group than the group receiving NBUVB therapy. But in NBUVB group, mean cumulative clearance dose and adverse reactions were significantly lower. The percentage of patients maintaining remission at six months were more in PUVA group as compared to NBUVB group. Conclusion: Both modes of phototherapy are useful in psoriasis. Patients got clearance of the lesions faster in the PUVA group but the side effects were markedly less in the NBUVB group. Keywords: Narrow-band UV-B, Psoralen UVA, Plaque psoriasis.

Narrowband UV-B (NBUVB) phototherapy is the mainstay of vitiligo treatment, but hyperpigmentation is one of the limitations. Meanwhile, topical tretinoin is effective against pigmentary disorders.To determine whether tretinoin 0.05% cream would prevent hyperpigmentation when patients with facial vitiligo underwent phototherapy.A randomized, controlled, split-face trial was conducted. Adult patients with stable, non-segmental facial vitiligo were enrolled. The left/right sides of the face were randomly allocated to receive either topical tretinoin 0.05% cream or moisturizer twice daily. The entire face was subjected to NBUVB phototherapy twice weekly for 12 weeks. The degree of hyperpigmentation was assessed as the delta L* (brightness) value of the darkest spot in each side of the face at baseline and every 4 weeks. The degree of repigmentation was assessed.Twenty-five patients were enrolled; 21 completed the study. The delta L* value was significantly different between the two groups: -0.5% in the tretinoin group and -8.7% in the control group at 12 weeks (Tretinoin 0.05% cream prevented hyperpigmentation during NBUVB phototherapy in patients with facial vitiligo, and did not compromise the overall treatment response.ClinicalTrials.gov NCT03933774.

Backgraund: the researchers explain the high prevalence of metabolic syndrome among patients with psoriasis by the development of systemic infl ammation, which is considered as a single pathogenetic mechanism in these pathological conditions. The response of patients with psoriasis with metabolic syndrome to treatment with narrowband therapy is currently insuffi ciently studied. Aims: the study evaluated the effi cacy of narrowband therapy (311 nm) in patients with psoriasis associated with metabolic syndrome. Materials and methods: an objective and instrumental examination was conducted in 72 patients diagnosed with psoriasis vulgaris, after which a course of 20 procedures of narrow-cavity medium-wave ultraviolet irradiation (UFO) with a wavelength of 311 nm (B) was conducted. Patients were divided into 2 groups: patients with psoriasis and patients with psoriasis combined with metabolic syndrome. To assess the eff ectiveness of treatment, the index of the area and severity of psoriasis (PASI), lipid and carbohydrate metabolism; insulin and leptin; proinfl ammatory cytokines —IL-1β, IL-8, TNF-α and anti-infl ammatory cytokine IL-10 before and after the 10th, 20th procedure of UV-B therapy and 3 and 6 months after treatment. Results: а signifi cant decrease in PASI was observed in all patients with psoriasis after 10 procedures of UV-B therapy, but in the group of patients with metabolic syndrome, the PASI index was higher. After 20 procedures, Pasi reduction by more than 50 % was observed in the group of patients with psoriasis without manifestations of metabolic syndrome (р < 0,001). Indicators of lipid and carbohydrate blood metabolism in MS patients decreased (р < 0,05), the eff ect remained up to 6 months. The level of proinfl ammatory cytokines was increased in both groups, but in the group of patients with MS these indicators were higher. In the course of therapy cytokines decreased in both groups, the eff ect was maintained up to six months. On the contrary, IL-10 was reduced in both groups, and increased after our treatment, with the prolongation of the eff ect to 6 months. Conclusions: the appointment of UV-B therapy (311 nm) in patients with psoriasis with metabolic syndrome reduces the eff ectiveness of the course in the long term, which apparently requires repeated courses of narrowband therapy after 6 months.

