Comparison of phototherapy two times and four times a week with low doses of narrow-band ultraviolet B in Asian patients with psoriasis

BACKGROUND/AIMS: The optimum narrow-band (TL-01) ultraviolet (UV) B weekly treatment frequency for psoriasis has yet to be defined, especially in Asian patients with TL-01. Our purpose was to compare 2 x weekly and 4 x weekly therapy with narrow-band UVB at low doses for psoriasis vulgaris. METHODS: Sixty-nine patients with moderately severe psoriasis were recruited and allocated to the 2 x weekly or 4 x weekly treatment group. The patients were treated with a new protocol using low doses of narrow-band UVB with varied exposure increments. Outcomes were evaluated by means of Psoriasis Area and Severity Index (PASI) scores, time (weeks), cumulative UVB dose and number of treatments to clearance. RESULTS: No significant difference was found between the two regimens in the PASI score at the end of treatment, in the proportion of patients whose skin cleared during treatment and in the time to clearance (8 weeks). Those who completed treatment achieved clearance after a median of 16 exposures with 2 x weekly treatment compared with 32 exposures with 4 x weekly treatment (P=0.0304), and 12.5 minimal erythema dose multiples (MEDs) compared with 39.7 MEDs (P=0.0470). Acute side effects of the treatment were similar for the two groups (P=0.8462). CONCLUSION: For skin phototype III-V populations, a greater long-term risk is expected, connected with the higher cumulative UVB dose and number of exposures required in the 4x weekly group. Therefore, 4 x weekly phototherapy will no longer be used for psoriasis.     

Narrow-band (TL-01) ultraviolet B phototherapy for chronic plaque psoriasis: three times or five times weekly treatment?

Three and five times weekly narrow-band TL-01 (311–313 nm) ultraviolet (UV) B phototherapy regimens for chronic plaque psoriasis were compared in a randomized, observer-blinded, half-body, within-patient paired study. Twenty-one patients [13 men, eight women, age range 21–68 years, skin phototypes I (two patients), II (14) and III (five)] entered the study. Sixteen reached clearance or minimal residual activity (MRA) on both sides. Of the other five, three withdrew because they did not reach clearance or MRA on the 5 × weekly side by a maximum of 30 treatments, one when he was satisfied with moderate improvement and one because of repeated failure to attend. Those who completed treatment reached clearance or MRA after a median of 35 days with 5 × weekly treatment compared with 40 days with 3 × weekly treatment ( P  = 0.007), but required a median of 23.5 compared with 17 UVB exposures ( P  = 0.001) and 94 minimal erythema dose multiples (MEDs) compared with 64 MEDs ( P  = 0.01). Fifteen (of 16) developed at least one episode of well-demarcated erythema during 5 × weekly treatment compared with just three of 16 treated 3 × weekly ( P  < 0.001). There was no significant difference between regimens in duration of remission. For this skin phototype I–III population, the more rapid clearance of psoriasis with 5 × weekly phototherapy is not, for the majority of patients, sufficient to justify the extra exposures and higher UVB dose. We no longer use 5 × weekly phototherapy for psoriasis.     

A randomized controlled trial of narrowband ultraviolet B vs bath-psoralen plus ultraviolet A photochemotherapy for psoriasis

BACKGROUND: In 1991, consensus guidelines recommended psoralen plus ultraviolet A photochemotherapy (PUVA) for those requiring second-line therapy for psoriasis. Narrowband (TL-01) UVB has since become more widely available, replacing the less effective broadband sources. Objectives To compare the efficacy of TL-01 UVB phototherapy and trimethoxypsoralen (TMP) bath-PUVA for chronic plaque psoriasis. PARTICIPANTS AND METHODS: A randomized, observer-masked, intraindividually controlled, paired (half-body) study was done in the Photo(chemo)therapy Unit in Ninewells Hospital and Medical School, Dundee. The study comprised 28 patients (skin phototypes I-III) with chronic plaque psoriasis. Each patient's body halves (sagittal plane) were treated independently, one-half with TL-01 UVB, the other with bath-PUVA. Both treatments were administered according to standard, optimized regimens. Treatment was continued until clearance or minimal residual activity (MRA), or a maximum of 30 treatments. The main outcome measures were treatments and time to clearance/MRA, the proportion reaching clearance/MRA, change in psoriasis severity score (scaling, erythema and induration) and remission durations. RESULTS: Of 18 who completed the study, all reached clearance/MRA with TL-01, but three were still not clear after 30 PUVA exposures. TL-01 achieved clearance/MRA a median of 11 (6.5-25; P = 0.001) days more quickly than PUVA, but required a median of 24.5 compared with 19 exposures [95% confidence interval (CI) for difference 1.5-5.5; P = 0.01]. Ten patients were withdrawn (four because of inadequate response of PUVA-treated halves). Analysed on an intention-to-treat basis, 21 of 28 (75%) of all participants reached clearance/MRA with TL-01 compared with 15 of 28 (54%) with PUVA (95% CI for difference 4-37%; P = 0.03). Remission durations did not differ. CONCLUSIONS: When administered according to these regimens in a skin phototype I-III population, TL-01 UVB is more efficacious than TMP bath-PUVA in the treatment of chronic plaque psoriasis.     

