窄谱UVB和宽谱UVB的光疗比较

波长280—320nm的紫外线辐射光疗对于许多疾病是安全有效的治疗。除了标准的宽谱中波紫外线外，用发射311nm几乎单色紫外线的荧光灯进行的窄谱光疗已经成为一些疾病的重要治疗措施，如银屑病、特应性皮炎和白癜风等。除了这些适应证外，窄谱中波紫外线光疗报道有效的疾病数量正在增多。     

窄谱中波紫外线治疗白癜风

白癜风是一种常见的色素脱失性疾病,应用窄谱中波紫外线治疗有一定疗效.比较单独应用窄谱中波紫外线、窄谱中波紫外线联合其他药物的临床疗效及不良反应.窄谱中波紫外线是治疗成人或儿童泛发性白癜风以及严重影响患者生活质量的限局性白癜风安全有效的方法;尤其对于肤色较深患者及面颈部的皮损,疗效更佳.对于窄谱中波紫外线联合其他药物的利弊及长期应用的风险,需要进一步评估.     

窄谱UVB治疗白癜风38例疗效观察

我们自2003年8月～2004年12月应用窄谱中波紫外线（窄谱UVB）光疗仪治疗38例白癜风患者，取得满意疗效，现报道如下。     

窄谱中波紫外线光疗联合阿昔洛韦治疗带状疱疹疗效观察

目的观察窄谱中波紫外线(NBUVB)光疗联合阿昔洛韦治疗带状疱疹的效果。方法用窄谱中波紫外线光疗联合阿昔洛韦治疗54例带状疱疹,并与单用阿昔洛韦治疗的对照组比较。结果治疗组在皮疹愈合、止痛及结痂时间比对照组明显缩短(P<0.01),带状疱疹后遗神经痛发生率比对照组明显减少(P<0.05)。结论用窄谱中波紫外线光疗联合阿昔洛韦治疗带状疱疹起效快,疗程短,疗效显著。     

窄谱中波紫外线治疗白癜风102例疗效观察

目的:探讨窄谱中波紫外线照射治疗白癜风的临床疗效.方法:采用ss-03型紫外线光疗仪对102例白癜风患者进行局部照射治疗2-3个疗程,对白癜风部位的色素生长情况进行评价.结果:痊愈19例,显效64例,好转18例,无效1例,总有效率为81.38%.局限型、散发型、泛发型、肢端型的总有效率分别为96.43%、73.08%、0、55.56%.结论:窄谱中波紫外线照射治疗白癜风疗效确切,色素生长快,是临床上治疗白癜风的一种安全有效的方法.     

参地冲剂联合窄谱中波紫外线治疗血热型银屑病疗效观察

目的观察参地冲剂联合窄谱中波紫外线治疗血热型银屑病的疗效和安全性。方法将159例符合条件的患者随机分为3组，联合治疗组患者按要求服用参地冲剂合用窄谱中波紫外线光疗；参地冲剂组患者服用参地冲剂；窄谱中波紫外线治疗组用窄谱中波紫外线光疗；治疗3个月后观察疗效以及不良反应，治疗结束后1年观察复发情况。结果参地冲剂联合窄谱中波紫外线治疗组治疗有效率为81．13％，1年后复发率为16．32％；窄谱中波紫外线治疗组有效率为52．83％；1年后复发率为68．88％；参地冲剂组有效率为47．6％，1年后复发率为53．19％。参地冲剂联合窄谱中波紫外线治疗组有效率均优于其他两组；1年后复发率均低于其他两组（P〈0．01）；三组患者治疗过程中不良反应轻微。结论参地冲剂联合窄谱中波紫外线治疗治疗血热型银屑病疗效确切，复发率低，毒副作用作用小，值得临床推广。     

窄谱中波紫外线治疗皮肤病的作用机制

窄谱中波紫外线为近年来治疗皮肤病应用较为广泛的紫外线，经临床证实对银屑病、白癜风、特应性皮炎、瘙痒症及其他炎症性皮肤病有显著疗效且安全性好。治疗机制可能与其较强的穿透性、抑制免疫系统作用及调节各种细胞因子和炎症介质的平衡等有关。对窄谱中波紫外线治疗上述皮肤病的可能作用机制作一综述。     