Introduction : Psoriasis is a complex disease that requires carefully designed therapy in order to achieve sustained remission. The disease can be effectively controlled by various therapeutic options, used alone or in combination. Phototherapy may be combined with topical or systemic agents to achieve higher clearance rates, longer disease free intervals and a lower carcinogenic risk. The combination of NB-UVB with calcipotriol increases the therapeutic efficacy of phototherapy as well as UVB reduces the irritation caused by calcipotriol Objective : The chief purpose of this study was to compare the efficacy and safety of Narrow Band-UVB alone and in combination with topical calcipotriol in patients with psoriasis vulgaris. Materials and Methods: Patients with chronic plaque type psoriasis of 100 numbers involving less than 20% of body surface area were randomly allocated to any one of the following 2 groups. Group A- Narrow Band UVB phototherapy. & Group B- Narrow Band UVB with topical calcipotriol ointment Results : In group A (NB-UVB), the mean baseline PASI score was 12.1 and the mean PASI score at the end of 12 weeks was 2.54. There was 79% reduction in PASI score at the end of 12 weeks. 31 patients showed good response and 13 patients showed more than 70% clearance. When NB-UVB group was compared with NB-UVB and calcipotriol combination group, there was a significant difference (p Limitations : Further studies with additional numbers of patients are essential to compare the efficacy and safety of Narrow Band-UVB alone as well as in combination with topical calcipotriol in patients with psoriasis vulgaris. Keywords: Psoriasis, Psoriasis Area and Severity Index, Calcipotriol, Phototherapy.

Varicella-zoster virus (VZV) infection often observed in children and usually lasts a short time. Its remains dormant in the nervous system and can reactivate causing herpes zoster (HZ). The objective of this study is to investigate the effective role of nb-UVB, on immunological response of T-regulatory cells via different types of HZV transcription factors and possible pathological mechanism. Together these data confirmed that the using of nb-UVB in treatment of VZV is associated with Tregulatory cells response changes and attenuated VZV infection

Ultraviolet (UV) radiation contributes to the development of skin cancer through direct and indirect DNA damage, production of reactive oxygen species, and local immunomodulation. The association between UV radiation and skin cancer has raised concern for the risk of carcinogenesis following phototherapy. The photocarcinogenic impact of psoralen and UVA radiation (PUVA) has been extensively studied, whereas limited safety studies exist for other phototherapy modalities, such as broadband and narrowband UVB and UVA1. Because of the as of yet unclear risk, patients who have undergone any type of phototherapy should be followed for age-appropriate skin cancer screening.

Psoriasis is a chronic, autoimmune condition characterized by abnormal epidermal hyperproliferation affecting about 3.2% of adults in the United States. Narrowband UVB (NBUVB) is a commonly used phototherapy option for patients with psoriasis and is an effective first-line therapy for generalized plaque psoriasis. This article covers fundamental considerations for physicians using NBUVB and highlights changes in the newest guideline recommendations for phototherapy treatment. Protocols for treatment initiation, maintenance, dose increases, and maintenance are compared and discussed. Readers will achieve a greater understanding of the fundamentals of NBUVB phototherapy and promising advances in the field, including home phototherapy and combination treatment.

Background: The sun is a natural source of UV radiation. It can be divided into three bands, UVA (315–400 nm), UVB (280–315 nm) and UVC (100–280 nm), where the radiation up to 290 nm is very effectively eliminated by the stratospheric ozone. Although UV radiation can have a beneficial effect on our organism and can be used in the treatment of several skin diseases, it must primarily be considered harmful. Methods: In the presented work, we focused on the study of the longer-wavelength UV components (UVA and UVB) on the human epidermal keratinocyte line HaCaT. As UVA and UVB radiation sources, we used commercially available UVA and UVB tubes from Philips (Philips, Amsterdam, The Netherlands), which are commonly employed in photochemotherapy. We compared their effects on cell viability and proliferation, changes in ROS production, mitochondrial function and the degree of DNA damage. Results: Our results revealed that UVB irradiation, even with significantly lower irradiance, caused greater ROS production, depolarization of mitochondrial membrane potential and greater DNA fragmentation, along with significantly lowering cell viability and proliferative capacity. Conclusions: These results confirm that UV radiation causes severe damages in skin cells, and they need to be protected from it, or it needs to be applied more cautiously, especially if the component used is UVB.

