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Vitamin D plays an important role in skin inflammation in psoriasis. The beneficial effects of ultraviolet light B (UVB) phototherapy in psoriasis are partly attributed to UVB-induced increase of vitamin D levels. In clinical practice, total 25-hydroxy vitamin D (25(OH)D) levels are measured to assess sufficiency, but it might be more accurate to measure free 25(OH)D levels. The aim of this study was to measure free serum 25(OH)D levels in psoriasis patients before and after phototherapy and to investigate if free 25(OH)D correlates stronger to disease severity than total 25(OH)D. Twenty adults (>18 years) with psoriasis were included for treatment with narrow-band UVB (NB-UVB) phototherapy for 10–12 weeks. Psoriasis Area and Severity Index (PASI) and Visual Analogue Scale (VAS) were used to assess disease severity. Serum levels of total 25(OH)D, free 25(OH)D, and 1,25(OH)2D were measured before and after NB-UVB. Total 25(OH)D, free 25(OH)D, 1,25(OH)2D and the percentage of free 25(OH)D increased after NB-UVB, and PASI and VAS improved. The increase in total and free 25(OH)D remained significant when stratifying for vitamin D confounders. No correlations between disease severity and vitamin D levels were found. Total and free 25(OH)D levels were positively correlated before and after NB-UVB. NB-UVB is an effective treatment for mild to severe plaque psoriasis and increases not only total but also free 25(OH)D levels, as well as the percentage of free 25(OH)D, suggesting an increased bioavailability of skin-produced vitamin D.

Intravenous immunoglobulins (IVIg) are increasingly being used to treat a wide spectrum of dermatological and neurological autoimmune diseases. Although the administration of IVIg does not usually result in severe adverse reactions, side effects of IVIg reportedly occur in 6-13% of patients. Most reported cases were not severe, and IVIg is considered a relatively safe drug. Some reports described a vesicular eczematous eruption caused by IVIg that was cured by applying topical steroid ointments or systemic steroids. Herein, we present, to the best of our knowledge, the first case of severe vesicular eczematous eruption all over the body induced by IVIg that was unresponsive to topical steroid ointment and was subsequently treated with narrow band-ultraviolet B (NB-UVB) therapy successfully. NB-UVB was started at a dose of 400 mJ/cm2 once a week, and swift improvement was observed. The skin rash disappeared in the first 2 months, and the pathogenesis of IVIg-induced eczematous eruption remains unelucidated. No change in eosinophils and complement levels were observed in our case. Given the increase in the widespread use of IVIg, we have shown that NB-UVB therapy is a candidate choice for the treatment of IVIg-induced severe vesicular eczematous eruption.

The objective of this review is to provide an update on narrowband ultraviolet B (NB-UVB) as a treatment for various skin conditions. NB-UVB works by suppressing the cutaneous cell-mediated immune response and has been shown to be an efficacious and clinically tolerable treatment for a range of inflammatory dermatoses. A literature search was conducted by advanced searches of PubMed for NB-UVB treatment of dermatologic skin diseases with a focus on reports from 2010 to 2021, including both office-based and home-based phototherapy (HBPT). Data were prioritized based on studies with a high level of evidence using the Oxford Evidence-Based Medicine guidance. We found that NB-UVB continues to serve as an effective form of therapy for several cutaneous conditions, including vitiligo, psoriasis, atopic dermatitis, mycosis fungoides, and other inflammatory dermatoses. The recent introduction of Janus kinase inhibitors in combination with NB-UVB suggests future promise in the treatment of vitiligo. Despite its rise in popularity, a decline was seen in office-based NB-UVB treatment during the coronavirus disease 2019 pandemic. Options are available to deliver NB-UVB at home with comparable efficacy to office-based treatments. In conclusion, for a select group of patients and conditions, NB-UVB continues to serve as an effective treatment modality with minimal side effects, with HBPT serving as an option to improve patient compliance.