A randomized comparison of selective broadband UVB and narrowband UVB in the treatment of psoriasis

UVB is widely used to treat psoriasis. Conventional broadband UVB lamps are less effective than narrowband UVB lamps, which have an emission peak at 311 nm. The long-term safety of narrowband UVB phototherapy is uncertain. "Selective" broadband UVB lamps, which have little emission <290 nm, are also available, but have not been adequately compared to narrowband UVB lamps. We performed a randomized comparison of narrowband UVB (TL-01 lamps) and selective broadband UVB (UV6 lamps) in 100 patients with psoriasis. The median number of exposures for clearance was 28.4 for TL-01 and 30.4 for UV6 (ratio of the medians 0.93; 95% confidence interval (CI) 0.80, 1.09; P=0.39). No significant difference was found in the proportion of patients achieving clearance: TL-01 56%, UV6 40% (odds ratio for clearance with TL-01 relative to UV6 was 2.00 (95% CI 0.87, 4.62), P=0.10). Side effects, including the development of erythema during phototherapy, were similar for the two lamp types. Risk estimates based on the human photocarcinogenesis action spectrum predict that narrowband UVB lamps will be 50% more carcinogenic for equal erythemal doses than selective broadband lamps (UV6). As these two lamp types appear to be of similar efficacy, phototherapy using a selective broadband source may be a safer option than use of narrowband UVB.     

Half-side comparison study on the efficacy of 8-methoxypsoralen bath-PUVA versus narrow-band ultraviolet B phototherapy in patients with severe chronic atopic dermatitis

In patients with severe chronic atopic dermatitis (AD), both photochemotherapy [psoralen ultraviolet A (PUVA)] and narrow-band (TL-01) UV B phototherapy have been reported to be very effective. As no data exist on the relative therapeutic efficacy of these two regimens, we performed a randomized investigator-blinded half-side comparison study on 12 patients with severe chronic AD. Half-side irradiation with threshold erythemogenic doses of 8-methoxypsoralen bath-PUVA and narrow-band UVB was performed three times weekly over a period of 6 weeks. The severity of the disease was assessed separately for the paired halves of the patients' bodies by a modified SCORAD score at baseline and after 2, 4 and 6 weeks of treatment. Ten of the 12 patients completed the trial. All but one showed marked improvement or complete remission with both treatments. The mean baseline SCORAD score decreased by 65.7% by the bath-PUVA treatment and by 64.1% by the narrow-band UVB treatment (P = 0.48). No serious adverse reactions to either of the two regimens were observed. Our data confirm the high efficacy of bath-PUVA and narrow-band UVB phototherapy in the treatment of patients with chronic severe AD. Both regimens appear to be equally effective when administered in equi-erythemogenic doses.     

Modulation of ultraviolet (UV) transmission by emollients: relevance to narrowband UVB phototherapy and psoralen plus UVA photochemotherapy