Although narrowband UVB (NB-UVB) has replaced broadband UVB (BB-UVB) because of its greater effectiveness in dermatological phototherapy, it is twice as carcinogenic as BB-UVB at an equivalent inflammatory dose. To clarify the basis of the different genotoxicities, we comparatively evaluated the mutagenicities in mouse skin of the two UVB types along with their efficiencies in the formation of cyclobutane pyrimidine dimer (CPD), which is a major mutagenic DNA photolesion specifically produced by UVR. We found that the mutagenicity averaged per single molecule of CPD was 2.5- and 1.8-fold higher in NB-UVB-exposed epidermis and dermis, respectively, which indicates that NB-UVB is more mutagenic for the skin than BB-UVB at doses producing an equimolar amount of CPD. Analysis of effective wavelengths for UV photolesion formation with each UVB source revealed a remarkable difference in the peak effective wavelengths for CPD formation: 15 nm longer for NB-UVB in the epidermis. Although the analysis of mutation profiles showed largely similar UV-specific signatures between the two UVB types, a relatively stronger preference for UVA-specific mutations was observed for NB-UVB. These results suggest that the difference in the effective wavelengths for CPD formation leads to the different mutagenicities and carcinogenicities between the UVB sources.

BACKGROUND NB-UVB has long been the vitiligo management pillar with capability of achieving the main treatment outcomes; repigmentation and stabilization. Its stabilizing effect in dark skin has been debatable. However, randomized controlled trials regarding NB-UVB ability to control disease activity are lacking. PURPOSE To assess stabilizing effect of NB-UVB in comparison to systemic corticosteroids, the mainstay in vitiligo stabilization, in skin photo-types (III-V). METHODS This is a multicenter, placebo-controlled, randomized, prospective study. Eighty patients with active nonsegmental vitiligo (NSV) (Vitiligo disease activity (VIDA) ≥2) were randomized to either NB-UVB and placebo (NB-placebo) or NB-UVB and dexamethasone oral mini-pulse (OMP) therapy (NB-OMP) for 6 months. Sixty four patients completed the study, 34 in the NB-OMP group and 30 in the NB-placebo group. Patients were evaluated fortnightly according to presence or absence of symptoms/signs of activity. RESULTS In spite of earlier control of disease activity observed in the NB-OMP group, it was comparable in both groups by the end of the study period. Disease activity prior to therapy, but not extent, was found to influence control of activity in both groups. Thus, NB-UVB is a safe sole therapeutic tool in vitiligo management. Not only does it efficiently achieve repigmentation, but also it is a comparable stabilizing tool for systemic corticosteroids in spite of slightly delayed control. CONCLUSION NB-UVB is the only well-established vitiligo therapy that can be used solely whenever corticosteroids are contraindicated or immune-suppression is unjustified. Nonetheless, its combination with corticosteroids expedites response and improves compliance.

Background Immunologic background of vitiligo, role of vitamin D on its pathogenesis, role of NB-UVB on its treatment and its stimulatory effect NB-UVB on VDR expression are challenging area of research. The current study will focus on evaluating the effect of NB-UVB on serum and tissue level of vitamin D in vitiligo patients and correlating it with the degree of improvement. Aim of the study The aim of the present study is to evaluate and compare the serum and tissue vitamin D level in vitiligo patients before and after NB- UVB therapy and correlate them together and with the degree of improvement. Patients and methods A case-control study included 16 vitiligo patients and 16 age and sex matched healthy controls. All patients will be examined by one dermatologist (demonstrating the extent of depigmentation according to rule of nines), and photographs will be taken before and after phototherapy to be evaluated by two different dermatologists to document the extent of repigmentation. Estimation of serum level of vitamin D by ELISA Results Five of the 15 patients achieved more than 55% repigmentation; the mean duration of disease was 13 months. The remaining 10 patients had 30% - 40% repigmentation.

Vitiligo is a chronic pigmentary skin disorder that results in white, hypopigmented macules and patches. It causes a considerable psychological and emotional burden on the affected individuals and their families. Several therapeutic options have been employed in vitiligo including topical and oral drugs, surgical techniques and phototherapy which is considered the cornerstone treatment. Different wavelengths and modalities are available, but narrow-band UVB (NB-UVB) is considered the safest and the most effective phototherapy alternative. NB-UVB acts on multiple steps in vitiligo pathogenesis, and it is capable of inducing stabilization and repigmentation of vitiligo lesions. Technological advances have led to the development of both new phototherapy devices and new medical and surgical therapeutic options that can be combined with phototherapy to achieve optimal results. There is no standard treatment and, individual patient and disease characteristics should be considered. We review the current evidence in what concerns UVB phototherapy for vitiligo treatment, including novel combination treatments that may help to provide the best care for these patients.

