Turkiye Klinikleri Journal of Medical Sciences

.: ORIGINAL RESEARCH
Evaluation of Long Term Prognosis in Patients Treated with Narrowband Ultraviolet B: A Retrospective Study for 8 Years
Dar-Band Ultraviyole B ile Tedavi Edilen Hastalarda Uzun Dönem Prognozun Değerlendirilmesi: 8 Yıllık Retrospektif Bir Çalışma
Gül Aslıhan ÇAKIR AKAYa, Dilsun YILDIRIMb, Fatma GÜLRU ERDOĞANa, İrem KARc
aDepartment of Dermatology, Ufuk University Faculty of Medicine, Ankara, TURKEY
bClinic of Dermatology, Şırnak State Hospital, Şırnak, TURKEY
cDepartment of Biostatistics, Ankara University Faculty of Medicine, Ankara, TURKEY
Turkiye Klinikleri J Med Sci. 2019;39(4):353-61
doi: 10.5336/medsci.2019-66821
Article Language: EN
Full Text
ABSTRACT
Objective: Narrow-band ultraviolet B (NB-UVB) is a proven treatment modality in the management of psoriasis, inflammatory skin diseases and pigmentation disorders. However, recurrence is an important problem both for the patient and the clinician. The long-term effects of narrow-band ultraviolet B treatment on different dermatological indications cause concern. The aim of this study is to evaluate the effectiveness and the recurrence rates of the NB-UVB treatment in several dermatological diseases. Material and Methods: A total of 126 patients aged 18 years or older who received narrow-band ultraviolet B treatment due to various indications were included in the study. Treatment response and recurrence rates were retrospectively evaluated and compared in different disease groups. In addition, a statistical comparison was made between the recurrent and non-recurrent groups in terms of some variables that might affect relapse. Results: Complete remission, partial remission and unresponsiveness were detected in 74.6%, 13.5% and 11.9% of the patients respectively. The mean follow up period was 27.3±23.8 months. Recurrence was observed in 46.8% of patients with complete remission. Of the patients who developed recurrence, 59.1% had psoriasis, 13.6% mycosis fungoides, 13.6% atopic dermatitis, 6.8% vitiligo and 6.8% idiopathic pruritus. Conclusion: Based on our study findings, narrow-band ultraviolet B treatment may reduce the relapse rate in all dermatoses when scheduled in the early period. In addition to its widespread use in the treatment of psoriasis, it would be beneficial to consider narrow-band ultraviolet B as an effective treatment method in patients with idiopathic pruritus in the long-term period.

Keywords: Ultraviolet therapy; recurrence
ÖZET
Amaç: Dar band ultraviyole B başta psoriasis, inflamatuvar deri hastalıkları ve pigmentasyon bozukluklarının tedavisinde etkinliği kanıtlanmış bir tedavi yöntemidir. Bununla birlikte hem hasta hem klinisyen için nüks bir sorun olup, farklı dermatolojik endikasyonlarda dar band ultraviyole B tedavisinin uzun dönem etkileri merak konusudur. Bu çalışmanın amacı çeşitli dermatolojik hastalıklarda dar band ultraviyole B tedavisinin etkinliğinin ve nüks oranlarının değerlendirilmesi amaçlanmıştır. Gereç ve Yöntemler: Bu çalışmaya kliniğimizde çeşitli tanılarla dar band ultraviyole B tedavisi almış 18 yaş üstü 126 hasta dahil edildi. Tedavi yanıtı ve nüks farklı hastalıklarda retrospektif olarak değerlendirildi ve karşılaştırıldı. Ayrıca nüks olan ve olmayan gruplar arasında nüksü etkileyebilecek bazı değişkenler açısından istatistiksel karşılaştırma yapıldı. Bulgular: Hastaların %74,6'ünde komplet remisyon, %13,5'ünde parsiyel remisyon %11,9' unda tedaviye yanıtsızlık saptandı. Ortalama takip süresi 27,29±23,8 aydı. Komplet remisyondaki hastaların %46,8'inde nüks mevcuttu. Nüks gelişen hastaların %59,1'i psoriasis %13,6'sı mikozis fungoides, %13,6'sı atopik dermatit, %6,8'i vitiligo ve %6,8'i idyopatik pruritus idi. Sonuç: Çalışma bulgularımız ışığında dar band ultraviyole B tedavisinin tüm dermatozlarda erken dönemde planlanması relaps oranını azaltabilecektir düşüncesindeyiz. Ayrıca psoriasis tedavisinde yaygın kullanımının yanı sıra, dar band ultraviyole B'nin idyopatik prurituslu hastalarda da uzun dönemde etkin bir tedavi ajanı olarak göz önünde bulundurulması faydalı olacaktır.

