Narrow-Band UVB Better Tolerated Than Other Vitiligo Therapies

Damian McNamara
Miami Bureau

Narrow-band UVB is an effective treatment for vitiligo, according to a retrospective study. Researchers found this type of phototherapy better tolerated than traditional approaches such as corticosteroids and topical PUVA, with the best results observed in patients with early-stage disease.

Dr. Lubomira Scherschun and colleagues treated seven patients three times a week with the narrow-band UVB therapy. The starting dose was 280 mJ/cm2 and was escalated by 15% for each subsequent treatment until side effects such as mild erythema or pruritis became a limiting factor. If burning or pain developed, the dose was reduced by 15% until the symptoms resolved (J. Am. Acad. Dermatol. 44[6]:999-1003, 2001).

Five of seven patients achieved more than 75% repigmentation. They all had early-stage disease (mean duration of 13 months) vs. two patients who had the disease longer (a mean of 132 months). Patients with disease of longer duration achieved only 40% and 50% repigmentation and were treated for 48 and 46 months, respectively.

This is the first report of greater success with earlier treatment, the researchers noted, but added “it is difficult to say whether these data represent a significant finding or reflect our small sample size.”

Most patients responded with repigmentation that was darker than their unaffected skin. This was observed primarily in patients with Fitzpatrick skin types IV and V, and in all cases it resolved within a few weeks.

Of the six patients followed after treatment, four maintained repigmentation. One developed some new depigmented macules and patches in previously uninvolved skin at 4 months; the other showed signs of vitiligo recurring in the same lesion after treatments were tapered to twice a week. Both patients were successfully retreated with the original dosing schedule.

Limitations to the use of narrow-band UVB for vitiligo include that only a few U.S. centers offer the treatment modality. Further, not all insurance carriers cover UVB therapy.

Skin and Allergi News, Sept 2001, vol 32, nr. 9

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