中药驱虫斑鸠菊和白灵联合窄谱中波紫外线治疗白癜风临床观察

目的：观察驱虫斑鸠菊和白灵联合窄谱中波紫外线治疗白癜风的疗效。方法：将病人随机分成3组,治疗12周后统计疗效。结果：三种方法联合治疗组和对照组比较差异有统计学意义。结论：采用驱虫斑鸠菊和白灵联合窄谱中波紫外线治疗白癜风的效果优于驱虫斑鸠菊、白灵分别联合窄谱中波紫外线治疗白癜风的效果,值得临床推广。     

窄谱中波紫外线联合卤米松乳膏治疗白癜风疗效观察及护理

目的:观察窄谱中波紫外线( NB - UVB)联合卤米松孔膏治疗白癜风的临床疗效及护理.方法:应用窄谱中波紫外线局部照射,同时联合卤米松乳膏外用治疗47例白癜风患者,连续治疗3个月,治疗结束后评价疗效和安全性.结果:47例患者中痊愈11例,显效26例,有效率为78.7％,显著高于对照组(44.5％),且无明显的不良反应.结论:窄谱中波紫外线局部照射联合卤米松乳膏外用治疗白癜风安全有效,操作简便,易于临床推广.     

窄谱UVB联合藜脂白癜风丸治疗白癜风临床观察

白癜风是一种以局限性或泛发性皮肤色素脱失为特征的难治性疾病,病因未明,治疗效果欠佳.我们于2005年5月～2007年5月应用窄谱中波紫外线(窄谱UVB)光疗仪和自制剂藜脂白癜风丸治疗60例白癜风患者,取得满意疗效,现报道如下.     

Phototherapy for the Treatment of Vitiligo in Asian Children

Vitiligo is a common acquired progressive depigmenting condition that can have devastating psychological effects in dark‐skinned patients. We performed a retrospective review of patients younger than 16 years of age with a clinical diagnosis of vitiligo treated using phototherapy at the National Skin Center, Singapore, over a 5‐year period. Seventy‐one Asian patients ages 5 to 15 years when they underwent phototherapy were identified. There was a higher proportion of Indian patients in our cohort than in the population. The duration of disease ranged from 2 months to 12 years. More than half of the patients had generalized vitiligo and more than one‐third had segmental vitiligo. Patients with generalized vitiligo had a better response than those with segmental vitiligo. Reported response rates were highest for narrowband ultraviolet B (UVB) phototherapy, followed by targeted phototherapy combining ultraviolet A1 (UVA1) and UVB; 308‐nm excimer lamp phototherapy and paint psoralen–UVA photochemotherapy had marginally lower reported response rates. The duration of treatment ranged from 3 to 40 months and the total number of treatments ranged from 20 to 209 sessions. Reported side effects were mild and included itching, scaling, erythema, pain, sunburn, blistering, and phototoxicity. We consider phototherapy to be a safe and efficacious modality for the treatment of vitiligo in Asian children.     

308 nm准分子激光治疗白癜风的现状

白癜风的治疗仍是皮肤科医生面临的一大难题。光疗作为有效、安全的治疗手段,在白癜风治疗中的应用正在逐步推广。308nm准分子激光治疗白癜风快速有效、不良反应少。联合其他治疗方法可提高紫外线抵抗区的疗效。为此,综述308nm准分子激光治疗白癜风的新进展,以供临床参考。     

Quality of life in vitiligo patients after treatment with long-term narrowband ultraviolet B phototherapy

Long-term treatments for chronic diseases such as vitiligo need to be evaluated for their clinical efficacy. Assessment of the quality of life (QOL), however, may provide the most relevant information on the actual benefit for these patients. In this study we evaluated QOL after long-term narrowband ultraviolet (UV) B for the treatment of vitiligo. All patients, with long-term stable vitiligo vulgaris, who were treated at our clinic during the last 4 years received specifically for this study a designed QOL questionnaire, which included questions about general well-being, camouflage and psychosocial aspects; 71.4% of the patients responded. Most patients indicated an improvement on a psychological level, but an increase in camouflaging. The present study shows that, after long-term narrowband UVB phototherapy, skin appearance does not play a major role in the life of vitiligo patients, while well being only improved in a minority of patients.     