Anahtar Kelimeler: Ultraviyole tedavisi; nüks
REFERENCES:
  1. Bandow GD, Koo JY. Narrow-band ultraviolet B radiation: a review of the current literature. Int J Dermatol. 2004;43(8):555-61. [Crossref]  [PubMed] 
  2. Sapam R, Walkhom R. Role of narrow band ultra violet radiation as an add-on therapy in peritoneal dialysis patients with refractory uremic pruritus. World J Nephrol. 2018;7(4):84-9. [Crossref]  [PubMed]  [PMC] 
  3. Ko MJ, Yang JY, Wu HY, Hu FC, Chen SI, Tsai PJ, et al. Narrowband ultraviolet B phototherapy for patients with refractory uraemic pruritus: a randomized controlled trial. Br J Dermatol. 2011;165(3):633-9. [Crossref]  [PubMed] 
  4. Sokolova A, Lee A, D Smith S. The safety and efficacy of narrow band ultraviolet B treatment in dermatology: a review. Am J Clin Dermatol. 2015;16(6):501-31. [Crossref]  [PubMed] 
  5. Powell JB, Gach JE. Phototherapy in the elderly. Clin Exp Dermatol. 2015;40(6):605-10. [Crossref]  [PubMed] 
  6. Rathanayake RMUK, Warnasuriya W, Muthumala PK, Palitha EWA, Jayasinghe J R de S. Factors influencing the response to narrow band ultra violet-B therapy among patients with chronic plaque psoriasis. JPGIM. 2015;2:1-7. [Crossref] 
  7. Karakawa M, Komine M, Takekoshi T, Sakurai N, Minatani Y, Tada Y, et al. Duration of remission period of narrowband ultraviolet B therapy on psoriasis vulgaris. J Dermatol. 2011;38(7):655-60. [Crossref]  [PubMed] 
  8. Esen Salman K, Kivanc Altunay I, Salman A. The efficacy and safety of targeted narrowband UVB therapy: a retrospective cohort study. Turk J Med Sci. 2019;49(2):595-603. [Crossref]  [PubMed] 
  9. Seckin D, Demircay S, Akin O. Generalized pruritus treated with narrowband UVB. Int J Dermatol. 2007;46(4):367-70. [Crossref]  [PubMed] 
  10. Yones SS, Palmer RA, Garibaldinos TM, Hawk JL. Randomized double-blind trial of treatment of vitiligo: efficacy of psoralen-UV-A therapy vs Narrowband-UV-B therapy. Arch Dermatol. 2017;143(5):578-84. [Crossref]  [PubMed] 
  11. Xiao BH, Wu Y, Sun Y, Chen HD, Gao XH. Treatment of vitiligo with NB-UVB: a systematic review. J Dermatolog Treat. 2015;26(4):340-6. [Crossref]  [PubMed] 
  12. Parsad D, Kanwar AJ, Kumar B. Psoralen-ultraviolet A vs. narrow-band ultraviolet B phototherapy for the treatment of vitiligo. J Eur Acad Dermatol Venereol. 2006;20(2):175-7. [Crossref]  [PubMed] 
  13. Kanwar AJ, Dogra S, Parsad D, Kumar B. Narrow-band UVB for the treatment of vitiligo: an emerging effective and well-tolerated therapy. Int J Dermatol. 2005;44(1):57-60. [Crossref]  [PubMed] 
  14. Scherschun L, Kim JJ, Lim HW. Narrow-band ultraviolet B is a useful and well tolerated treatment for vitiligo. J Am Acad Dermatol. 2001;44(6):999-1003. [Crossref]  [PubMed] 
  15. Silpa-Archa N, Weerasubpong P, Junsuwan N, Yothachai P, Supapueng O, Wongpraparut C. Treatment outcome and persistence of repigmentation from narrow-band ultraviolet B phototherapy in vitiligo. J Dermatolog Treat. 2019;30(7):691-6. [Crossref]  [PubMed] 
  16. Cabrera R, Hojman L, Recule F, Sepulveda R, Delgado I. Predictive model for response rate to narrowband ultraviolet b phototherapy in vitiligo: a retrospective cohort study of 579 patients. Acta Derm Venereol. 2018; 98(4):416-20. [Crossref]  [PubMed] 
  17. Jang MS, Baek JW, Park JB, Kang DY, Kang JS, Suh KS, et al. Narrow band ultraviolet B phototherapy of early stage mycosis fungoides in Korean patients. Ann Dermatol. 2011;23(4):474-80. [Crossref]  [PubMed]  [PMC] 
  18. Clark C, Dawe RS, Evans AT, Lowe G, Ferguson J. Narrowband TL-01 phototherapy for patch-stage mycosis fungoides. Arch Dermatol. 2000;136(6):748-52. [Crossref]  [PubMed] 
  19. Ponte P, Serrao V, Apetato M. Efficacy of narrowband UVB vs. PUVA in patients with early-stage mycosis fungoides. J Eur Acad Dermatol Venereol. 2010;24(6):716-21. [Crossref]  [PubMed] 
  20. Boztepe G, Sahin S, Ayhan M, Erkin G, Kilemen F. Narrowband ultraviolet B phototherapy to clear and maintain clearance in patients with mycosis fungoides. J Am Acad Dermatol. 2005;53(2):242-6. [Crossref]  [PubMed] 
  21. Sidbury R, Davis DM, Cohen DE, Cordoro KM, Berger TG, Bergman JN, et al. Guidelines of care for the management of atopic dermatitis: section 3. management and treatment with phototherapy and systemic agents. J Am Acad Dermatol. 2014;71(2):327-49. [Crossref]  [PubMed]  [PMC] 
  22. George SA, Bilsland DJ, Johnson BE, Ferguson J. Narrow-band (TL01) UVB air-conditioned phototherapy for chronic severe adult atopic dermatitis. Br J Dermatol. 1993;128(1):49-56. [Crossref]  [PubMed] 
  23. Reynolds NJ, Franklin V, Gray JC, Diffey BL, Farr PM. Narrowband ultraviolet B and broad-band ultraviolet A phototherapy in adult atopic eczema: a randomised controlled trial. Lancet. 2001;357(9273):2012-6. [Crossref] 
  24. Der-Petrossian M, Seeber A, Honigsmann H, Tanew A. 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. Br J Dermatol. 2000;142(1):39-43. [Crossref]  [PubMed] 

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