Exploring the gaps in the evidence‐based application of narrowband UVB for the treatment of vitiligo

While narrowband ultraviolet light B (NB‐UVB) has become integral to the treatment of diffuse vitiligo, evidence‐based guidelines have been lacking with regard to dosing and administration. This is largely the result of heterogeneous study designs, ambiguous methodologies, disparate dosing strategies, and the use of varied, and somewhat arbitrary, outcome measures. In the absence of prospective trials to address each of these concerns, the available literature regarding the application of NB‐UVB for vitiligo was reviewed and the authors now pose a set of questions to the phototherapy community in an attempt to highlight gaps within our understanding. We aim to stimulate discussion, elicit expert opinion, and identify areas for future research to move toward a unified and safe treatment guideline for patients afflicted by this disease.     

Successful treatment of verruca plana with NB‐UVB: A case report

Verruca plana is a kind of benign proliferative skin disease that generally occurs in exposed parts, but the treatment of warts poses a therapeutic challenge for physicians, as there is no method, among numerous approaches, that has been proven effective for completely curing this disease. We report a case of verruca plana cured by narrow‐band ultraviolet B (NB‐UVB), which provides a new treatment of verruca plana.     

中波紫外线对人角质形成细胞MMP-9 mRNA的影响

目的：研究中波紫外线（UVB）诱导的永生化人角质形成细胞中MMP-9 mRNA的表达,探讨其与UVB照射所致的细胞损伤的关系。方法：绘制细胞生长曲线,采用MTT方法测定UVB照射后细胞的增殖活性,反转录-聚合酶链反应（RT-PCR）方法测定UVB照射后HaCaT细胞中MMP-9 mRNA的表达。结果：UVB照射后,HaCaT细胞的增殖活性受到抑制,MMP-9 mRNA表达增强;随UVB剂量增加,照射组的MMP-9 mRNA表达逐渐增多,与未照光组比较,差异有统计学意义（P〈0.01）。结论：UVB照射可引起HaCaT细胞中MMP-9 mRNA表达显著增加,且与UVB照射剂量呈正相关,与光老化的发生有一定的关系。     

双氢青蒿素对UVB诱导的人皮肤HaCaT细胞凋亡的保护作用

目的:明确双氢青蒿素(DHA)对UVB诱导人皮肤HaCaT细胞凋亡的保护作用。方法:将体外培养的HaCaT细胞分为空白对照组,UVB照射组和UVB+DHA(20、40、60、80μmol/L)组,采用MTT法检测细胞系的增殖情况,流式细胞仪检测细胞的凋亡率,RT-PCR法检测抗凋亡基因survivin和促凋亡基因caspease-3(激活型)mRNA水平,Western检测相关蛋白表达水平。结果:30 mJ/cm~2 UVB照射24 h后,UVB组和UVB+DHA(20、40、60、80μmol/L)组细胞的增殖率分别为空白对照组的(50.13±2.42)%,(60.23±2.30)%,(69.24±3.19)%,(79.37±2.47)%和(70.41±2.24)%。UVB组和UVB+60μmol/L DHA组中HaCaT细胞凋亡率分别为(46.7±3.2)%和(23.71±1.2)%。与UVB组比较,UVB+60μmol/L DHA组中HaCaT细胞caspase-3 mRNA及蛋白表达降低、survivin mRNA及蛋白表达升高。结论:DHA可抑制UVB所致HaCaT细胞的凋亡,其机制可能与survivin和caspase-3有关。     

Notalgia paresthesica successfully treated with narrow‐band UVB: report of five cases

Background Notalgia paresthesica is a disorder of unknown origin characterized by pruritus localized to the patients’ back. Local pain, burning or paresthesias have also been described. No definite treatments have been found for this disorder and most of those reported to date are anecdotal. Topical capsaicin is the option most widely used among dermatologists. Transcutaneous electrical nerve stimulation, gabapentin, oxcarbazepine and botulinum toxin have recently shown promising effects. UVB has been used for decades to treat different pruritic skin diseases, but its benefits in the management of NP have not been stated to date. Objectives To test the effects of UVB in notalgia paresthesica. Methods We used a course of UVB narrow band to treat five patients with notalgia paresthesica. The treatment was administered following a phototype protocol in a UV 7002 cabinet. Results We provide the results of a course of UVB narrow‐band phototherapy in five patients. Phototherapy contributed substantially to improve pruritus in all of them. Conclusion Given the benefits achieved, we stress the interest of UVB narrow‐band as a safe and well tolerated alternative treatment for notalgia paresthetica.     

Phototherapy and photochemotherapy

The treatment of skin diseases with ultraviolet radiation represents an important therapeutic modality in clinical dermatology, and the number of skin diseases that improve under the phototherapeutic modalities of today is still growing. While clinical phototherapy was originally based on empirical observations, our present understanding of the underlying mechanisms has improved substantially due to important progress in photobiological science. The better understanding of this scientific basis of treatment allows to both choose the correct phototherapeutic modality and determine the most effective treatment regimen. The aim of this article is to discuss the appropriate indications for phototherapy as well as its safe and effective employment, providing practical help in daily clinical phototherapeutic practice.     

Variables in full‐body ultraviolet B treatment of skin diseases

Ultraviolet B (UVB) treatment is most often performed according to a fixed schedule, not necessarily considering important variables such as UV intensity, type of UVB source and skin pigmentation. These variables can rather easily be taken into consideration by the right choice of dosing unit. The advantage of going from dosing in time to Joule to standard erythema dose or to minimal erythema dose is considered. The size of most variables may be diminished considerably. Following these guidelines, it is possible to increase the efficacy of UVB phototherapy without increasing the risk of unintentional burning.     

Expression of nitric oxide synthases in keratinocytes after UVB irradiation

The importance of nitric oxide (NO) in mediating vasodilation, neurotransmission, and immune and inflammatory responses has been demonstrated. Human keratinocyte express inducible nitric oxide synthase (iNOS) and the neuronal constitutive isoform of NOS (ncNOS). We established an in vitro model in keratinocytes to investigate changes in NO, iNOS and ncNOS expression after UVB exposure. We demonstrated a large induction of NO after UVB exposure and that the source of NO produced in UVB-exposed keratinocytes was increased expression of iNOS and ncNOS. The increased NO production with increased expression of iNOS and ncNOS may contribute to the pathological and physiological features of UVB-induced erythema and skin inflammation.