Vitiligo: new and emerging treatments

ABSTRACT:  Vitiligo is a cosmetically disfiguring condition, and, although there is no therapeutic full solution yet, some treatment may induce good results in most patients. The disease can be successfully treated with various medical options. Both nonfocused or focused narrowband ultraviolet B phototherapy represents the current treatment of choice, to minimize side effects and reach optimal clinical results. Topical novel approaches are also considered. Surgical methods, consisting of autologous transplantation methods, is generally recommended for focal/stable vitiligo, after medical therapy has failed. Finally, for patients with extensive vitiligo, depigmentation of the residual melanin should be taken into account.     

Review of narrowband ultraviolet B radiation in vitiligo

Vitiligo is a common, acquired pigmentary disorder of unknown etiology with great impact on patient’s appearance and quality of life. It presents a therapeutic challenge to many dermatologists. Photochemotherapy using psoralen and ultraviolet A (UVA) therapy, topical and oral immunosuppresants, as well as cosmetic camouflage are also commonly employed with varying clinical efficacy. Phototherapy is a popular treatment option, which includes both of the generalized ultraviolet B (UVB) therapies, broadband UVB and narrowband UVB (NB-UVB). It has been used favorably, both alone as well as in combination with other agents like topical calcineurin inhibitors, vitamin-D analogs. Combination therapies are useful and may provide quicker regimentation and treat vitiligo with an additive mechanism of action than UVB phototherapy. Advances in technology may lead to the continuing use of UVB phototherapy as a treatment for vitiligo through the development of sophisticated devices and delivery systems as well as innovative application methods. These will provide increased therapeutic options for all vitiligo patients, particularly those with refractory disease. In this article, I have reviewed the available data pertaining to efficacy and safety issues for NB-UVB as monotherapy, its comparison with psoralen plus UVA and other modes of phototherapy, combination regimens that have been tried and future prospects of NB-UVB in vitiligo.     

Triple combination treatment with fractional CO2 laser plus topical betamethasone solution and narrowband ultraviolet B for refractory vitiligo: a prospective,randomized half‐body,comparative study

Vitiligo on extremities and/or bony prominences is very resistant to treatment. Twenty‐five patients with symmetrical and stable vitiligo on extremities and/or bony prominences were enrolled. The treatment side received fractional carbon dioxide laser followed by topical compound betamethasone solution and narrowband ultraviolet B phototherapy. The control side received laser treatment plus phototherapy. The result of treatment side showed that 44% patients achieved over 50% re‐pigmentation and patient satisfaction score was 5.12 ± 3.23, higher than those of control (p < 0.05). Adverse events were slight and tolerable. The triple combination treatment could be used as an alternative modality for refractory vitiligo.     

Comparison between 308-nm monochromatic excimer light and narrowband UVB phototherapy (311–313 nm) in the treatment of vitiligo – a multicentre controlled study

BACKGROUND: Vitiligo is an acquired pigmentary disorder characterized by areas of depigmented skin resulting from loss of epidermal melanocytes. Recently, it has been shown that narrowband ultraviolet B (NB-UVB) phototherapy may be more effective than psoralen and ultraviolet A (PUVA) photochemotherapy in treating vitiligo, and that 308-nm monochromatic excimer light (MEL) may present some advantages as compared to NB-UVB for the treatment of vitiligo. AIM The aim of this study was to compare the effectiveness of NB-UVB phototherapy and 308-nm MEL in vitiligo patients. METHODS: The study was done in a randomized, investigator-blinded and half-side comparison design. Twenty-one subjects with symmetrical vitiligo lesions were enrolled in this study. Vitiligo lesions on one body side were treated twice weekly for 6 months with 308-nm MEL, while NB-UVB phototherapy was used to treat lesions on the opposite side. RESULTS: At the end of the study six lesions (37.5%) treated with 308-nm MEL and only one lesion (6%) treated with NB-UVB achieved an excellent repigmentation (score 4) while four lesions (25%) treated with 308-nm MEL and five lesions (31%) treated with NB-UVB showed a good repigmentation (score 3). CONCLUSIONS: It appears that 308-nm MEL is more effective than NB-UVB in treating vitiligo lesions and it induces repigmentation more rapidly.     