BACKGROUND: Patients with psoriasis undergoing or about to undergo ultraviolet (UV) phototherapy and photochemotherapy often have thick scale on their plaques which can prevent the penetration of UV radiation. Emollients are used to moisturize the skin and to prevent or reduce some of the milder side-effects ('dryness', itching) sometimes experienced during UV therapy. However, emollients can alter the UV transmission of skin and thus may alter the clinical effects of phototherapy and photochemotherapy. OBJECTIVES: We tested 30 of the topical emollients in the British National Formulary (BNF) using a standard in vitro technique used to test sunscreens. We also surveyed U.K. phototherapy units to establish routine practice for emollient use in phototherapy and photochemotherapy. METHODS: We used a standard in vitro technique to measure the monochromatic protection factors (MPFs) of 30 non-bath emollients from the BNF. An application rate of 2 mg cm-2 was used. For the assessment of effects during narrowband UVB (TL-01) phototherapy, the mean of the protection factors at 310 and 315 nm was calculated; for psoralen plus UVA photochemotherapy the mean UVA protection factor was used. A questionnaire survey was used to assess routine practice concerning emollient use prior to phototherapies in phototherapy units throughout the U.K. RESULTS: In the UVA range, 17 of the 30 emollients gave protection factors of 1.2 or above. In the UVB range, 23 of 30 had an MPF of 1.2 or above. Yellow soft paraffin had the highest protection factor in the UVB range. Of 78 centres surveyed, 57 returned completed questionnaires (73%). Seventeen of 57 (30%) centres routinely used emollients immediately prior to administering phototherapy treatments. The remaining 40 of 57 (70%) did not. Forty-five (79%) responding centres recommended the use of emollients after phototherapy. CONCLUSIONS: This study has revealed considerable variability in the practice of emollient use before phototherapy treatments. Although the majority of centres included in this study did not routinely use emollients, almost one third did. Our in vitro measurement of 30 emollients revealed marked variation in UV transmission, with many emollients blocking sufficient UV to affect the response to therapy.     

Taking treatment to the patient: development of a home TL-01 ultraviolet B phototherapy service

BACKGROUND: While most patients requiring phototherapy can attend for hospital-based out-patient ultraviolet (UV) B therapy, a significant number cannot attend because of geographical, work, economic and other reasons. OBJECTIVES: To determine whether there was a need for home phototherapy in the Tayside area and, if so, to establish protocols and then to assess if such a service would be workable. METHODS: Patients referred from dermatology out-patient clinics in Tayside for narrow-band UVB (TL-01) phototherapy completed a pilot questionnaire that was followed by a two-phase project. In phase 1, patients with psoriasis were trained to use the home phototherapy equipment (HoPE) within the hospital department under nursing supervision while a teaching package and protocols were developed. In phase 2, home phototherapy was made available for patient use in the community, supported by a specialist home phototherapy nurse. Waldmann UV100 home therapy units were used, with accurate dosimetry. Detailed treatment records were kept and questionnaires were used to assess acceptability and costs of therapy. RESULTS: Fifty-two pilot questionnaires were completed. Forty-two per cent of respondents found hospital phototherapy inconvenient and 75% felt phototherapy at home would be helpful. In phase 1, seven of 10 patients trained to use the HoPE completed therapy with the HoPE unit alone, reaching minimal residual activity (MRA) or clearance in a median of 18 exposures (median dose 10.38 J cm-2). In phase 2, 32 courses of home phototherapy were given to 30 patients. Of 23 with psoriasis, 18 reached clearance or MRA in a median of 22.5 exposures (median dose 9.84 J cm-2). Although self-reported erythema rates appeared higher than expected, all post-treatment questionnaire respondents would choose home phototherapy over hospital therapy if required in the future. CONCLUSIONS: UVB (TL-01) home phototherapy is a useful practical development that has fulfilled a need in our catchment area. Where appropriate training and support teams are available it appears to be similar in effectiveness to hospital therapy, to be safe and to be cost-effective for patients.     

Evaluation of vaseline oil applied prior to UVB TL01 phototherapy in the treatment of psoriasis

BACKGROUND: Use of emollient prior to phototherapy could enhance UV transmission through psoriasis plaques on the condition that the emollient is not photoprotective. Emollient pretreatment with narrow-band phototherapy (313 nm) has not been studied extensively. We conducted a study to assess if vaseline oil prior to UVB TL01, in chronic psoriasis plaques could accelerate psoriasis clearance. METHODS: Fifteen patients with chronic psoriasis plaques were enrolled in a prospective, single-blind, controlled study. For each patient, one to three symmetrical pairs of plaque were selected and scored initially and after every six exposures. RESULTS: On the vaseline oil pretreated side, significantly more plaques were cleared, especially in severe psoriasis. Scaling and infiltration were significantly improved. Application of vaseline oil was more interesting in thick and scaly psoriasis probably because the oil penetrates the intercellular space allowing an optical matching effect which increases the UV transmission. CONCLUSION: We strongly recommend vaseline oil pretreatment with UVB TL01 phototherapy in psoriasis, especially in severe psoriasis.     

