A comparison of narrow band phototherapy (TL-01) and photochemotherapy (PUVA) in the management of polymorphic light eruption

Abstract

Twenty-five patients suffering from severe polymorphic light eruption (PLE) were randomized to either photochemotherapy (PUVA) or narrow-band phototherapy (TL-01 UVB) treatment in early spring; patients receiving UVB were given placebo tablets to achieve a matching therapy procedure. During the 4 months following treatment, patient exposure to solar UVB was monitored with polysulphone badges. PLE occurrence, severity, and restriction of outdoor activity were recorded, using weekly diary-sheets. Analysis of covariance on this data, using the logarithm of UVB exposure as the explanatory variable, showed no significant differences between the treatments. TL-01 UVB is an effective alternative to PUVA in the management of PLE.

Phototherapy with Narrowband vs Broadband UVB

“…For patients with severe forms of PLE effective photo-hardening in spring with nUVB has been described as equally effective as with PUVA, UVA1 or bUVB (109,110). Photohardening with nUVB has also been used for actinic prurigo, idiopathic solar urticaria, erythropoietic protoporphyria, amiodarone photosensitivity, congenital erythropoietic protoporphyria, homozygous variegate porphyria or hydroa vacciniforme, even when patients showed abnormal photosensitivity in the UVB spectrum (86,111,112).…”

Lupus Erythematosus Tumidus

“…In 2 studies determining ANAs in patients with PLE, 10% to 14% showed titers of 1:80 or higher, correlating positively in a study with a longer duration of skin lesions. 37,57 In particular, desensitization phototherapy or photochemotherapy are the most effective forms of preventive treatment in PLE 58,59 ; nevertheless, the uncertain long-term risks have to be weighed against the benign and self-limited disease. 36 In Jessner's lymphocytic infiltration of the skin, the development of asymptomatic, papulonodular, nonscarring lesions classically involving the face is unrelated to UV exposure in most of the patients.…”

Formation of 8‐hydroxy‐2′‐deoxyguanosine in the DNA of cultured human keratinocytes by clinically used doses of narrowband and broadband ultraviolet B and psoralen plus ultraviolet A

“…Narrowband UVB phototherapy has thus significantly improved the therapeutic efficacy of conventional broadband UVB (290 -320 nm) phototherapy for skin diseases such as psoriasis, atopic dermatitis, vitiligo and others. (10)(11)(12)(13) Narrowband UVB is widely used in the treatment of skin disease, and the current trend toward the increased use of narrowband UVB phototherapy is justified.(14) Its carcinogenic potential is judged to be substantially less than that of psoralen plus UVA (PUVA) photochemotherapy.(15) Although the results of studies in mice indicate that narrowband UVB could induce more skin cancers than broadband UVB therapy, (16) the participants in a workshop on the use of narrowband UVB in phototherapy concluded that the long-term human cancer risk should be no greater than that with broadband phototherapy. (17) When the DNA damage in keratinocytes induced by narrowband or broadband UVB was measured by single cell gel electrophoresis (comet assay), narrowband UVB produced less DNA damage than broadband UVB at equal doses.…”

“…Narrowband UVB phototherapy has thus significantly improved the therapeutic efficacy of conventional broadband UVB (290 -320 nm) phototherapy for skin diseases such as psoriasis, atopic dermatitis, vitiligo and others. (10)(11)(12)(13) Narrowband UVB is widely used in the treatment of skin disease, and the current trend toward the increased use of narrowband UVB phototherapy is justified. (14) Its carcinogenic potential is judged to be substantially less than that of psoralen plus UVA (PUVA) photochemotherapy.…”