Background Vitiligo is an acquired pigmentary disorder of unknown etiology, affecting approximately 1 % of the world population, without predilection for race or sex. It is characterized by white macules and patches, whose size increases over time, due to the loss of melanocytes. Vitiligo can appear at any time, and it significantly impairs the patients’ quality-of-life. Objectives The aim of the work was to study the influence of the NB-UVB radiation therapy on tissue level of IL-33 in patients with vitiligo. Patients and Methods This prospective study was carried out on 10 patients diagnosed as having non -segmental vitiligo stable for 6 months duration. All patients were selected from the dermatology outpatient clinic of vitiligo, Ain-Shams University Hospitals. All patients were subjected to full history taking, general examination and dermatological examination. The disease characteristics of vitiligo were recorded as regards stability, duration and extent of vitiliginous lesions. The activity of the disease was evaluated according to VIDA score, and the disease severity was evaluated according to VASI score. Digital photographic documentation was done. Results Hydropic degeneration of lower epidermis was also detected in (40%) of them and apoptotic keratinocytes were found in (10%) of them. After therapy, these inflammatory changes were significantly reduced this can be partially explained by immunosuppressive properties of NB-UVB as it is believed to cause a reduction of T cells by inducing apoptosis and impairs in-vitro antigen presentation by both murine DCs and human Langerhans cells. The main limitation of our study was the small cohort of the studied patients. Further large-scale studies are needed. Investigatory techniques other than immunohistochemical analysis may be also used to evaluate abnormalities of keratinocytes in vitiligo skin. Conclusion We concluded that NB-UVB has no effect on tissue expression of IL-33 and and that NB-UVB was effective in treating vitiligo as manifested by VASI score change after treatment with NB-UVB. Based on our results we recommend further studies with larger sample size and studying the effect of treatment on IL-33 expression in active vitiligo cases is also recommended.

Background Psoriasis is a chronic, recurring inflammatory disease affecting the skin, joints and nails that has a significant negative impact on the quality of life.Highly sensitive c reactive protein ( hsCRP) could be useful as biomarker for assessing the psoriasis severity(1). Objectives Assess the changes in high-sensitive C-reactive protein serum level in patients with chronic plaque psoriasis before and after treatment with narrow band ultraviolet B therapy and Methotrexate. Patients and Methods Our Prospective clinical study included 40 patients of both sex, aged 20-60 years old with psoriasis vulgaris recruited from dermatology outpatient clinic of Ain Shams University Hospital from January 2018 to December 2018. The study was approved by Ain Shams University ethical committee. Informed consents were taken from each Patient after full description of the study aims and procedures Results Both methotrexate and nb-uvb showed significant decrease in serum level hscrp ,PASI score and DLQI after 12 weeks of treatment ,although there were statistically significant lower PASI , DLQI scores and serum level hscrp after 12 weeks of treatment in methotrexate group of patient compared to nb-uvb group of patients Conclusion Highly sensitive C reactive protein(hscrp) is a promising inflammatory marker for monitoring psoriasis severity and efficacy of treatment respectively .Methotrexate treatment showed significant effect on psoriasis severity regarding lowering hscrp serum level ,PASI and DLQI in compared to Nb_UVB therapy .

Psoriasis is a chronic autoimmune disorder that affects 3-4% of the world population. Keratinocytes and immune cells in patient’s skin secrets excess pro-inflammatory cytokines that in turn...

Introduction: Vitiligo is a disorder of skin pigmentation that is associated with tremendous psychological impact on the affected patients. The prevalence of vitiligo range from 0.1% to 8%. Narrow Band Ultraviolet B (NBUVB) therapy has been reported to be effective and a safe tool in vitiligo. Aim: To determine the effect of NBUVB treatment on vitiligo patients and to assess the impact on Dermatology Life Quality Index (DLQI) of patients after the therapy. Materials and Methods: This was a prospective study conducted pre and post intervention (NBUVB) on all the vitiligo patients attending Dermatology Outpatient Department (OPD) at our Institute from January 2019 to June 2019. The estimated sample size was 80 patients. The patients who met the inclusion criteria underwent whole body NBUVB irradiation. The treatment was started with an initial dose of 300 mJ/cm2 in all the cases. It was administered two days per week on non consecutive days. The irradiation dose was increased by 50 mJ/cm2 on each subsequent visit until the optimal dose was obtained to have a minimal erythema in the lesion. The DLQI questionnaire designed by Finlay and Khan was used to determine the quality of life impairment in the study patients. The DLQI scoring was done twice, the first scoring at the start of therapy and the second scoring at the end of therapy. The data was analysed using Statistical Package for the Social Sciences (SPSS) 20.0 version software for determining statistical significance. Chi-square test, Fisher-exact test and odds ratio were used to check for the associated factors, p-value

