NB-UVB phototherapy for generalized granuloma annulare

Abstract

Granuloma annulare (GA) is a benign, usually self-limited, granulomatous skin disease of unknown etiology. The generalized form of the disease shows a more chronic, relapsing course, rare spontaneous resolution, and poorer response to therapy. Psoralen plus UVA phototherapy has been reported to be effective for GA. However, little is known regarding the efficacy of narrowband UVB phototherapy. Our goal was to determine the efficacy of NB-UVB phototherapy in generalized GA. We carried out a retrospective study of patients with generalized GA treated with NB-UVB phototherapy over a period of 3 years. On completion of treatment, outcome was assessed as complete response (complete clearance of the lesions), partial response (>50% clearance of the lesions), and poor response (<50% clinical response). Therapy was stopped if no improvement was seen after 20 treatments. Thirteen patients were included in the study. 54% of patients treated with NB-UVB had a complete/partial response by the end of the treatment period. NB-UVB phototherapy was well-tolerated, with no serious adverse effects. NB-UVB phototherapy is effective in a substantial portion of patients with generalized GA. To determine the true efficacy of this therapeutic modality, a prospective study comparing it to PUVA is warranted.

Phototherapy in dermatological maladies (Review)

“…The case presented by Muylaert et al (40) highlights the efficiency of NB-UVB phototherapy in disseminated annular granuloma, refractory to other therapies. Along with this case, other studies were carried out and reached the same conclusion (41)(42)(43).…”

A Perspective on the Use of NB-UVB Phototherapy vs. PUVA Photochemotherapy

“…More recently, superiority of NB-UVB compared with PUVA has been shown for urticaria ( 101 ), and thus NB-UVB should be considered as a treatment option if antihistamines and other pharmacological therapies fail and may provide useful disease remission. A range of other conditions may be effectively treated by NB-UVB and PUVA and include pityriasis lichenoides ( 102 ), granuloma annulare ( 103 , 104 ), urticaria pigmentosa and cutaneous mastocytoses ( 105 – 107 ), aquagenic pruritus ( 108 – 110 ), lichen planus ( 111 – 114 ), alopecia areata ( 115 – 118 ), generalized pruritus, such as secondary to uraemia or cholestasis ( 119 , 120 ), and graft vs. host disease ( 2 , 3 , 5 , 6 ) and these phototherapeutic modalities may be invaluable treatment approaches for these otherwise difficult-to-treat groups of diseases. For conditions such as pityriasis rubra pilaris, which may be aggravated and flared by the use of NB-UVB, 8-MOP systemic PUVA should be considered.…”

Combination treatment of disseminated granuloma annulare

“…Положительный эффект наблюдался через месяц терапии, при этом около 64% пациентов достигли полного или частичного регресса высыпаний [54]. Имеются отдельные публикации об эффективности методов фототерапии при диссеминированной форме кольцевидной гранулемы [55][56][57][58]. В результате использования методов дальней длинноволновой ультрафиолетовой терапии, узкополосной (311 нм) фототерапии, ПУВА-терапии отмечалась положительная динамика в виде частичного или полного регресса высыпаний.…”