Treatment of vitiligo with UV-B radiation vs topical psoralen plus UV-A.
OBJECTIVE
To compare the efficacy and safety of 2 treatment modalities, topical psoralen plus UV-A (PUVA) with unsubstituted psoralen and 311-nm UV-B radiation, in patients with vitiligo.


METHODS
This intervention study was designed as a before-and-after trial with 2 arms, in which patients were consecutively included.


METHODS
Male (n = 99) and female (n = 182) patients, who predominantly had skin type III, with extensive, generalized vitiligo of more than 3 months' duration.


METHODS
Two patient groups were investigated. The first group of patients was treated for 4 months with either topical PUVA (n = 28) or 311-nm UV-B radiation (n = 78). The second group of patients, treated twice weekly with 311-nm UV-B radiation, was followed up for 3 (n = 60), 6 (n = 27), 9 (n = 37), or 12 months (n = 51).


RESULTS
Thirteen (46%) patients in the first group treated with topical PUVA showed repigmentation after 4 months. Fifty-two patients (67%) in the 311-nm UV-B treatment group showed repigmentation after 4 months. After 3 months, 5 patients (8%) in the second group showed more than 75% repigmentation of lesional skin compared with 32 patients (63%) after 12 months. As in other treatment modalities, the face showed good repigmentation, whereas hands and feet responded poorly. No adverse effects were encountered with treatment with narrowband UV-B radiation, contrary to those seen with topical PUVA treatment. The cumulative UV-B dose was very small compared with that of the topical PUVA treatment.


CONCLUSIONS
According to our results, the treatment of patients with vitiligo with 311-nm UV-B radiation is as efficient as with topical PUVA and has fewer adverse effects.
Westerhof
W
W
The Netherlands Institute for Pigmentary Disorders, Amsterdam, The Netherlands. snip-ww@knoware.nl
Nieuweboer-Krobotova
L
L
D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D011564:Furocoumarins / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011701:PUVA Therapy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D011879:Radiotherapy Dosage; D012074:Remission Induction; D013997:Time Factors; D014467:Ultraviolet Therapy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D014820:Vitiligo / Q000188:drug therapy*
D011564:Furocoumarins