Enhanced Response of Childhood Psoriasis to Narrow‐Band UV‐B Phototherapy with Preirradiation Use of Mineral Oil

Abstract

Studies in adults show that pretreatment with an optimal emollient may improve transmission of ultraviolet-B. In our study, we evaluated whether the preirradiation use of mineral oil enhanced the efficacy of narrow-band ultraviolet-B phototherapy in childhood psoriasis. Twenty children, aged 5 to 14 years with widespread, symmetrical psoriasis involving >20% body surface area were enrolled in a prospective, single-blind, controlled study. Mineral oil was applied prior to irradiation over one half of the body and the other half was emollient-free control. Narrow-band ultraviolet-B phototherapy was administered to whole body twice a week on nonconsecutive days with initial dose of 50 mJ/cm(2) and increment of 10% at each session. Clinical response was evaluated as grades of erythema, scaling and induration, area of involvement and modified psoriasis area severity index score on each side at baseline, 3, 6, 9, and 12 weeks. Two patients dropped out, 18 patients completed the study. Significantly greater improvement (p< 0.05) in scaling, induration, area of involvement, and modified psoriasis area severity index score was seen on the mineral oil pretreated side as early as 3 weeks and was maintained throughout the study. Difference in erythema was noticed later at 6 weeks. The cumulative dose for clearance was significantly lower on the emollient pretreated side. No adverse effects were observed with mineral oil or narrow-band ultraviolet-B phototherapy. We conclude that preirradiation use of mineral oil enhances the therapeutic efficacy of narrow-band ultraviolet-B phototherapy in children with widespread psoriasis.

The influence of psoriatic plaques pretreatment with crude coal tar vs. petrolatum on the efficacy of narrow‐band ultraviolet B: a half‐vs.‐half intra‐individual double‐blinded comparative study

“…Several studies have been conducted to enhance the outcome of phototherapy through skin pretreatment with specific topical preparations (3–23). In this context, tar and petrolatum were reported to enhance the outcome of NB‐UVB; nevertheless, some authors reported some potential drawbacks due to the physical properties of the preparation that may lead to screening rather than enhancement of UVR (5, 19, 23–25).…”

“…Trials were conducted on tar (3–5), anthralin (6), steroids (7), mineral oil, salicylic acid, petrolatum (5), calcipotriene (8, 9), and tazarotene (10). With the development of NB‐UVB, it represented a new target for combination trials with dithranol (11, 12), vitamin D derivatives (13–17), tazarotene (18), dithranol (14), petrolatum (19), oleic acid (20), mineral oil (21), saltwater (22), and tar (23). Although the outcome of these combinations was encouraging, the physical properties of the preparation, the thickness and/or the color of the film, represented a challenge to overcome the undesirable UV‐blocking effect (5, 24, 25).…”

Psoriasis in children: An insight

“…Pretreatment with emollients like mineral oil or vaseline augments the therapeutic efficacy of narrow-band ultraviolet-B therapy, possibly because it penetrates the intercellular space, producing an optical matching effect which enhances the UV transmission. [11]…”

Phototherapy and photochemotherapy in childhood dermatoses

“…In a recently published side to side comparison study by Jain et al from India, it was shown that preradiation mineral oil application improved the efficacy of NBUVB in treatment of childhood psoriasis. [45] The mean cumulative dose for clearance in the mineral oil pre-treated side was 2,956 mJ/cm 2 compared to 4,088 mJ/cm 2 in the non-pre-treated side. The mean maximum dose and number of exposures for clearance on the emollient pre-treated side were 297 mJ/cm 2 and 20.56, respectively, while the corresponding figures in the non-pre-treated side were 394 mJ/cm 2 and 23.78.…”