There is a continuous need for modifications of epidermal cell grafting techniques treating stable vitiligo to make it easier, more economic, and with better outcome. To evaluate the efficacy and safety of noncultured, nontrypsinized epidermal cell graft homogenized with plasma gel, followed by narrow band-ultraviolet B (NB-UVB) in treatment of stable vitiligo, about 40 patients with stable vitiligo underwent harvesting of epidermal cells from the donor site by dermabrasion then the harvested cells were prepared, homogenized with autologous plasma gel, and applied to the abraded recipient, followed by 16 NB-UVB sessions after complete healing. Patches within the same anatomical site received only NB-UVB as controls. The percentage of improvement ranged from 23.33% to 100% with more than 75% uniform, homogenous repigmentation in 65% of patients. Donor site healed completely with normal skin. Noncultured, nontrypsinized epidermal cell grafting technique homogenized with plasma gel followed by NB-UVB sessions gave positive responses and was well tolerated in different body sites in stable resistant vitiligo.

Vitiligo is an acquired disorder of skin pigmentation that produces significant psychological impact especially in those with skin of color. Narrow-band ultraviolet B (NB-UVB) therapy, which was first used in vitiligo in 1997 by Westerhof and Nieuweboer-Krobotova, has emerged as one of the safest and most effective therapy for this dermatosis. The light source used for NB-UVB phototherapy is the TL-01 lamp, and the most common model of the NB-UVB phototherapy device is the upright in-office booth or chamber which has 24-48 such lamps. In recent years, there have been several advances in the understanding of the mechanism of action of NB-UVB and the use of combination treatments, many of which increase the efficacy of NB-UVB. In 2017, the Vitiligo Working Group made vital recommendations on the dosage, frequency, and safety of NB-UVB in vitiligo. Furthermore, home phototherapy devices are gaining popularity as they lead to an improved patient compliance. There is still need for large multicenter randomized controlled trials to assess benefits of home phototherapy in vitiligo and studies investigating additional benefits of phototherapy following surgical therapy.

Coexistence of psoriasis and vitiligo in the same patient is a therapeutic challenge; several modalities have been tried with varying results. Apremilast is a PDE4 inhibitor used in psoriasis, while recent reports are highlighting its additional role in repigmentation of vitiligo. However, data are scarce, regarding its usage in the pediatric population. Narrowband ultraviolet B therapy (NB-UVB) is an effective treatment modality in both psoriasis and vitiligo and can be safely combined with apremilast. Here, we present an adolescent girl with anatomical colocalization of psoriasis and vitiligo effectively treated with combination of apremilast and NB-UVB therapy.

Background and Objective: Vitiligo is a depigmantation disorder that depends on genetic and non-genetic factors and results from skin melanocytes malfunction. The aim of this study was to compare the effectiveness of narrow band Ultraviolet B (NBUVB) therapy combined with 0.1% topical tacrolimus and NBUVB monotherapy in vitiligo treatment. Materials and Methods: In this double-blind clinical trial study, 30 patients with vitiligo who had at least two symmetrical lesions were selected (60 lesions in total). The patients were randomly divided into intervention and control groups. Phototherapy with 0.1% tacrolimus ointment and with eucerin ointment (placebo) was administered to the intervention and control groups, respectively. The size of the lesions and the degree of repigmentation were evaluated with photogram and Visual Approach Slope Indicator (VASI) scoring system, respectively, at the beginning of the treatment, 1.5 and three months after the treatment. The results were then recorded in checklists and the data were analyzed in SPSS software (version 16.0). Results: The results of the study showed that the mean age of patients was 31.60 years with the prevalence of females (n=18, 60%). The mean and standard deviation of the size of vitiligo lesion in the intervention and control groups at the beginning of the treatment were 5.41 cm ±2.81 and 5.40 cm ±2.82, respectively. Moreover, the mean size of vitiligo lesion 1.5 and three months after the treatment lesion in the intervention and control groups were 4.96 cm ±2.84, 4.59 cm ±2.77, 3.85 cm ±2.35, and 4.66 cm ±2.80, respectively (P>0.05). The mean score of VASI in the intervention and control groups were 0.50 ±0.51 and 0.53 ±0.51 at the beginning of the treatment and 1.46 ± 1.44 and 1.13±1.01 after 1.5 months treatment and 2.18±1.57 and 1.52±1.21 after three months of treatment, respectively (P>0.05). Furthermore, the percentages of repigmentation in the intervention and control groups after 1.5 months were 18.25% and 14.12%, and three months were 30.63% and 19%, respectively. Conclusion: The percentage of vitiligo recession in the combined treatment group was higher than that of monotherapy; however, no significant statistical difference was observed regarding the two therapeutic methods.

