Narrowband ultraviolet B phototherapy and 308-nm excimer laser in the treatment of vitiligo: A review

Nicolaidou, Electra; Antoniou, Christina; Stratigos, Alexander J.; Katsambas, Andreas

doi:10.1016/j.jaad.2008.07.053

Cited by 90 publications

(87 citation statements)

References 73 publications

(157 reference statements)

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“…Patients who started to respond after 1 month of treatment achieved greater repigmentation, in contrast to those who responded later. If this finding is verified, it may be possible to identify patients with a greater chance of achieving satisfactory final repigmentation early in the course of treatment [5].…”

Section: Disease Duration and Time To Initial Responsementioning

confidence: 93%

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Phototherapy in vitiligo

El‐Mofty¹,

Mostafa²,

Esmat³

et al. 2012

Journal of the Egyptian Womenʼs Dermatologic Society

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Phototherapy is the backbone of vitiligo treatment. Besides the use of heliotherapy since ancient times, artificial sources have been introduced for the last decades in different wavelengths and administration devices utilizing a multitude of regimens and treatment combinations. In this article, we present a comprehensive compilation of the use of different modalities of phototherapy in vitiligo on the basis of a multitude of related comparative studies that have been carried out during the last decade, including those performed at the Phototherapy Unit, Kasr Al Aini Hospital. The phototherapeutic modality most commonly utilized in the treatment of vitiligo at present is narrowband ultraviolet B (NB-UVB) (311 nm), although in our area, photochemotherapy still continues to be used. Efforts have been made to take into account most comparative studies including the different combinations of NB-UVB with other modalities. The different types of psoralens used in photochemotherapy are discussed, besides comparison of the use of various ultraviolet light sources in vitiligo. The results of studies comparing both psoralen plus ultraviolet A and NB-UVB are also included. A more recently emerging phototherapeutic modality in the treatment of vitiligo and other photoresponsive dermatoses is broadband UVA, which awaits shortterm and long-term safety evaluation studies, both clinical and laboratory. Diverse tools yielding targeted phototherapy are widely being used nowadays in the treatment of vitiligo. Systems range from laser to incoherent pointed light equipment to larger but localized sources, all aiming at sparing the unaffected skin undue radiation exposure.

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Section: Disease Duration and Time To Initial Responsementioning

confidence: 93%

“…There is no universally accepted protocol for NB-UVB therapy; hence, treatment protocols differ from one study to another [5]. Other constraints included the lack of a unified quantitative scale to measure the response to the therapy used in most studies, paucity of controlled studies, and inconsistent follow-up periods [6].…”

Section: Narrowband Ultraviolet Bmentioning

confidence: 99%

Phototherapy in vitiligo

El‐Mofty¹,

Mostafa²,

Esmat³

et al. 2012

Journal of the Egyptian Womenʼs Dermatologic Society

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“…4 The 308 nm wavelength delivered by either laser/lamp has shown satisfactory superiority to broad band (BB-UVB) and NB-UVB for clinically treating vitiligo. 5 Only few researchers studied histopathological changes before and after treatment with NB-UVB. 6 However, to the best of our knowledge, none compared the histopathological changes of lesions before and after treatment with MEL and NB-UVB.…”

Section: Introductionmentioning

confidence: 99%

Comparison Between (311–312 nm) Narrow Band Ultraviolet-B Phototherapy and (308 nm) Monochromatic Excimer Light Phototherapy in Treatment of Vitiligo: A Histopathological Study

Eldin¹,

Sami²,

Aly

et al. 2017

J Lasers Med Sci

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IntroductionVitiligo is an idiopathic pigmentary disorder of the skin characterized by sharply demarcated asymptomatic depigmented macules. Its pathogenesis is still unclear. Many mechanisms and theories have been suggested including autoimmunity, auto cytotoxicity, biochemical and neuronal mechanisms. No universally effective nor curative medical or surgical treatment has been proposed till this day. First line treatments include topical treatments such as corticosteroids and calcineurin inhibitors. While surgical options such as autologous melanocytes transplantation are suggested later on. Phototherapy, including narrow band ultraviolet B (NB-UVB) and monochromatic excimer light (MEL) of wavelengths 311 nm and 308 nm respectively, is considered as a successful method of treatment among those approaches.2 The cytotoxic T-cells accountable for the destruction of melanocytes and disappearance of melanin are eliminated by phototherapy through apoptosis (diffuse repigmentation) and UVB does stimulate melanocytic proliferation and their migration to the epidermis from nearby follicular units (follicular repigmentation) and perilesional active melanocytes (marginal repigmentation).3 NB-UVB indoor cabins have been used to treat vitiligo since the early 1990s, but recently, MEL was used and adapted for the treatment of some dermatological diseases including vitiligo. 4 The 308 nm wavelength delivered by either laser/lamp has shown satisfactory superiority to broad band (BB-UVB) and NB-UVB for clinically treating vitiligo. 5Only few researchers studied histopathological changes before and after treatment with NB-UVB. 6 However, to the best of our knowledge, none compared the Recently, the monochromatic excimer light (MEL) of 308 nm wavelength has shown some advantages in comparison to narrow band ultraviolet B (NB-UVB) for the treatment of vitiligo. To histopathologically compare the early effects of NB-UVB and 308-nm MEL phototherapy on vitiliginous patches using H&E and HMB-45. Methods: Thirty subjects with non-segmental vitiligo lesions were treated twice a week for 6 weeks with 308-nm MEL, while NB-UVB was used to treat lesions contra laterally. Skin biopsies were taken from lesional areas before and after 6 weeks of treatment by either modality. It was prepared for light microscopy and immunohistochemical study . This study was performed as a clinical trial (Trial registration: http://www.pactr.org; Identifier: PACTR201705002279419) Results: All lesions before treatment had labeling index (number of pigmented cells/nonpigmented cells) of 0.0 (0%). After treatment the LI for MEL was 4.2 ± 2.6, while for NB-UVB LI it was 0.3 ± 0.7. MEL showed higher statistical significance regarding increase of basal pigmented cells, and significant decrease in vacuolated keratinocytes and basal membrane thickness than NB-UVB. Conclusion:Although NB-UVB is considered as treatment of choice for vitiligo, MEL is acknowledged as an effective treatment modality for vitiliginous lesions that induces more repigmentation than NB-UVB, and ...

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“…It is assumed that multiple factors may combine to contribute to the occurrence of the disease (2). Vitiligo affects 0.1-2% of the world population (3), without race or sex predilection (4,5). Vitiligo patches can be cosmetically disturbing and have a great negative psychosocial impact (6).…”

Section: Introductionmentioning

confidence: 99%