title: Narrowband UV-B Phototherapy for Steroid-Refractory Sclerotic Chronic Cutaneous Graft-vs-Host Disease.
abstract: OBJECTIVE
  Chronic graft-vs-host disease (GVHD) affects 50% to 70% of patients who receive allogeneic hematopoietic cell transplants (HCTs), and the skin is the most common site of involvement. Chronic cutaneous GVHD can present with sclerotic or nonsclerotic changes of the skin and often requires treatment with systemic immunosuppressants, extracorporeal photopheresis, or phototherapy. We describe the first reported case, to our knowledge, of the effective treatment of sclerotic chronic cutaneous GVHD with narrowband UV-B (NB UV-B) phototherapy.
  
  
  METHODS
  A woman in her 40s presented with sclerotic chronic GVHD of the skin 6 years after HCT for treatment of chronic myelogenous leukemia. The patient's cutaneous disease progressed despite treatment with prednisone and oral tacrolimus. The patient was initiated on NB UV-B phototherapy 3 times per week, resulting in clinically significant improvement of cutaneous lesions over the first 2 months. The NB UV-B regimen allowed for a reduction of prednisone dose and continued control of cutaneous GVHD over 6 months of therapy.
  
  
  CONCLUSIONS
  Our case report describes the successful use of NB UV-B phototherapy for the treatment of sclerotic chronic cutaneous GVHD. Further study should be performed to evaluate the effectiveness of this therapeutic modality for patients with sclerotic chronic cutaneous GVHD.
authors: Keck School of Medicine, University of Southern California, Los Angeles.
authors: Eric
authors: E
authors: Sorenson
authors: Michigan State University College of Human Medicine, East Lansing.
authors: Rachel
authors: R
authors: McAndrew
authors: University of California, Irvine, School of Medicine, Irvine.
authors: Viraat
authors: V
authors: Patel
authors: Division of Hematologic Malignancies and Blood and Marrow Transplantation, Department of Medicine, University of California, San Francisco.
authors: Aaron C
authors: AC
authors: Logan
authors: Psoriasis Treatment Center, University of California, San Francisco.
authors: John
authors: J
authors: Koo
authors: Psoriasis Treatment Center, University of California, San Francisco.
authors: Ethan
authors: E
authors: Levin
mesh_terms: D000328:Adult; D002908:Chronic Disease; D004305:Dose-Response Relationship, Drug; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use; D006086:Graft vs Host Disease / Q000473:pathology / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D011241:Prednisone / Q000008:administration & dosage / Q000627:therapeutic use; D012871:Skin Diseases / Q000473:pathology / Q000628:therapy*; D016896:Treatment Outcome; D014467:Ultraviolet Therapy / Q000379:methods*
chemical_list: D005938:Glucocorticoids; D011241:Prednisone