Narrowband UV-B produces superior clinical and histopathological resolution of moderate-to-severe psoriasis in patients compared with broadband UV-B
T. R. Coven, L. H. Burack, R. Gilleaudeau, M. Keogh, M. Ozawa and J. G. Krueger
Laboratory for Investigative Dermatology, Rockefeller University Hospital, New York, NY. 10021-6399, USA.
OBJECTIVE: To compare the therapeutic effectiveness of daily exposure to
narrowband (NB) UV-B vs broadband (BB) UV-B with and without tar. DESIGN:
Half-body exposures to NB UV-B or BB UV-B were given daily for 4 weeks in
this comparative treatment study. Narrowband UV-B was delivered from TL-01
fluorescent bulbs and BB UV-B from conventional bulbs in the same
phototherapy cabinet. Narrowband UV-B was compared using a paired treatment
approach to BB UV-B above the waist and to BB UV-B with tar (Goeckerman
treatment) below the waist. SETTING: General clinical research center of a
university hospital inpatient unit. PATIENTS: Twenty-two patients with
moderate-to-severe plaque-type psoriasis completed the study. MAIN OUTCOME
MEASURES: Clinical efficacy was measured weekly using psoriasis severity
scoring. Therapeutic outcomes after 4 weeks were compared in paired biopsy
samples from treated lesions using objective histopathological measures
(quantitative reduction in epidermal acanthosis and keratin 16 expression).
RESULTS: Clinical resolution of psoriasis was achieved on 86% of paired
sites treated with NB UV-B vs 73% treated with BB UV-B. Histopathological
resolution of epidermal hyperplasia (marked by keratin 16 expression) was
achieved in 88% of lesions treated with NB UV-B vs 59% treated with BB
UV-B. Epidermal acanthosis was reduced more completely by NB UV-B
treatment. Clinical resolution of psoriatic lesions occurred more rapidly
following NB UV-B treatment, with some patients achieving complete
resolution after 2 to 3 weeks of treatment. CONCLUSIONS: Narrowband UV-B
offers a significant therapeutic advantage over BB UV-B in the treatment of
psoriasis, with faster clearing and more complete disease resolution. The
erythema response to NB UV-B treatment was significantly more intense and
persistent compared with BB UV-B. Considerably more necrotic keratinocytes
were observed in histopathological sections of skin treated with NB UV-B
after a single 2.0-minimum erythema dose exposure. Treatment should be
coupled with obligate minimum erythema dose testing to NB UV-B and close
clinical observation during dose increases.
Psoriasis treatment: traditional therapy
Lebwohl et al.
Ann Rheum Dis 2005;64:ii83-ii86.
ABSTRACT
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Narrowband UV-B (TL-01) Phototherapy vs Oral 8-Methoxypsoralen Psoralen-UV-A for the Treatment of Chronic Plaque Psoriasis
Markham et al.
Arch Dermatol 2003;139:325-328.
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Narrowband (312-nm) UV-B Suppresses Interferon {gamma} and Interleukin (IL) 12 and Increases IL-4 Transcripts: Differential Regulation of Cytokines at the Single-Cell Level
Walters et al.
Arch Dermatol 2003;139:155-161.
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Narrowband TL-01 Phototherapy for Patch-Stage Mycosis Fungoides
Clark et al.
Arch Dermatol 2000;136:748-752.
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Narrowband UV-B Phototherapy vs Photochemotherapy in the Treatment of Chronic Plaque-Type Psoriasis: A Paired Comparison Study
Tanew et al.
Arch Dermatol 1999;135:519-524.
ABSTRACT
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The Use of Narrowband UV-B (Tube Lamp) in the Management of Skin Disease
Ferguson
Arch Dermatol 1999;135:589-590.
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312-nanometer Ultraviolet B Light (Narrow-Band UVB) Induces Apoptosis of T Cells within Psoriatic Lesions
Ozawa et al.
J. Exp. Med. 1999;189:711-718.
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