Narrowband UV-B (TL-01) phototherapy vs oral 8-methoxypsoralen psoralen-UV-A for the treatment of chronic plaque psoriasis

OBJECTIVE: To compare the efficacy of narrowband UV-B (TL-01) phototherapy with oral 8-methoxypsoralen photochemotherapy (8-MOP psoralen-UV-A [PUVA]) in patients with chronic plaque psoriasis (CPP). DESIGN: Open, randomized, controlled study. SETTING: Phototherapy unit in a dermatology hospital. PATIENTS: Fifty-four patients with CCP. INTERVENTIONS: Patients received whole-body threshold erythemogenic dose of either 3-times weekly TL-01 or twice-weekly oral 8-MOP PUVA, based on minimal erythema or phototoxic doses. Patients were treated until completely clear. OUTCOME MEASURES: Number of treatments to clear, number of days in treatment, number of days in remission, and adverse effects of both therapies were assessed. RESULTS: Forty-five patients completed the study. Those in the PUVA group required significantly fewer treatments to clear (P =.03). There was no significant difference in the number of days to clear or number of days in remission. A similar percentage of patients in the TL-01 and PUVA groups developed minimal perceptible erythema, showing that the regimens were equally erythemogenic. Asymptomatic, well-defined erythema occurred only in the PUVA group. Pruritus and polymorphic light eruption occurred equally in both groups, but only patients in the PUVA group developed nausea. CONCLUSION: Narrowband UV-B phototherapy, used 3 times weekly, is as effective for the treatment of CPP as oral 8-MOP PUVA used twice weekly.     

Narrowband UVB phototherapy for the treatment of psoriasis: a review and update.

An advance in UVB-based phototherapy has been the introduction of fluorescent lightbulbs (Philips TL-01) that deliver monochromatic light at 311-nm UVB, a narrowband wavelength that seems to maximize clearing of plaques relative to its erythrogenic potential. Narrowband UVB phototherapy has considerable advantages over traditional treatment options such as broadband UVB and psoralen plus UVA (PUVA). It is clearly more effective than broadband UVB, safer than PUVA, and well tolerated by patients when taken at suberythemogenic doses. Narrowband UVB represents an important new therapy for psoriasis.     

A comparison of the efficacy and relapse rates of narrowband UNV (TL-01) monotherapy vs. etretinate (re-TL-01) vs. etretinate-PUVA (re-PUVA) in the treatment of psoriasis patients

Forty-five patients with extensive chronic plaque or guttate psoriasis were treated with either narrowband (TL-01) phototherapy, etretinate TL-01 combination therapy (re-TL-01) or etretinate and PUVA (re-PUVA) (15 patients in each group). Re-PUVA was the most effective therapy with 100% satisfactory clearance rate. TL-01 monotherapy had an 80% success rate; the relapse rate compared favourably with re-PUVA (50% in remission after 6 months). In the etretinate-TL-01 group, there was a 93% success rate and a one-third reduction in the total irradiation dose (8.0 J/cm2 vs. 12.7 J/cm2) but the relapse rate was higher, only 33% remaining in remission after 6 months.     

Narrow-band (TL-01) UVB air-conditioned phototherapy for chronic severe adult atopic dermatitis

In an open study of 21 severely affected adult atopic dermatitis patients, air-conditioned narrow-band UVB phototherapy using the Philips TL-01 lamp three times weekly for 12 weeks resulted in a 68% reduction in atopic dermatitis severity scores, with a concomitant 88% reduction in potent topical steroid use.
Follow-up at 24 weeks revealed that six patients had relapsed to >70% of pre-phototherapy severity scores; the remaining 15 continued to derive long-term benefit. The mean value of potent topical steroid use remained 50% below pre-phototherapy needs.
Narrow-band UVB (TL-01) phototherapy appears an effective, steroid-sparing treatment for chronic severe atopic dermatitis, offering long-term benefits in the majority of those treated.     

Narrow-band UVB (TL-01) phototherapy: an effective preventative treatment for the photodermatoses

Summary Twenty patients with photodermatoses [actinic prurigo n=6), hydroa vacciniforme (n=4). idiopathic solar urticaria (n=1), amiodarone-induced photosensitivity (n=1) and a range of cutaneous porphyrias (n=8)] were treated with a ‘hardening’ course of narrow-band ultraviolet B (TL-01) phototherapy in springtime. The response to phototherapy was monitored subjectively, by interviewing patients after the summer, and objectively by monochromator phototesting, before and after phototherapy. Fifteen patients reported that treatment was worthwhile. Monochromator phototesting after phototherapy revealed a fourfold increase in the minimal erythema dose in those with abnormal photosensitivity to ultraviolet A wavebands. Adverse effects included erythema (seven patients), pruritus (five) and provocation of the eruption (four). We now routinely consider narrow-band UVB phototherapy for problem photodermatoses.     

