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Case Studies

Case Study Synopses

VITILIGO

  • Treatment of Vitiligo With UV-B Radiation
    vs Topical Psoralen Plus UV-A

    By: Wiete Westerhof, MD, PhD; Ludmila Nieuweboer-Krobotova, MD

    Archives of Dermatology
    VOL 133, December 1997

    STUDY SYNOPSIS:
    Compared efficacy and safety of 2 treatment modalities in patients with vitiligo. Study was a before-and-after trial with 2 arms, involving 99 men and 182 women with predominately skin type III and generalized vitiligo of at least 3 months' duration. 46% of first PUVA treatment group showed repigmentation after four months. 67% of of 311-nm treatment group showed repigmentation after four months.

    STUDY CONCLUSION:
    According to 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.

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  • Treatment of Generalized Vitiligo in Children
    with Narrow-Band (TL-01) UVB Radiation Therapy

    By: M. D. Njoo, MD, PhD and W. Westerhof, MD, PhD

    Journal of American Academy of Dermatology
    VOL 42, Number 2, Part 1. February 2000

    STUDY SYNPOSIS:
    Studied efficacy and safety of UVB (311 nm) therapy in children with generalized vitiligo. 51 Children were treated twice a week for one year. Psychosocial impact of disease and treatment were carefully evaluated before and after. 75% overall repigmentation in 53% of patients and a stabilization of the disease in 80%.

    STUDY CONCLUSION:
    Narrow-band UVB therapy is effective and safe in childhood vitiligo; it may also significantly improve the quality of life.
     
  • Narrow-band Ultraviolet B is a Useful
    and Well-Tolerated Treatment for Vitiligo

    By: Lubomira Scherschun, MD; Jane J. Kim, MD; Henry W. Lim, MD

    Journal of American Academy of Dermatology
    VOL 44, Number 6. June 2001

    STUDY SYNOPSIS:
    Seven diverse vitiligo patients treated for one year with narrow-band UVB therapy. Five of the seven achieved 75% repigmentation with a mean of 19 treatments.

    STUDY CONCLUSION:
    Treatment protocol resulted in rapid repigmentation in many patients, including those with skin phototypes IV and V. In accordance with previous studies, this report indicates that narrow-band UVB is a useful and well-tolerated therapy for vitiligo.

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PSORIASIS

  • Suberythemogenic Narrow-band UVB is
    Markedly More Effective Than
    Conventional UVB in Treatment of

    Psoriasis Vulgaris

    By: Ian B. Walters, MD; Lauren H. Burack, MD; Todd R. Coven, MD; Patricia Gilleaudeau, RN, BSN; James G. Krueger, MD, PhD

    Journal of the American Academy of Dermatology
    VOL 40, Number 6, Part 1. June 1999

    STUDY SYNOPSIS:
    Eleven patients treated using split-body approach, three times a week, for six weeks. Able to induce clinical clearing in 81.8% of patients after NB-UVB, but only 9.1% after BB-UVB.

    STUDY CONCLUSION:
    NB-UVB is superior to UVB-BB in reversing psoriasis at suberythemogenic doses when given three times per week. This schedule was well tolerated by all patients.

 

  • Narrowband UV-B Produces Superior Clinical
    and Histopathological Resolution of
    Moderate-to-Severe Psoriasis in Patients

    Compared With Broadband UV-B

    By: Todd R. Coven, MD; Lauren H. Burack, MD; Patricia Gilleaudeau, RN, BSN; Mary Keogh, RN, MSN; Maki Ozawa, MD; James G. Krueger, MD, PhD

    Archives of Dermatology
    VOL 133, December 1997

    STUDY SYNOPSIS:
    22 patients treated over four week span to compare therapeutic effectiveness of daily exposure to narrowband (NB) UV-B vs broadband (BB) UV-B with and without tar. Clinical resolution of psoriasis was achieved on 86% of paired sites treated with NB UV-B, compared to 73% with BB UV-B. Histopathological resolution of epidermal hyperplasia was achieved in 88% of lesions treated with NB UV-B, compared with 59% with BB UV-B.

    STUDY CONCLUSION:
    Narrowband UV-B offers a significant therapeutic advantage over BB UV-B in the treatment of psoriasis, with faster clearing and more complete disease resolution. The erythema response to NB UV-B treatment was significantly more intense and persistent compared with BB UV-B. Considerably more necrotic keratinocytes were observed in histopathological sections of skin treated with NB UV-B after a single 2.0- minimum erythema dose exposure. Treatment should be coupled with obligate minimum erythema dose testing to NB UV-B and close clinical observation during dose increases.

 

  • A Randomized Comparison of Narrow-band
    TL-01 Phototherapy and PUVA

    Photochemotherapy for Psoriasis

    By: P. M. Gordon, MRCP; B. L. Diffey, PhD; J. N. S. Matthews, PhD; and P. M. Farr, MD

    Journal of American Academy of Dermatology
    VOL 41, Number 5, Part 1. November 1999

    STUDY SYNOPSIS:
    100 patients were randomly allocated with twice-weekly treatments with PUVA or narrow-band UVB. Clearance of psoriasis was achieved in 84% of PUVA patients vs 63% with TL-01. Plus, the PUVA success took significantly fewer treatments.

    STUDY CONCLUSION:
    When given twice weekly, PUVA is more effective for psoriasis than narrow-band UVB phototherapy.

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MYCOSIS FUNGOIDES

  • Narrowband TL-01 Phototherapy for
    Patch-Stage Mycosis Fungoides


    By: Colin Clark, MRCP; Robert S. Dawe, MRCP; Alan T. Evans, MRCPath; Graham Lowe, FRCP; James Ferguson, FRCP

    Archives of Dermatology
    VOL 136, June 2000

    STUDY SYNOPSIS:
    Eight patients with patch-stage MF received TL-01 phototherapy 3 times weekly using standard protocol. Complete clearance of MF achieved in 6 cases in a mean of 9 weeks. 4 patients have had prolonged remissions.

    STUDY CONCLUSION:
    TL-01 is an effective, convenient therapy that may have less risk of long-term adverse effects than current alternatives. Although larger prospective studies are necessary, for some patients intermittent courses of TL-01 may offer effective long-term

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