Granuloma annulare is a rare, benign, inflammatory dermatosis of unknown origin, characterized by the annular arrangement of small papules. The generalized form is a very rare entity. It has been linked to several diseases, especially autoimmune thyroiditis. There is no established consensus for the treatment of generalized granuloma annular but phototherapy is considered one of the best therapy options for this entity. We report a case of a 66-year-old woman, who presented this pathology, treated with phototherapy showing a good response.

Introduction: Treatment with ultraviolet light is a well-established and effective treatment option for mild to moderate psoriasis. The aims of the study were to measure the psoriasis area and severity index (PASI) reduction after narrow-band ultraviolet B (NB UVB) therapy, to evaluate the quality of life before and after treatment using the dermatology life quality index (DLQI), and to compare the clinical effectiveness with quality of life improvement. Material and methods: Twenty two patients (13 male and 9 female patients), aged between 21 to 70 years (mean age 40±14.65 years) were enrolled in the study. NB UVB treatment was performed with 10 to 25 (mean 18.5; SD 3.39) procedures with cumulative doses of 5 to 19.4 J/cm2. The baseline median PASI score was 20.027 which decreased after therapy to 11.11. More than PASI 50% reduction was achieved in 40.91% of the patients after at least 6 weeks of treatment and the results are highly statistically significant. Quality of life (QoL) assessed using DLQI was found moderately affected by disease pretreatment. NB UVB therapy significantly increased DLQI score in spectrum of ‘symptoms and feelings’ and ‘treatment’. Discussion: The PASI score reduction that we observed after NB-UVB therapy is consistent with the results reported by other authors. Baseline DLQI scores were indicative of moderate QoL impairments associated with disease. At the same time, the reduction of the DLQI index corresponding to improved QoL correlated with the objective clinical symptom assessment. Conclusion: Our data suggest that DLQI and PASI indexes are important complementary methods for comprehensive health assessment of patients with psoriasis.&nbsp

Vitiligo is the most commonly seen depigmentation disease with clinical manifestations of milk colored white macules, complex pathogenesis that is not well understood so that evolution of the disease is unpredictable and therapeutic outcomes are often unsatisfactory. Until now narrowband-ultraviolet B (NB-UVB) is considered the most effective and safe treatment for vitiligo. Therapy evaluation by looking at melanocytes function that can be seen with microphthalmia-associated transcription factor (MITF) immunohisto - chemistry will become more objective and accurate. This is a comparative analytic experimental study using pre-post test method comparing MITF in vitiligo patients before and after receiving NB-UVB conducted at Dr. Soetomo general hospital Surabaya, 12 vitiligo samples treated only with NB-UVB twice a week until 8 times therapies. The first exposure dose was 200 mJ and gradually increased 20% every therapy. Biopsy was performed before and after therapies and then MITF was compared. There was a significant difference between the amount of MITF in vitiligo before NB-UVB and after NB-UVB therapy stastistically, p=

Mycosis fungoides (MF) is the most common type of primary cutaneous lymphomas. Several clinical variants of MF have been described. Purely, hypopigmented variant of MF (HMF) is rare. Phototherapy, especially photochemotherapy (Psoralen and ultraviolet), is the most widely used method and is recommended as the first-line treatment for HMF. However, there are no standard guidelines for phototherapy as the disease is uncommon. We, hereby, report a 30-year-old woman with HMF in whom clinical, histopathological, and immunohistochemical remission was achieved following narrow-band ultraviolet B therapy.

Background: Different surgical techniques in the form of tissue or cellular grafting procedures are used alone or in combination with narrow band ultraviolet B (NBUVB) to treat stable vitiligo resistant to medical treatment. The aim of the study was to assess the cosmetic results obtained with combination therapy of ultrathin split-thickness skin grafts and adjuvant NBUVB therapy in resistant, stable vitiligo.Methods: Forty patients of stable vitiligo were treated with ultrathin split-thickness grafting and the patients were then put on NBUVB therapy. Extent of repigmentation and final cosmetic outcome at the recipient as well as donor sites were assessed.Results: The initial evidence of repigmentation was noted in the second week after starting NBUVB. Results showed 85% of patients had more than 90% repigmentation and the overall cosmetic results at the recipient site was good to excellent in 90% patients at the end of NBUVB treatment. Perigraft halo of depigmentation was seen in five patients (12%) on the recipient site. Hypertrophic scarring was seen in two patients at the donor site.Conclusions: Ultrathin split-thickness skin grafting, when combined with NBUVB therapy, leads to better cosmetic outcome with faster onset of repigmentation in resistant and stable vitiligo.