Itch and scratching as predictors of time to clearance of psoriasis with narrow-band ultraviolet B therapy

Background  Narrow-band ultraviolet (UV) B phototherapy is an effective treatment for psoriasis. However, there is considerable variability in the number of treatment sessions needed to achieve psoriasis clearance. While several clinical and treatment-related factors predict time to clearance, the effect of itching and scratching on the number of irradiation sessions is insufficiently understood.
Objective  Predictors of the time to clearance were assessed in patients with psoriasis who were referred for UVB treatment in a randomized double-blind comparison of irradiation regimens for UVB phototherapy.
Methods  After randomization to either UVB irradiation with a suberythematogenic or an erythematogenic regimen, patients were irradiated with 20% and 40% incremental doses, respectively, three times weekly. The Psoriasis Area and Severity Index (PASI) score was measured at baseline and every 4 weeks, and itching and habitual scratching were measured at baseline.
Results  Among the 77 patients who achieved psoriasis clearance (90% reduction of PASI), itching and scratching were correlated with the number of irradiation sessions needed to achieve clearance, with higher levels of itch and scratching predicting more sessions. These effects remained significant after controlling for the initial PASI score, irradiation schemes, minimal erythema dose (MED), skin type, cumulative dose, protocol adjustments and lifestyle factors (smoking habits and alcohol consumption).
Conclusions  Patients with higher levels of itch and scratching need more irradiation sessions to achieve clearance of psoriasis with UVB phototherapy. Systematic assessment of the severity of itch and scratching, followed by short-term itch-coping programmes for patients at risk, might be a cost-effective, adjunct to UVB therapy.     

Effects of phototherapy on the production of cytokines by peripheral blood mononuclear cells and on systemic antibody responses in patients with psoriasis

Exposure to ultraviolet B (UVB) radiation results in the suppression of many cell-mediated immune responses, and recent studies using mice and murine cells in vitro suggest a shift from a T-helper 1 (Th1) to a Th2 type of response on irradiation. Active psoriasis is considered to be a Th1-type disorder, chiefly on the basis of the cytokines produced by inflammatory cells in psoriatic lesions. We investigated the effect of phototherapy in patients with psoriasis on the cytokine profile of mitogen-stimulated mononuclear cells from peripheral blood and the concentration of IgG subclasses and IgE in the plasma. Eight patients were irradiated with a broad-band UV source (Sylvania UV6; 280–400 nm) three times a week and another eight with a narrow-band UVB source (Philips TL-01; 311–313 nm). Peripheral blood was collected before therapy started and after 1–4 weeks of therapy. Peripheral blood mononuclear cells were stimulated in vitro with phytohemagglutinin; proliferation was measured by incorporation of tritiated thymidine and culture supernatants assayed for interleukin (IL)?2, ?4 and ?10 and γ-interferon (IFN) by enzyme-linked immunosorbent assays. Lymphoproliferation was not consistently affected by 4 weeks of UV6 therapy, and there was also no consistent change in the production of IL-2, IL-10 or γ-IFN. In contrast, 4 weeks of TL-01 therapy significantly suppressed lymphoproliferative responses. In addition the production of IL-2, IL-10 and γ-IFN was lowered after 1 week of TL-01 therapy, and this was even more apparent after the treatment had been extended to 4 weeks. IL-4 concentrations were below detectable levels in all the samples throughout the study. The amounts of IgG1, ?2, ?3 and ?4 and IgE in the plasma of the patients did not vary with either of the two phototherapies. Thus, although no evidence was obtained to indicate that UV6 exposure affected T-helper subsets in psoriasis, TL-01 inhibited the activity of both Th1 and Th2 subsets while not altering plasma antibody concentrations.     