The use of Janus kinase inhibitors and narrowband ultraviolet B combination therapy in non-segmental vitiligo

Vitiligo is a depigmentation disorder of the skin that occurs secondary to the destruction of melanocytes by an immune-mediated process. Vitiligo clinically presents with depigmented macules and patches, most commonly on the face, acral sites, and genitalia. It can be characterized as generalized or localized based on distribution. The localized form can be further divided into segmental (linear, band-like, or Blaschkoid) and non-segmental vitiligo. The classical treatment of vitiligo includes topical steroids, pulsed oral steroids in unstable vitiligo, phototherapy, a combination of steroid therapy and phototherapy, surgical grafting, as well as intentional depigmentation therapy in severe cases. However, recent advances in understanding the immune mechanisms implicated in the pathogenesis of vitiligo have led to the use of an FDA-approved topical Janus kinase (JAK) inhibitors for vitiligo. Despite this novel therapy advancement, we recommend the addition of narrowband ultraviolet B (NB-UVB) to JAK inhibitors in patients with extensive and progressive lesions, or those not fully responsive to JAK inhibitor monotherapy.     

Effects of autologous micrografts on stable bilateral vitiligo: A focus on hand lesions

Vitiligo is an autoimmune skin disorder characterized by depigmented patches of the skin associated with, among several factors, dysregulation and death of melanocytes. Currently, the treatment of vitiligo is based both on the arrest of the progression of active disease and on the stimulation of the skin repigmentation. The aim of this study was to assess the effects of autologous micrografts and narrowband ultraviolet B (NBUVB) phototherapy for skin repigmentation of patients with bilateral stable vitiligo. Autologous micrografts are derived from mechanical disaggregation of small pieces of the patient’s own skin, while phototherapy is a strategy treatment already used. Twenty patients with stable bilateral vitiligo were treated, showing a mean percentage rate of 59.1% at baseline. Combined treatment by autologous micrografts and NBUVB was performed only on the lesions of the hands, and the clinical follow up was performed after 3 and 6 months by photographs taken under Wood’s light. After 6 months, we classed 100% of patients as responders. We also reported a mean of repigmentation rate of 36.7% after 3 months and 64.6% after 6 months of treatment. In particular, six of the 20 patients reached a marked repigmentation rate (75–100%), four moderate (51–75%) and 10 mild (26–50%). No adverse effects were observed and no drugs were administrated as co-adjuvant therapy. These results are suggestive of a potential wide use of autologous micrografts associated with NBUVB phototherapy for the treatment of stable vitiligo.     

Novel topical cream delivers safe and effective sunlight therapy for vitiligo by selectively filtering damaging ultraviolet radiation

Numerous studies have demonstrated that natural sunlight therapy at the Dead Sea provides therapeutic efficacy for vitiligo patients on par with artificial broadband and narrowband ultraviolet B (UVB) phototherapy; however, similar treatments at locals at or above sea level fail due to the development of erythema prior to sufficient therapeutic dosage. We conducted a pilot study at sea level to assess the efficacy of a novel topical cream that selectively filters nontherapeutic wavelengths of UVB from natural sunlight and delivers treatment for acrofacial vitiligo. In our pilot study, after an average of 11 weeks of treatment, all patients in the treatment arm responded to therapy. In particular, 28% of the treatment group had 70% surface area repigmentation, 28% had 50% repigmentation, and 44% had 30–40% repigmentation. In contrast, only 10% of the patients in the placebo arm had 20% repigmentation. Our results demonstrate that the novel topical cream can provide a safe and effective alternative to artificial light phototherapy.