Efficacy and Safety of Targeted High‐Intensity Medium‐Band (304–312 nm) Ultraviolet B Light in Pediatric Vitiligo

Abstract

Targeted high-intensity medium-band UVB phototherapy alone can produce clinical improvement in pediatric vitiligo and is well tolerated.

Home-based narrowband UVB, topical corticosteroid or combination for children and adults with vitiligo: HI-Light Vitiligo three-arm RCT

“…22 This study suggested that combination treatment may be more effective than NB-UVB monotherapy, but the study was small and so lacked power to demonstrate any statistically significant difference between the intervention groups; the relative risk ratio for achieving > 75% repigmentation was 1.38 (95% CI 0.71 to 2.68). 83 No significant safety issues have been identified in previous small studies of home-based hand-held phototherapy devices for vitiligo, used instead of hospital NB-UVB therapy, 25,26 and this is confirmed by the findings of our study. Long-term NB-UVB treatment (mean number of treatments = 211) in a study of patients with darker skin types conferred no increase in skin cancer risk, suggesting that NB-UVB can safely be continued for longer periods of time than in our study, although most patients in that study were skin types IV-VI.…”

“…This is consistent with previous research, which has shown that combination treatments are generally more effective than monotherapies in treating vitiligo, although overall response rates, both in our study and in previous research, are generally modest. 22,25,26 Although there have not been any studies assessing the same interventions as those used in this study, the response rates are comparable with other studies. A meta-analysis of studies assessing phototherapy for vitiligo, 82 including 29 prospective studies of NB-UVB, reported a 'marked response' (> 75% repigmentation) in around 19% of participants after 6 months of NB-UVB monotherapy.…”

“…Following this pilot trial, other studies have suggested the efficacy of using hand-held NB-UVB devices for vitiligo, including in children, but the studies have been small or retrospective, 25,26 making it difficult to draw firm conclusions.…”

“…Clinical studies have suggested that treatment of vitiligo in its early stages is more likely to be beneficial than treatment of longstanding vitiligo. 25,32 For this reason, participants in the HI-Light Vitiligo trial were required to have at least one patch of vitiligo that had changed in the last 12 months (see Chapter 2, Participants, for further details).…”

Randomized controlled trial of topical corticosteroid and home‐based narrowband ultraviolet B for active and limited vitiligo: results of the HI‐Light Vitiligo Trial*

“…NB‐UVB is usually reserved for people with extensive vitiligo and is delivered in secondary care using full‐body units, requiring regular hospital attendance 22 . Limited vitiligo can be treated with handheld NB‐UVB devices, 25 but studies assessing these have been retrospective, or too small to inform clinical practice 26,27 . Using a handheld NB‐UVB device reduces the need for hospital visits and avoids exposure of unaffected skin to NB‐UVB.…”