Identifying safe, effective, and affordable evidence-based dermatologic treatments for older adults can be challenging because of age-related changes. Few studies have examined the effectiveness of phototherapy in older adults. Our retrospective study of patients 65 years and older who were treated with narrowband UVB(NB-UVB) phototherapy aimed to (1) identify the most common dermatologic conditions treated with phototherapy in older adults, (2) examine the effectiveness and safety of phototherapy in older adults, and (3) compare the outcomes to 2 similar studies in the United Kingdom and Turkey.

The radiance equation is applied in this study to model the ultraviolet (UV) radiation dose distribution over the skin in paediatric and adult patients treated in a whole-body phototherapy cabin. This approach extends a previously published model of UV radiation dose based on thermal radiation exchange between surfaces (Colemanet al2020Biomed. Phys. Eng. Express6055023). The new model makes it feasible to predict the distribution of UV irradiance over the head, trunk and legs in patients of varying height. The modelled irradiance distributions to directly lamp-facing skin surfaces agree to within 10% of those measured in simulated clinical paediatric treatments in a modern narrowband UVB treatment cabin. For a 10 year old (of height 1.36 m), for example, the model and the clinical measurements both show a UV radiation dose to the face that is around 25% more than that in an adult (of height 1.8 m). The dose to the crown of the head of a 10 year old is both predicted and measured to be more than double that of an adult. The automated dosimetry system, incorporated within the treatment cabin, is also predicted to overestimate irradiance to the body by between 10% and 25% in patients aged between 10 and 4 years (height 1.36-1.0 m). The value of the model and its implications for paediatric whole-body UV treatment in adult-size whole-body treatment cabins are considered.

Targeted phototherapy, including excimer light involves the localised delivery of ultraviolet (UV) light directly to lesional skin1,2 . Narrowband UVB as well as soak and topical psoralen-UVA (PUVA) can be used as localised phototherapy, whereby there is irradiation only to a localised area of the skin. Common indications include localised psoriasis, vitiligo, atopic dermatitis (AD)1 , and lymphoproliferative skin disorders involving a limited area of the body or difficult-to-treat anatomical areas3 . Phototherapy can be used as monotherapy, but is more often part of a multi-modal treatment regime involving topical and systemic agents1 .

Background: Simvastatin is now considered a potential therapeutic agent to treat vitiligo. To the best of our knowledge, this is the first case report about the successful treatment of topical simvastatin with narrowband UVB.Case presentation: a 34-year-old Chinese female patient vitiligo was cured by topical simvastatin solution with narrowband UVB.Conclusions: topical simvastatin may be a potential treatment against vitiligo.

Phototherapy methods commonly used in the treatment of vitiligo include narrow-band ultraviolet B (NB-UVB). A 23-years old male was diagnosed with vitiligo in the dermatology polyclinic and was followed up in the phototherapy unit with NB-UVB treatment of 3 sessions per week; in the 42nd session psoriasis plaques were seen to have developed. We suggest that this rare but important association should be considered as a side effect of narrow-band phototherapy.

Background: Psoriasis-specific proteins dysregulated in keratinocytes and involved in the pathophysiological process of psoriasis remains elusive.Objective: This study aimed to investigate the seru...

Objectives:Narrow band UVB (NBUVB) treatment is a preferred dermatological treatment modality especially in pregnant women because of high safety profile. Previous studies have shown photodegradation may decrease folate levels in blood. In this study we aim to investigate if phototherapy causes low folic acid levels in our patients.Materials and Methods:Patients applying to dermatology unit and receiving either psoralen plus UVA or NBUVB treatment with regular folic acid level check-ups were analysed retrospectively.Results:In none of the patients folic acid levels lower than reference levels were detected. Mean serum folate values in baseline were 9.30 (±3.22 SD). The mean value after 18 treatment sessions was 7.26 (±4.82 SD), and after 36 sessions was 8.69 (±3.6 SD). In PUVA group baseline mean folate level was 9.16 (±3.76 SD), followed by 6.76 (±4.89 SD) after 18 sessions and 9.41 (±3.79 SD) after 36 sessions. Repeated measure in time were not statistically significant in both groups (p>0.05).Conclusion:NBUVB and PUVA treatments appear to be safe in regards to blood folic acid levels in our population where Fitzpatrick skin type III and IV is more common.