Immune checkpoint inhibitors targeting the programmed cell death receptor 1 (PD-1) are increasingly used to treat several malignancies, with the most common adverse event being cutaneous toxicity. We report the case of a 68-years-old man with stage IV non-small cell lung cancer treated with nivolumab who developed a pruritic, lichenoid eruption refractory to treatment with topical or systemic steroids, who was started on narrow band ultraviolet B therapy which resolved the reaction.

Background and design: Considering the probable long-term side-effects of narrowband UVB (NB-UVB) therapy, various studies have been conducted to provide more effective and reliable protocols by applying the different initial doses, numbers of sessions or dose increments. The aim of this study is to compare the clinical effectiveness of weekly low-dose increments and weekly high-dose increments of NB-UVB therapy in psoriasis. Materials and methods: Twenty-nine patients with psoriasis vulgaris underwent NB-UVB therapy with a weekly low-dose (20%) increment protocol (group 1; n=14) or weekly high-dose (40%) increment protocol (group 2; n=15). Patients were monitored weekly for 12 weeks and evaluated by the Psoriasis Area Severity Index (PASI). Results: The PASI scores prior to the therapy and during the 12-weeks of therapy for each week between the groups were compared and no statistically significant difference was found except week 12. The mean PASI scores at week 12 was significantly lower in patients from group 2 than in patients from group 1 (p=0.045). The mean number of patients and therapy sessions required with ≥50%, ≥75% and ≥90% PASI reduction did not differ between both groups. Although comparison of the two groups according to the mean cumulative doses with ≥50% and ≥90% PASI reduction did not reveal a statistically significant difference; however, those of patients with ≥75% PASI reduction and at the end of the 12-week therapy were significantly higher in the group with a weekly high-dose increment than in the group with a weekly low-dose increment (p=0.014 and p=0.00, respectively). Conclusion: Although we are aware that our results may need to be supported with large-series studies, we suggest that a weekly low-dose increment regime of NB-UVB therapy is preferable in the treatment of psoriasis as it produces nearly similar effects as a weekly high-dose increment regime but with the lower cumulative doses.

Eosinophilic annular erythema (EAE) is a rare and relatively newly described eosinophil-rich dermatosis. Debate still exists as to whether it represent a subtype of Well syndrome or a separate disease entity. We report an 8-year-old boy with a 4-year history of recurrent, asymptomatic annular lesions, which were diagnosed after clincopathological correlation as EAE. This condition usually runs a relapsing and remitting course with resistance to multiple treatments. Prednisolone and hydroxychloroquine have been reported as successful but the response to these was limited in this case. Complete resolution occurred after treatment with ultraviolet B (UVB) therapy. To our knowledge, this is the first report of a favourable response of EAE to such therapy.

Background Cultured autologous melanocyte transplantation (CMT) is an effective treatment for stable vitiligo, but the current method is time consuming and expensive because of the requirement of a large number of melanocytes. Objective To assess the clinical effect of low-density CMT combined with narrowband ultraviolet B (NB-UVB) in treating stable vitiligo. Materials and methods The authors treated 8 patients with CMT at a low cell density (less than 2.5 × 10 cells/cm). Among them, 6 patients underwent NB-UVB therapy after CMT. Results All the 6 patients treated with low-density CMT combined with NB-UVB obtained more than 90% repigmentation at the 1-year follow-up. Conclusion The authors' data suggest that low-density CMT combined with NB-UVB can be an effective form of surgical treatment for stable vitiligo.

Background and Design: Pentraxin 3 (PTX 3), an acute phase protein, plays an important role in activation of innate immunity and in the regulation of inflammatory reactions. Thus, considering the importance of PTX 3 in immune and inflammatory responses, it has been suggested that PTX 3 may play a role in the pathogenesis of psoriasis. The aim of this study was to evaluate plasma PTX 3 levels in patients with psoriasis and their relationship with the disease severity and the effect of narrowband ultraviolet B (nbUVB) therapy on PTX 3 levels. Materials and Methods: The study comprised 40 patients with psoriasis and 88 age-and sex-matched healthy controls. Dermatological examinations and psoriasis area severity index (PASI) were performed. The patients received 20 courses of nbUVB therapy with a mean value of 13 joule/cm2. The efficacy of nbUVB was evaluated using PASI scores. Plasma PTX 3 levels in the patient group were measured before and after therapy by sandwich enzyme-linked immunosorbent assay in patients with the diagnosis of psoriasis and were compared with that in the control group. Results: The mean plasma PTX3 level in the patient group (1.24±0.83) was statistically significantly increased compared to that in the control group (0.55±0.26) (p0.05). Conclusion: We found that plasma PTX3 levels that are increased in patients with psoriasis were not correlated with disease severity and that they significantly decreased after nbUVB therapy.

