An Update on Narrowband Ultraviolet B Therapy for the Treatment of Skin Diseases

Abstract

The objective of this review is to provide an update on narrowband ultraviolet B (NB-UVB) as a treatment for various skin conditions. NB-UVB works by suppressing the cutaneous cell-mediated immune response and has been shown to be an efficacious and clinically tolerable treatment for a range of inflammatory dermatoses. A literature search was conducted by advanced searches of PubMed for NB-UVB treatment of dermatologic skin diseases with a focus on reports from 2010 to 2021, including both office-based and home-based phototherapy (HBPT). Data were prioritized based on studies with a high level of evidence using the Oxford Evidence-Based Medicine guidance. We found that NB-UVB continues to serve as an effective form of therapy for several cutaneous conditions, including vitiligo, psoriasis, atopic dermatitis, mycosis fungoides, and other inflammatory dermatoses. The recent introduction of Janus kinase inhibitors in combination with NB-UVB suggests future promise in the treatment of vitiligo. Despite its rise in popularity, a decline was seen in office-based NB-UVB treatment during the coronavirus disease 2019 pandemic. Options are available to deliver NB-UVB at home with comparable efficacy to office-based treatments. In conclusion, for a select group of patients and conditions, NB-UVB continues to serve as an effective treatment modality with minimal side effects, with HBPT serving as an option to improve patient compliance.

Reducing costs in atopic dermatitis

“…Without insurance office‐based phototherapy costs, on average, $65 per session or $3083 per year for UVB phototherapy (Table 2). 55 Home‐based phototherapy (home UVB), an increasingly utilized treatment modality, is also recommended for patients with AD, and may increase patient adherence, and reduce treatment costs compared with in‐office phototherapy, while producing comparable results 56–60 . The dose is to be evaluated according to skin type and clinical phase in the absence of a specific phototherapy protocol for AD.…”

“…55 Home-based phototherapy (home UVB), an increasingly utilized treatment modality, is also recommended for patients with AD, and may increase patient adherence, and reduce treatment costs compared with in-office phototherapy, while producing comparable results. [56][57][58][59][60] The dose is to be evaluated according to skin type and clinical phase in the absence of a specific phototherapy protocol for AD. In several studies, home UVB was financially advantageous compared to traditional office-based phototherapy, with a home UVB device costing $5000 on average, over 3 years.…”

An Overview of Mycoviral Curing Strategies Used in Evaluating Fungal Host Fitness

“…UV radiation with a wavelength of 300 to 320 nm is employed for light treatment in medical applications, e.g., 311 nm [ 136 ]. Ultraviolet B (UVB) narrowband lamps are used in phototherapy to treat T-cell cutaneous lymphoma and psoriasis, such as mycosis fungoides [ 137 ]. UV radiations have not been widely reported to be used for curing mycoviral infections, but a partial success was obtained by Castillo and colleagues [ 138 ].…”

Oxidative Stress and Phototherapy in Atopic Dermatitis: Mechanisms, Role, and Future Perspectives

“…Monotherapy or combination therapy with topical or systemic agents represent the two possible uses. [ 6 , 45 ]. However, numerous factors can limit phototherapy’s usefulness and effectiveness, especially because it requires cycles of bi-weekly sessions, so it can be difficult for patients who live far from centers equipped with this technology [ 46 ].…”

“…Compared to other UV phototherapies, NB-UVB has been shown to be more clinically tolerable with fewer side effects compared to other UV phototherapies. NB-UVB causes reduced expression of pro-inflammatory cytokines, downregulation in antigen presentation through inhibition of Langerhans cell activity, and consequent suppression of the lymphocytes T-mediated skin immune system [ 45 ]. In addition to AD, this therapy is also indicated for the treatment of psoriasis, parapsoriasis, mycosis fungoides, renal and hepatic pruritus, vitiligo, acute and chronic graft versus host disease, and other skin diseases [ 46 ].…”