To compare the efficacy and safety of narrowband ultraviolet B (NB-UVB) phototherapy in home vs in hospital for the management of limited new-onset vitiligo.Patients with new-onset vitiligo (3 months) with5% body surface area involvement were recruited and randomly assigned to either a home-based or a hospital-based treatment group. Both groups were administered NB-UVB phototherapy thrice a week. The body surface area (BSA) involved with vitiligo, Vitiligo Area Scoring Index (VASI), the effectiveness of repigmentation, Vitiligo Quality of Life index (VitiQoL), and the cost of treatment were examined.A total of 100 patients completed the study. Patients in both groups exhibited improvements demonstrated by BSA and VSAI decrease. No significant differences were found between the two groups in terms of skin repigmentation (P 0.05). Improvements in the VitiQoL scores were reduced to the greatest degree at week 8 for all patients in both groups. Adverse events, such as painful erythema, burning, blistering, and excessive hyperpigmentation, were more frequently observed in the home-based treatment group than in the hospital-based treatment group. The cost of phototherapy in hospital exceeded the cost of home phototherapy after 7 weeks of treatment.Home NB-UVB phototherapy treatment was as effective as treatment in hospital, but exhibited cost-effective and a better compliance. However, the education of the patients should be strengthened to avoid excessive UVB exposure and related adverse events.

Background: Vitiligo is an acquired pigmentary disorder of unknown etiology that affects up to 1% of the general population of all skin types.It is a multifactorial disorder. There are numerous medical and surgical treatments aimed at repigmentation.Microneedling is a minimally invasive procedure that uses fine needles to puncture the epidermis. The indications for microneedling therapy have grown significantly and it is becoming a widely used treatment in Dermatology.Aim of Study: To study the clinical and histological efficacy of combined NB-UVB phototherapy and microneedling versus NB-UVB phototherapy in the treatment of vitiligo.Patients and Methods: Twenty patients were divided into two Groups (A & B), each of 10 patients. Both groups were matched regarding age, sex, skin type and have a depigmented patch at the same corresponding site. Group A was subjected to microneedling with dermapen at one depigmented patch followed by NB-UVB phototherapy sessions twice weekly for three months. Group B was subjected to NB-UVB photo-therapy sessions twice weekly for three months. Two Skin biopsies one before and one after the therapy were taken for immunohistochemical examination by HMB 45.Results: The mean percentage of improvement was sig-nificantly high in Group A (48.50%±26.46) than Group B (20.0%±19.58). In Group A 20% showed mild improvement (G1), 20% showed moderate improvement (G2), (40%) showed good improvement (G3) and 20% showed excellent improve-ment (G4). In Group B 30% showed no improvement, 50% showed mild improvement (G1), 10% showed moderate improvement (G2) and 10% showed good improvement (G3). There was statistically significant difference between both groups (p=0.027*).Immunohistochemical changes revealed marked expression of HMB45 in Group A more than Group B, the mean of color intensity in Group A was 0.05±0.04 and a median of 0.03 while in Group B was 0.01±0.01. There was statistically significant difference between both groups (p=0.002*).Conclusion: Microneedling prior to NB-UVB photother-apy sessions was clearly superior to NB-UVB phototherapy alone with accelerating response. Microneedling is a tolerable procedure, safe with minimal side effects.