Background: Phototherapy is one of the most effective treatment options in vitiligo. Targeted phototherapy devices are becoming more popular as they offer a lot of advantages over the conventional whole-body phototherapy units. Aims and Objectives: The present study was conducted to assess the efficacy and safety of a targeted narrowband ultraviolet B (NBUVB) device in vitiligo. Materials and Methods: A total of 40 patients of vitiligo were treated with a targeted NBUVB device twice-weekly for a maximum of 30 sessions or until 100% repigmentation, whichever was reached first. The extent of repigmentation achieved was assessed and adverse effects, if any, were also noted down. Results: There were 31 responders (77.5%) who achieved repigmentation ranging from 50% to 100%. The onset of repigmentation was seen as early as the 3 rd dose in some cases and by the 10 th dose in all responders. A total of 97 lesions were treated out of which 45 lesions (46.6%) achieved 90-100% repigmentation. Lesions showing 75% and 50% repigmentation were 14 and 15 in number respectively. 23 lesions failed to show any significant repigmentation at the end of 30 doses. Best response was seen on the face and neck with 20 of the 31 lesions achieving 90-100% repigmentation in this area. Duration of vitiligo was seen to have no statistically significant impact on the repigmentation achieved. Conclusion: Targeted NBUVB phototherapy seems to be an effective treatment option in localized vitiligo with a rapid onset of repigmentation seen as early as 2 nd week of treatment.

Developed and perfected as a specific treatment for psoriasis, narrowband ultraviolet B (UV-B) therapy entered the clinical practice of dermatology back in the last century, at the beginning of the 1980s. The hindsight afforded by a certain distance allows us to state that the arguments underlying the use of this treatment, that is, a peak close to 311 nm is the ideal UV-B band for the treatment of psoriasis, would prove more than debatable from a strictly scientific standpoint. Thus, the studies on which this paradigm was based had very small samples, and their methodology was not sufficiently rigorous to support such a forceful statement. 1,2 Nevertheless, the history of medicine has occasionally shown that weakness in the concept is compensated by the benefit of experience. Thus, the evidence gathered over a short period proved sufficient to conclude that the old broadband UV-B therapy was surpassed both in efficacy and in ease of use by the then novel narrowband UV-B therapy, at least when the usual TL12 lamps (broadband UV-B) were compared with the TL01 lamps (narrowband UV-B). This nuance will be discussed below. 3 The good results obtained compared to broadband UV-B therapy encouraged phototherapists to consider the new arrival as an interesting and powerful option, capable of challenging the—until then—undisputed psoralen UV-A therapy (or PUVA, that is, psoralens combined with UV-A). For almost 20 years, PUVA was considered the most effective treatment in the moderate and severe forms of psoriasis, not only with respect to other types of phototherapy, but also when compared with the available pharmacologic alternatives. Comparisons aside, and although we could cite methodologic nuances, an assessment of the most rigorous studies has shown some advantage for the old PUVA, in terms both of efficacy and of duration of response, which was longer the more severe the psoriasis. 4 However, this circumstance did not prevent

