Role of Narrowband Ultraviolet B Phototherapy in the Treatment of Childhood Psoriasis in Asian Children

Wong, Yisheng; Koh, Mark Jean‐Aan; Chong, Wei‐Sheng

doi:10.1111/pde.12632

Cited by 14 publications

(16 citation statements)

References 5 publications

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“…In 2011, a retrospective study in pediatric psoriasis patients showed complete clearance in 51% and a good response (at least 75% improvement) in 41% of the subjects through a mean treatment duration of 3.3 months [ 20 ]. Recently, Wong et al performed a retrospective study on 12 pediatric psoriasis patients treated with NB-UVB, also performing a thorough review of the literature, and concluded that this type of phototherapy is a safe and effective treatment for childhood psoriasis and should be considered in children with suboptimal response to topical therapy [ 21 ]. Indeed, there are several published case series in the literature attesting to the efficacy of UVB phototherapy, in particular NB-UVB phototherapy, in treating plaque and guttate psoriasis in children aged 2–18 years, with the majority of patients achieving a moderate to significant response or almost complete to total remission over an average of 25–34 treatments, with one study reporting a mean duration of remission of 8 months [ 16 , 20 , 22 – 25 ].…”

Section: Phototherapymentioning

confidence: 99%

Systemic Treatment of Pediatric Psoriasis: A Review

Napolitano

Megna

Balato

et al. 2016

Dermatol Ther (Heidelb)

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Psoriasis is a chronic, immune-mediated, inflammatory skin disease, affecting 1–3% of the white population. Although the existence of two psoriasis incidence peaks has been suggested (one in adolescence before 20 years of age and another in adulthood), its onset may occur at any age, including childhood and adolescence, in which the incidence is now estimated at 40.8 per 100,000. As for adult psoriasis, pediatric psoriasis has recently been associated with obesity, metabolic syndrome, increased waist circumference percentiles and metabolic laboratory abnormalities, warranting early monitoring and lifestyle modifications. In addition, due to psoriasis' chronic nature and frequently occurring relapses, psoriatic patients tend to have an impaired quality of life, often requiring long-term treatment. Therefore, education of both pediatric patients and their parents is essential to successful and safe disease management. Given the lack of officially approved therapies, the very limited evidence-based data from randomized controlled trials, and the absence of standardized guidelines, to date, pediatric psoriasis treatment is primarily based on published case reports, case series, guidelines for adult psoriasis, expert opinions and experience with these drugs in other pediatric disorders coming from the disciplines of rheumatology, gastroenterology and oncology. This review focuses on the use of systemic treatments in pediatric psoriasis and their specific features, analyzing the few literature evidences available, expanding the treatment repertoire and guiding dermatologists in better managing of recalcitrant pediatric psoriasis.

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Section: Phototherapymentioning

confidence: 99%

Systemic Treatment of Pediatric Psoriasis: A Review

Napolitano

Megna

Balato

et al. 2016

Dermatol Ther (Heidelb)

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“…NB-UVB with a peak at 311 nm, which is considered to be more effective than broadband UVB, has been widely used in dermatological phototherapy. In particular, it is a well-established treatment modality for psoriasis [ 34 ].…”

Section: Discussionmentioning

confidence: 99%

Narrow-Band Ultraviolet B Phototherapy Ameliorates Acute Graft-Versus-Host Disease of the Intestine by Expansion of Regulatory T Cells

et al. 2016

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Narrowband ultraviolet B (NB-UVB) has been widely used in dermatological phototherapy. As for the application of NB-UVB phototherapy to graft-versus-host disease (GVHD), we previously reported that it was highly efficacious for cutaneous lesions of acute GVHD (aGVHD) and that expansion of regulatory T (Treg) cells induced by NB-UVB might be one of the mechanisms. In order to examine whether NB-UVB irradiation through expansion of Treg cells is effective for the treatment of not only cutaneous aGVHD but also aGVHD of inner organs such as the intestine or liver, we conducted experiments in which a murine lethal aGVHD model, characterized by severe involvement of the intestine, was irradiated with NB-UVB. We found that NB-UVB irradiation improved the clinical score and survival rate. The pathological score of aGVHD was improved in all affected organs: intestine, liver, and skin. In the serum of mice irradiated with NB-UVB, the levels of Treg cells-associated cytokines such as transforming growth factor beta (TGFβ) and interleukin-10 (IL-10) were elevated. The numbers of infiltrating Treg cells in inflamed tissue of the intestine and those in spleen were increased in mice treated with NB-UVB. This is the first report demonstrating that NB-UVB phototherapy has the ability to ameliorate intestinal aGVHD through the expansion of Treg cells.

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“…Eleven studies reported on the efficacy of phototherapy in children with plaque and guttate psoriasis (364 patients aged 3 to 17). [54][55][56][57][58][59][60][61][62][63][64] NB-UVB treatment was used in all studies, whereas the retrospective review by Ersoy-Evans et al 62 also included psoralen-UVA (PUVA) and regular UVB. In this study, the authors concluded that the efficacy of NB-UVB and UVB treatment were equally more effective with 75% less clearance achieved in 93% of the patients compared to PUVA treatment with <75% clearance achieved in 83%; the assessment score was not specified.…”

Section: Phototherapymentioning

confidence: 99%

“…Phototherapy was effective overall in a large number of participants, although erythema was a common adverse event observed in 8/11 studies. [56][57][58][60][61][62][63][64] Two patients discontinued treatment in one study due to the development of erythroderma following NB-UVB treatment. 54 It is notable that topical treatment was used or allowed in 6/ 11 studies, 58,60,[62][63][64] while the clinical trial by Tan et al 56 allowed both topical and systemic treatment.…”

Section: Phototherapymentioning

confidence: 99%

Off-Label Treatments for Pediatric Psoriasis: Lessons for the Clinic

Haulrig¹,

Zachariae²,

Skov³

2021

PTT

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Psoriasis is a chronic inflammatory skin disease that affects up to 1.2% of children and adolescents. The treatment options for childhood psoriasis are often based on the same principles as in adults. However, most data on safety and efficacy derive from adult studies, and only a few of the frequently used treatments have achieved approval for use in children. The aim of this study was to review the current literature on off-label treatments for psoriasis in children and adolescents. We searched PubMed and identified 50 studies on offlabel treatments. Of these, 23 studies were clinical trials (four randomized). There are only a small number of available studies on off-label treatments for children and adolescents with psoriasis, and many of these are retrospective reviews with few participants. Despite the current lack of studies, we still recommend the use of unapproved treatments since we have clinical experience with treatments such as topical corticosteroids, vitamin D analogs, and methotrexate that have shown promising effects. Regular clinical trials are needed to investigate the safety and efficacy of unapproved treatments. Due to The Pediatric Investigation Plans issued by The European Union, new drugs developed by pharmaceutical companies are required to undergo clinical trials in a pediatric population to get their application for marketing authorization processed. This will hopefully lead to much more data on the efficacy and safety of the new treatments, including treatments for children and adolescents with psoriasis.

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Role of Narrowband Ultraviolet B Phototherapy in the Treatment of Childhood Psoriasis in Asian Children

Cited by 14 publications

References 5 publications

Systemic Treatment of Pediatric Psoriasis: A Review

Systemic Treatment of Pediatric Psoriasis: A Review

Narrow-Band Ultraviolet B Phototherapy Ameliorates Acute Graft-Versus-Host Disease of the Intestine by Expansion of Regulatory T Cells

Off-Label Treatments for Pediatric Psoriasis: Lessons for the Clinic

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