Comparison of narrow-band UV-B phototherapy and PUVA photochemotherapy in the treatment of psoriasis

The therapeutic effectiveness of a new fluorescent lamp, Philips TL-01, which emits a narrow peak around 311-312 nm, was compared with the currently used PUVA photochemotherapy consisting of oral 8-MOP followed 2 h later by UV-A from fluorescent lamps Philips TL-09. Comparisons of therapeutic efficacy were performed in 10 patients with widespread, symmetrically distributed psoriasis lesions. They received treatment with PUVA on one half of the body and with TL-01 light on the other half; both treatments were given twice a week. It is concluded that on the average phototherapy with narrow-band UV-B is an effective as PUVA; it is certainly more convenient and probably less carcinogenic.     

Clinical effect of vitamin D3 analogues is not inactivated by subsequent UV exposure

BACKGROUND: Combining phototherapy with topical vitamin D3 analogues is a useful therapy for the treatment of psoriasis by reducing the cumulative UV dose required for clearance of lesions. Experimental investigations demonstrated that calcipotriol is degraded by UV radiation, and suggested that calcipotriol should be applied after phototherapy but not immediately before. METHODS: Calcipotriol or maxacalcitol ointment was topically applied to psoriatic plaques of six patients immediately before or after phototherapy on the right or left side of the body, respectively. RESULTS: Topical application of vitamin D3 analogues either before or after irradiation by psoralen and UVA radiation (PUVA) or narrow-band (NB)-UVB showed exactly similar effects in all patients. CONCLUSION: Therapeutic effects of vitamin D3 analogues are not clinically inactivated by subsequent irradiation with PUVA or NB-UVB phototherapy.     

UVABA therapy for psoriasis. Efficacy with shortened treatment times with the combined use of coal tar, anthralin, and metal halide ultraviolet machines

Rapid clearing of psoriasis in a psoriasis treatment center setting has been obtained with a combination of short-contact coal tar, phototherapy from high-pressure metal halide lamps (consisting of UVA and UVB), and short-contact high-potency anthralin therapy. These intensive 1 1/2- to 2-hour treatment sessions done three or four times weekly were as efficacious as reported responses to PUVA therapy or conventional psoriasis day care therapy. The treatment schedule allows minimal time away from work, decreased hours per week in contact with crude coal tar, shortened UV treatment times, decreased cost, and a low risk of side effects. It is suggested that the use of UVA and UVB combined with anthralin (UVABA) is effective for many patients with moderate to severe psoriasis.     

Quantitative assessment of narrow-band UVB induced tanning during phototherapy in Korea

BACKGROUND/PURPOSE: Narrow-band (TL-01) UVB lamps are being increasingly used for phototherapy of psoriasis and other dermatoses, for their excellent effect compared with broad-band UVB sources. Many patients receiving phototherapy have complained about the tanning effect of ultraviolet radiation especially in dark-skinned ones. So we wished to know the degree of pigmentation induced by phototherapy during narrow-band UVB treatment. METHODS: A total of 20 psoriasis patients receiving narrow-band UVB phototherapy were included in this study. A Minolta spectrophotometer CM-2002 was used to measure pigmentation. All patients were evaluated for skin color every seventh day for 7 weeks. The L* value (luminance) gives information about the relative lightness ranging from total black to pure white. The a* value represents the balance between red and green, and the b* value between yellow and blue. RESULTS: The L* values which indicate luminance decreased continuously until the 5th week, when maximum tanning was obtained. Afterwards minimal change was observed until the 7th week. The change of a* and b* values also showed the pattern that was compatible with the above results. The mean individual typology angle of our subjects was 41.9 degrees, which indicated they fell into "light" group of constitutional skin color category. CONCLUSION: From this study, we found that pigmentation induced by narrow-band UVB phototherapy increased continuously until the 5th week and then did not progress. Our results provide standard data of skin pigmentation during narrow-band UVB phototherapy in Korean brown skin.     

A comparison of narrow band phototherapy (TL-01) and photochemotherapy (PUVA) in the management of polymorphic light eruption

Twenty-five patients suffering from severe polymorphic light eruption (PLE) were randomized to either photochemotherapy (PUVA) or narrow-band phototherapy (TL-Ol UVB) treatment in early spring; patients receiving UVB were given placebo tablets to achieve a matching therapy procedure. During the 4 months following treatment, patient exposure to solar UVB was monitored with polysulphone badges. PLE occurrence, severity, and restriction of outdoor activity were recorded, using weekly diary-sheets. Analysis of covariance on this data, using the logarithm of UVB exposure as the explanatory variable, showed no significant differences between the treatments. TL–01 UVB is an effective alternative to PUVA in the management of PLE.