Treatment of paediatric eczema with narrowband ultraviolet light B therapy

Abstract

Background Narrowband ultraviolet B phototherapy (nbUVB) is a well‐established, well‐tolerated and efficacious treatment for eczema. There is a distinct lack of literature surrounding the therapeutic use of nbUVB in eczema in children and especially in children with higher skin phototypes (III to VI). Methods We undertook a retrospective review of children aged 18 years and under with eczema who had undergone nbUVB in our department between 1 January 2011 and 31 December 2017. Abstracted data included sex, age, skin phototype, severity as graded by a paediatric dermatologist, cumulative dose, response to treatment and subsequent remission. Results In total, 60 children had nbUVB. Of those, 56 had more than 10 nbUVB exposures. Complete or near‐complete clearance was achieved in 31 children (52%). Of those, 24 (77%) had a skin phototype of III or greater. Clinical remission rates of these patients were 100%, 87%, 57% and 52% at 0, 3, 6 and 12 months, respectively. Seventeen patients (28%) suffered side effects. Most commonly these were mild side effects such as erythema and xerosis. Conclusion We have demonstrated that nbUVB is a safe, well‐tolerated and efficacious form of treatment for children with atopic eczema. We have shown it to be effective in those with skin phototypes greater than III and shown that they are a group that may derive greater long‐term efficacy. In clinical practice, preference for nbUVB as second‐line treatment, over oral systemics, should always be considered.

Phototherapy for the treatment of atopic dermatitis in Singaporean children and adolescents

“…reported 52% of children with complete or near‐complete clearance. Their study included children with mild, moderate, and severe eczema, although the majority of their patients (42 out of 60; 70%) had severe disease 12 . Similar to our study, both studies consisted of patients in which topical steroids and emollients were administered in tandem with phototherapy.…”

“…Similar to our study, both studies consisted of patients in which topical steroids and emollients were administered in tandem with phototherapy. This was found to be an unlikely confounding factor, as these patients had previously failed topical therapy 10,12 …”

“…Their study included children with mild, moderate, and severe eczema, although the majority of their patients (42 out of 60; 70%) had severe disease. 12 Similar to our study, both studies consisted of patients in which topical steroids and emollients were administered in tandem with phototherapy. This was found to be an unlikely confounding factor, as these patients had previously failed topical therapy.…”

“…This was found to be an unlikely confounding factor, as these patients had previously failed topical therapy. 10,12 Short-term complications which patients experienced from NBUVB were limited to xerosis, pruritus, erythema, and pain. Most of these were mild and self-limiting with only a few patients having to cease therapy from these side effects.…”

Refractory nummular eczema in child successfully treated with NB‐UVB and topical delgocitinib

“…NB-UVB therapy is a tolerant and effective treatment for children with AD. 1 NB-UVB inhibits immunological reactions and has anti-inflammatory and anti-bacterial effects. It also recovers skin barrier defects.…”