Psoralen–narrowband <scp>UVB</scp> phototherapy for the treatment of vitiligo in comparison to narrowband <scp>UVB</scp> alone

Bansal, Shivani; Sahoo, Bijaylaxmi; Garg, Vijay Kumar

doi:10.1111/phpp.12072

Cited by 37 publications

(36 citation statements)

References 19 publications

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“…Their results showed that the extent of repigmentation in the P‐NBUVB group was significantly higher in the face and neck as well as hands, compared with NBUVB group. The difference was significant even after removing sunlight as a confounding factor . These results are compatible with our findings.…”

Section: Discussionsupporting

confidence: 93%

“…This is in line with the study by Bansal and colleagues, in which four patients in the NBUVB group and 10 patients in the P‐NBUVB group had side effects, but the difference was not significant. Nine of 10 patients in the P‐NBUVB group had nausea after taking the psoralen tablet and one of them suffered from phototoxic reactions . In contrast, El‐Mofty and colleagues found the rate of phototoxic reactions to be significantly higher in the P‐NBUVB side of the body, compared to the other side that received NBUVB when psoralen was not taken …”

Section: Discussionmentioning

confidence: 97%

“…Few studies have investigated the therapeutic effects of P‐NBUVB in comparison with NBUVB alone to treat vitiligo. Nearly, all of them yielded better outcomes in P‐NBUVB treated patients, compared with those underwent NBUVB alone, especially in longer periods . This study was aimed to evaluate the efficacy of P‐NBUVB in comparison with NBUVB alone in a population of Iranian patients with vitiligo.…”

Section: Introductionmentioning

confidence: 99%

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Psoralen and narrowband UVB combination provides higher efficacy in treating vitiligo compared with narrowband UVB alone: A randomised clinical trial

et al. 2019

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Background/Objectives Side effects of current treatments and the need for a safe treatment with higher efficiency necessitate seeking new treatment options for vitiligo. Few studies have investigated the combination of psoralen with narrowband ultraviolet B (NBUVB). In this study, we compared the efficacy and safety of psoralen and NBUVB combination (P‐NBUVB) with NBUVB alone in treatment of vitiligo. Methods This randomised clinical trial was carried out during 2015–2017 in dermatology clinics of Ghaem and Imam Reza hospitals, Mashhad, Iran on 40 vitiligo patients with 5–60% body involvement. The patients were randomly divided into two groups of NBUVB alone and P‐NBUVB. Both groups underwent 60 phototherapy sessions (three sessions per week), and the repigmentation rate was measured using vitiligo area severity index (VASI) score. SPSS v. 16 software and appropriate statistical tests were used to analyse the data. P < 0.05 was considered statistically significant. Results The mean age of patients was 33.9 ± 11.3 years. Twenty patients (50%) were females. The P‐NBUVB group showed greater VASI improvement in lower extremities (P = 0.003) and overall (P = 0.026) compared with NBUVB group. Moreover, the treatment response appeared sooner in P‐NUVB group. Conclusion Based on our results, we can conclude that adding psoralen to NBUVB phototherapy can result in increased efficacy. However, more studies are needed to evaluate the long‐term effects and side effects of this treatment.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

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Psoralen and narrowband UVB combination provides higher efficacy in treating vitiligo compared with narrowband UVB alone: A randomised clinical trial

et al. 2019

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“…UVR has both positive and negative effects on human health. It is responsible for the biosynthesis of vitamin D 3 , can stimulate the production of photoprotective melanin (2)(3)(4)(5), and is used therapeutically to treat inflammatory skin diseases, such as psoriasis, vitiligo, localized scleroderma, and atopic dermatitis (6)(7)(8). At the same time, UVR has many negative effects, most notably that it is directly absorbed by cellular DNA, resulting in cyclobutane pyrimidine dimer (CBPD) mutations that can lead to carcinogenesis of resident epithelial cells.…”

mentioning

confidence: 99%

Ultraviolet Radiation Signaling through TLR4/MyD88 Constrains DNA Repair and Plays a Role in Cutaneous Immunosuppression