Objective: To evaluate the effect of NB-UVB therapy on serum levels of 25-hydroxyvitamin D [25(OH)D] in Saudi patients with vitiligo. Method: We estimated the levels of 25-hydroxy vitamin D [25(OH)D] before, and after NB-UVB radiation in patients with vitiligo who did not take vitamin D supplement. A comparison was done between subsets of patients concerning gender and duration of treatment of NB-UVB. Results: There were 39 patients with vitiligo. Females were 22 (56.4%) and males were 17 (43.6%).The mean vitamin D level before NB-UVB treatment was 29.575 ± 16.315 nmol/L. while vitamin D level was increased to 78.871 + 22.776 after treatment with significant differences (P < 0.0001). The males had mean vitamin D level 36.232 ± 19.505 nmol/L, while females had mean vitamin D level 24.431 ± 11.321 nmol/L at baseline. After NB-UVB treatment the males had vitamin D level of 78.888 ± 25.683 nmol/L. While females had mean vitamin D level78.859 ± 20.884 nmol/L. After 6 months of the NB-UVB treatment the delta change in vitamin D level was 38.888 ± 20.255 nmol/L while after 12 - 24 months of treatment with NB-UVB the delta change in vitamin D level was 60.252 ± 17.565 nmol/L (P = 0.001). Conclusion: Patients who received narrow band ultra violet B radiation at wave length 309 nm as treatment of vitiligo are less likely to need vitamin D supplement to correct their vitamin D deficiency. More studies are needed in order to confirm these results and to establish UVB as treatment modalities to correct vitamin D levels in patients who cannot absorb vitamin D either orally or parentally.

Background: Acquired melanocytic nevi (AMN) have been reported to undergo morphological and dermoscopic changes following exposure to narrow-band ultraviolet B (NB-UVB) radiation. Objective: To study the morphological, dermoscopic and immunohistochemical changes in AMN following NB-UVB radiation. Methods: Suberythemogenic NB-UVB sessions were delivered to 40 patients with AMN. For each patient, a minimum of 2 nevi were selected. One nevus was surgically removed from each patient prior to sessions as control; for the other nevus, dermoscopic images were captured before and after NB-UVB sessions. The images were evaluated for changes. At the end, another nevus was surgically removed for immunohistochemical assessment of Ki-67 and melan-A. Results: Our study showed a statistically significant increase in the size of AMN following NB-UVB radiation. Benign dermoscopic changes were observed. Statistically significant positive correlations were found between some dermoscopic findings and the total cumulative dose of NB-UVB. Immunohistochemical analysis did not show any significant change in the exposed AMN. Conclusion: AMN irradiated with repeated suberythemogenic doses of NB-UVB showed benign morphological and dermoscopic changes, and this was confirmed by our immunohistochemical study.

Narrow-band ultraviolet B phototherapy with Philips TL-01 lamps is being used increasingly in the treatment of psoriasis. However, the effectiveness of phototherapy with narrow-band ultraviolet B in different clinical types of psoriasis vulgaris has not yet been evaluated in the literature. In the present study, we aimed to determine the efficacy and safety of narrow-band ultraviolet B therapy for different clinical forms of psoriasis vulgaris in our patient population. In this open study, 53 patients with psoriasis vulgaris, skin types II--IV, were enrolled. The patients were classified as guttate, nummular, plaque, or mixed according to their predominant morphological lesions. Evaluation of therapeutic efficacy was performed by comparing their Psoriasis Area and Severity Index (PASI) scores before and after treatment. The cumulative dose and the number of treatments were also calculated. Side effects were noted during the therapy. With respect to the different types of psoriasis, reductions of the PASI were not significantly different (p>0.05). The mean cumulative dose and total sessions in the plaque-type group were greater than those in the guttate and nummular groups (p

Background: Psoriasis is one of the most common skin diseases in the general population. One of the treatments is narrowband ultraviolet B (NBUVB) therapy. While the efficacy of NBU

Narrow-band ultraviolet B (NB-UVB) therapy is widely used for refractory skin diseases. Targeted phototherapy is now being used to reduce the number of sessions and to avoid exposing normal skin. We developed a targeted NB-UVB therapy using a flat-type lamp emitting a wavelength similar to that of the TL-01 fluorescent lamp. Six Japanese patients with psoriasis were recruited and treated with the flat-type NB-UVB device with an initial dose of 70% of the minimal erythema dose, with a 20% increase at each subsequent session. The plaque severity score was determined. All lesions of the tested patients were responsive to NB-UVB therapy using the flat-type lamp. The mean percent reduction of the lesion was 58.3 ± 17.7%. The mean cumulative dose was 20.8 ± 10.8 J/cm². No side effects were observed during treatment. The flat-type targeted NB-UVB device is compact and convenient, and highly effective for the treatment of limited psoriasis lesions.

Pigmented purpuric dermatoses are a group of dermatoses characterized by petechia and hyperpigmented macules that occur predominantly on the lower extremities. Although it is most commonly seen in adults, this disease can also affect children. Phototherapy has been shown to be effective in some cases in the literature. Here, we present two cases of Schamberg's disease that improved rapidly with narrowband ultraviolet B (UVB) therapy. To our knowledge, they were the first pediatric cases of successful narrowband UVB therapy in this disease.

