The efficacy of narrowband UVB treatment in pediatricvitiligo: a retrospective analysis of 26 cases

Abstract

Medical records of a total of 26 patients with an age of <18 years who were treated with Nb UVB phototherapy for vitiligo between January 2009 and January 2014 at our clinic were evaluated retrospectively. Age, sex, duration of the disease, presence of family history, comorbidities, skin type, vitiligo subtype, topical treatment the patient had used, duration of Nb UVB treatment, total number of sessions, total cumulative dose, response to treatment, and adverse effects secondary to the treatment were recorded. Lesions were grouped as generalized, focal, and acrofacial according to the Fitzpatrick classification (5). Phototherapy protocolWritten informed consent was obtained from all parents and standard phototherapy precautions were taken in all cases; eyes were covered and the genitals were protected. A Daavlin cabin (Daavlin, Bryan, OH, USA) with a Philips TL-01/100W fluorescent light (Philips Company, Eindhoven, the Netherlands) was used as the phototherapy source. The Nb UVB treatment was administered twice Background/aim: Narrowband UVB (Nb UVB) treatment is commonly used for the management of psoriasis and atopic dermatitis, and is less often used for vitiligo in children. The aim of this study was to evaluate the efficacy and short-term safety of Nb UVB phototherapy in children diagnosed with vitiligo retrospectively Materials and methods: A total of 26 patients younger than 18 years with the diagnosis of vitiligo and managed with Nb UVB phototherapy as documented in archive records were evaluated. Clinical response was assessed according to repigmentation of the lesions: good response when there was more than 75% repigmentation, moderate response when there was 25%-74% repigmentation, poor response when repigmentation was less than 24%, and unresponsive when there was no pigmentation and new lesions occurred.Results: A total of 26 patients received Nb UVB treatment; 14 were girls and 12 were boys. The age at onset of the disease varied between 2 and 18 years, with a mean age of onset of 10.07 ± 4.53 years. Repigmentation rate of >75% was detected in 45.4% of cases. Conclusion:Nb UVB phototherapy seems to be a well-tolerated effective and safe treatment option in children, especially those unresponsive to topical treatment and those with widespread lesions. However, long-term risks such as photocarcinogenesis and photoaging should kept in mind.

Clinical and Demographic Characteristics of Children with Vitiligo: Retrospective Analysis of 105 Cases

“…It has impact on success in clinic type (34). Various treatment guides are being discussed (34)(35)(36)(37)(38). With regards to vitiligo treatment, systemic, topical treatments (containing topical corticosteroid, topical vitamin D analogues and topical calcineurin inhibitors), phototherapy (narrow band UVB, PUVA, microphototherapy), depigmenting agents, surgical intervention are among the options (34)(35)(36)(37).…”

“…It is recommended for patients with an involvement area of over 2 % if topical treatment is not beneficial. However, it should not be used for more than 12 months (38).A number of studies have reported 44-78 % of success rate with narrow band UVB treatment (38). Depending on the lesion conditions of the patients, local UVB, microphototherapy or general narrow band UVB treatments have been implemented.…”

Fototerapia na População Pediátrica: Particularidades e Indicações

“…19 A repigmentação é o objetivo secundário, alcançado segundo vários estudos entre 37% a 75% dos casos, com efeitos adversos ligeiros. [23][24][25][26][27][28] Nas crianças tratadas com UVB-BE ocorre repigmentação em mais 75% que nos adultos (37% vs 15,6%, respetivamente). Em muitos desses estudos, a fototerapia foi menos eficaz nas regiões acrais, devido à menor densidade de folículos pilosos nessas áreas e, portanto, diminuição da capacidade da radiação UV para estimular os melanócitos foliculares residuais.…”

“…Em muitos desses estudos, a fototerapia foi menos eficaz nas regiões acrais, devido à menor densidade de folículos pilosos nessas áreas e, portanto, diminuição da capacidade da radiação UV para estimular os melanócitos foliculares residuais. [23][24][25][26][27][28] Como há falta de dados relativamente à segurança e dose cumulativa apropriada, tem sido proposto manter terapêutica com UVB-BE durante 12 meses, descontinuando ao fim de 6 meses caso não haja melhoria significativa. 19,20 A utilização em fototipos baixos (fototipo I de Fitzpatrick) não é aconselhada pela baixa tolerância e visibilidade mínima das lesões neste tipo de pele.…”

Evaluation of the therapeutic effect of PUVA therapy in chronic vitiligo patients

“…Study by Serkan Yazici et al, stated generalised vitiligo (16 cases) was common subtype followed by acrofacial (6 cases) and focal vitiligo (4 cases). 7 Study by Hari Kishan Kumar Y et al, stated that 59.3% cases had generalized vitiligo, 30% cases had acral/acrofacial type, 5.3% had focal and 5.3% had segmental type of vitiligo. 8 In the present study erythema was the common side effect followed by xerosis, pruritus, nausea and vomiting, bulla and burning (Table 2).…”