Harberts

Zhou

Fishelevich

et al. 2015

The Journal of Immunology

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UV radiation (UVR) induces DNA damage, leading to the accumulation of mutations in epidermal keratinocytes and immunosuppression, which contribute to the development of nonmelanoma skin cancer. We reported previously that the TLR4–MyD88 signaling axis is necessary for UV-induced apoptosis. In the dinitrofluorobenzene contact hypersensitivity model, UV-irradiated MyD88-deficient (MyD88−/−) C57BL/6 mice had intact ear swelling, exaggerated inflammation, and higher levels of dinitrofluorobenzene-specific IgG2a compared with wild-type (WT) mice. Even with normal UV-induced, dendritic cell migration, DNA damage in the local lymph nodes was less pronounced in MyD88−/− mice compared with WT mice. Cultured, UV-irradiated WT APCs showed cleavage (inactivation) of the DNA damage–recognition molecule PARP, whereas PARP persisted in MyD88−/− and TLR4−/− APCs. Epidermal DNA from in vivo UV-irradiated MyD88−/− mice had an increased resolution rate of cyclobutane pyrimidine dimers. Both in vitro treatment of MyD88−/− APCs with and intradermal in vivo injections of PARP inhibitor, PJ-34, caused WT-level cyclobutane pyrimidine dimer repair. Lymphoblasts deficient in DNA repair (derived from a xeroderma pigmentosum group A patient) failed to augment DNA repair after MyD88 knockdown after UVR, in contrast to lymphoblasts from a healthy control. These data suggest that interference with the TLR4/MyD88 pathway may be a useful tool in promoting DNA repair and maintaining immune responses following UVR-induced damage.

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“…A number of clinical studies have been conducted all over the world and all of these studies have documented a positive effect of narrow-band UVB therapy in vitiligo [6, 10, 11]. …”

Section: Discussionmentioning

confidence: 99%

Narrow-Band Ultraviolet B versus Oral Minocycline in Treatment of Unstable Vitiligo: A Prospective Comparative Trial

Siadat

Zeinali

Iraji

et al. 2014

Dermatology Research and Practice

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Background. We have compared NB-UVB and oral minocycline in stabilizing vitiligo for the first time. Subjects and Methods. 42 patients were divided equally into two groups: the NB-UVB and minocycline groups. Phototherapy was administered twice a week on nonconsecutive days. In the minocycline group, patients were advised to take minocycline 100 mg once daily. The treatment period was 3 months. Vitiligo disease activity (VIDA) score was noted every 4 weeks for 12 months. Digital photographs were taken at baseline and monthly intervals. Results. Before the therapy, disease activity was present in 100% of the patients, which was reduced to 23.8% and 66.1% by the end of therapy in the NB-UVB and minocycline groups retrospectively (P < 0.05). 16 of the 21 (76/1%) patients with unstable disease in the NB-UVB group achieved stability, whereas this was the case for only 7 of the 21 (33.3%) in the minocycline group (P < 0.001). The diameter changes were statistically significant at the end of treatment in the NB-UVB group compared to the minocycline group (P = 0.031). Side effects in both groups were mild. Conclusion. NB-UVB was statistically more advantageous than oral minocycline in unstable vitiligo in terms of efficacy and the resulting stability.

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Psoralen–narrowband UVB phototherapy for the treatment of vitiligo in comparison to narrowband UVB alone

Abstract: Addition of psoralen increased the extent of repigmentation due to NBUVB therapy in vitiligo. Further studies are required to determine the long-term efficacy and safety of P-NBUVB.

Cited by 37 publications

References 19 publications

Psoralen and narrowband UVB combination provides higher efficacy in treating vitiligo compared with narrowband UVB alone: A randomised clinical trial

Psoralen and narrowband UVB combination provides higher efficacy in treating vitiligo compared with narrowband UVB alone: A randomised clinical trial

Ultraviolet Radiation Signaling through TLR4/MyD88 Constrains DNA Repair and Plays a Role in Cutaneous Immunosuppression

Narrow-Band Ultraviolet B versus Oral Minocycline in Treatment of Unstable Vitiligo: A Prospective Comparative Trial

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