BACKGROUND: Psoralen UVA (PUVA) and narrow-band UVB (NBUVB) chemophototherapy are treatment options for psoriasis. AIM: To compare the effectiveness of NBUVB with PUVA in Vietnamese psoriasis patients. METHODS: We conducted a non-randomized trial on 60 patients with plaque-type psoriasis (30 NBUVB, 30 PUVA). Both regimens were thrice-weekly. The extent of lesion was assessed by the Psoriasis Area Severity Index (PASI). Clearance was defined as a ≥ 75% reduction in a follow-up PASI score from baseline. Patients with clearance were followed-up until 6 months after stopping treatment. Relapse was defined as 50% or more of the original extent. RESULTS: The proportion of patients achieving PASI75 was comparable (76.7% in NBUVB versus 80% in PUVA; p > 0.05). Patients in both groups had a similar number of sessions to achieve clearance but patients in the PUVA group exposed to a significantly higher cumulative UV dose. After six months, the relapse rate was higher in the NBUVB group compared with in the PUVA group (p > 0.05). CONCLUSION: Thrice weekly NBUVB is as effective as thrice weekly PUVA in treating psoriasis for Vietnamese patients.

Background : Vitiligo is a disease marked by depigmented macules. Prevalence of vitiligo varies between 0.1- 2.3% worldwide. The objectives of this study are to identify the socio-demographic profile of vitiligo patients and distribution of narrowband-UVB given as a treatment modality. However, in Indonesia, including at dr. Cipto Mangunkusumo General Hospital, there has not been any study on the profile of vitiligo patients. Therefore, a preliminary study on the patients’ profile would be very useful for healthcare providers in calculating the need for narrowband-UVB equipment and evaluation of its current use. Method : A retrospective descriptive study, using secondary data obtained from dr. Cipto Mangunkusumo General Hospital medical records during the period of 2015-2017. Result : There were 255 vitiligo patients enrolled. Females were greater in number (55.3%). Most patients were distributed evenly in all age groups, highest number of patients were the 21-30 years age group (18.8%). Most patients received elementary school–high school education (56.9%), worked as private employees (36.9%), resided in Jakarta (47.8%). The common diagnosis were unspecified vitiligo (53.3%). Onset of symptoms were mostly around 2 months prior to diagnosis (38.8%) and most of the patients received other treatments other than narrowband-UVB (N=180, 70.6%). Conclusion : The number of vitiligo cases decreased each year with the average vitiligo cases of 85 cases per year and mostly women whereas the number of unspecified vitiligo were quite high. Therefore, more attention is needed from the physicians to treat the patient starting from the establishment of vitiligo to the decision treating with narrowband-UVB Keywords: patient profile, prevalence, vitiligo

Background: Psoriasis is a common chronic and immune-mediated inflammatory skin disease.Objectives: This study aimed to investigate the serum levels of Chitinase-3-like protein 1 (YKL-40) i...

BACKGROUND Narrowband-ultraviolet B (NB-UVB) is a promising, effective, and safe therapeutic option for atopic dermatitis (AD), but the treating courses frequently need an extended period since they might have a possible hazard for several side effects and cases of non-compliance. OBJECTIVE To discover the influence of platelet-rich plasma (PRP) injecting on the outcomes of short-term NB-UVB treatment for AD cases. PATIENTS AND METHODS The present study includes 44 atopic dermatitis cases with general symmetric lesions. For every case, the left side of the body was treated with NB-UVB (control side) whereas the right side was treated with NB-UVB plus PRP intradermal injection, at 3-week interval for 3-months. RESULTS A statistically high significant reduction was found in the EASI score, IGA score in the combined side (PRP plus NB-UVB) in comparison with NB-UVB side. CONCLUSION Intradermal PRP injecting in addition to NB-UVB can be considered as a simple, acceptable, and economical method for treating atopic dermatitis. It decreases the NB-UVB therapeutic period and is predictable to raise case compliance. Assessments through follow-up were proposed and undertaken to rate the efficacy of treatment.

Immune-mediated cutaneous reactions are a frequent occurrence in cancer patients treated with immune checkpoint inhibitors. A small subset of these adverse events are psoriasiform reactions. To date, there is no high-level evidence supporting the most appropriate management of this often debilitating dermatologic side effect. In many cases where topical therapy is ineffective, oral steroids are often prescribed which may lead to poorer outcomes in cancer patients. In this case report and review, we describe the clinical courses of two patients with anti-PD-1 inhibitor induced psoriasiform reactions who were treated with narrow band UVB phototherapy. We review the rationale, advantages, and disadvantages of this underutilized treatment as a therapeutic option to spare cancer patients from systemic immunosuppressive agents.