Background Vitiligo is an acquired skin disorder with great social impact. It can be successfully treated using cultured autologous melanocytes transplantation. Objective To evaluate the effect of different modalities of narrow-band ultraviolet B (NB-UVB) therapy on the outcome of cultured autologous melanocyte transplantation in treating vitiligo. Methods Patients undergoing cultured autologous melanocyte transplantation were randomly assigned to four different study groups. Group 1 underwent 20 sessions of NB-UVB treatment before transplantation; Group 2 underwent 30 sessions of NB-UVB treatment after transplantation; Group 3 underwent 20 sessions of NB-UVB treatment before transplantation and 30 sessions after transplantation; Group 4 underwent only transplantation. Results Four hundred thirty-seven patients were enrolled. Group 3 responded best, more than 90% repigmentation was achieved in 81.3% of patients, and 94.8% patients experienced 50% or greater repigmentation. Statistical analysis showed that there was a highly significant difference between the four groups (χ2 = 35.56, p

Background: Narrowband ultraviolet B (NB-UVB) has been widely used in the treatment of psoriasis. It has been shown that vitamin D is a major regulator of the expression of human antimicrobial peptide cathelicidin LL-37, which has a critical role in inflammatory cascade in psoriasis. Objective: To evaluate the effect of NB-UVB therapy on serum levels of cathelicidin LL-37 and 25-hydroxyvitamin D [25(OH)D] in psoriasis patients. Methods: Ninety-three psoriasis patients and 50 controls were included in the study. For psoriasis patients, serum levels of 25(OH)D and cathelicidin LL-37 were estimated before and after NB-UVB therapy. Results: Before treatment, serum 25(OH)D levels were significantly lower in psoriasis patients (31.5 ± 14.41 nmol/L) compared to controls (53.5 ± 19.6 nmol/L), p = .015. In contrast, serum LL-37 was significantly higher in psoriasis patients (13.24 ± 3.2 ng/mL) than in controls (7.92 ± 5.33 ng/mL), p < .001. After NB-UVB treatment, there was a highly significant elevation of serum 25(OH)D to reach 56.85 ± 5.2 nmol/L ( p < .001) and further elevation of serum LL-37 to reach 29.4 ± 4.2 ( p = .02). Conclusions: The elevation of serum 25(OH)D and cathelicidin LL-37 could be an additional possible mechanism of action of NB-UVB therapy in the treatment of psoriasis.

Objective: To compare the conventional psoralen-ultraviolet A treatment with psoralen-ultraviolet B therapy in the treatment of psoriasis. Methodology: We studied 50 patients of plaque type psoriasis who were selected to receive either conventional psoralen-ultraviolet A or psoralen-ultraviolet B treatment. Results: There was no significant difference between the two treatment groups in the number of patients whose skin cleared of psoriasis or the number of exposures required for clearance. Profile of side effects and disease status was also similar after three months of follow up. Conclusion: Psoralen-ultraviolet B treatment is as effective as conventional psoralen-ultraviolet A in the treatment of psoriasis. Further long term studies are needed to assess the safety of psoralen-ultraviolet B.

Background. There is raised interest in the involvement of interleukin-(IL-)23/T-helper 17 cells (Th17) axis in the pathogenesis of psoriasis. Objectives. To compare the effect of narrow band ultraviolet B (NB-UVB) and methotrexate (MTX) therapy on serum levels of IL-17 and IL-23 in psoriatic patients. Methods. Thirty patients with severe plaque psoriasis were included: 15 patients received NB-UVB three times weekly (group I) and 15 patients received MTX 0.3 mg/kg per week (group II), both for 8 weeks. Before and after treatment, serum levels of IL-17 and IL-23 were investigated by ELISA technique and psoriasis area and severity index (PASI) was calculated. Results. After treatment, all patients showed a reduction in their PASI score, IL-17 and IL-23 serum levels with a nonsignificant difference between both therapeutic modalities ( value ). A positive correlation was detected between the percent of reduction of IL-17, IL-23 and the percent of reduction of PASI score for patients receiving both treatments. No correlation was found between the percent of reduction of IL-17, IL-23 and duration of disease or age of all patients in this study. Conclusion. Interleukin-17 and IL-23 serum level may serve as a potential biomarker for predicting the prognosis and therapeutic response of NB-UVB or MTX in treating psoriasis.