Narrowband UV-B phototherapy in childhood atopic dermatitis: efficacy and safety

Abstract

BackgroundNarrow-band UVB is the most innovative steroid sparing treatment in atopic dermatitis. There are studies showing efficacy of Narrow-band UVB in childhood atopic dermatitis, but there is lack of clinical trials in the literature determining the length of remission. Therefore, we sought to highlight its efficacy, safety and its post-treatment efficacy in childhood atopic dermatitis.ObjectiveTo assess the clinical efficacy, safety of Narrow-band UVB in the treatment of paediatric atopic dermatitis and length of remission during 2 years of post-treatment follow-up.MethodsThirty children (4-14 years) having moderate to severe AD (SCORAD index > 25) were enrolled for 12 weeks. Narrow-band UVB phototherapy was administered twice a week on non-consecutive days for three months. SCORAD index was calculated by the same dermatologist at baseline, 6th, 12th, 18th and 24th treatment session. Secondary outcomes were measured using visual analog scale for pruritus and sleep loss. Patients were also followed-up for 2 years to know the length of remission after end of therapy.ResultsThere was a significant reduction in SCORAD index at 6th, 12th, 18th and 24th treatment session in comparison to baseline. This improvement in SCORAD was also maintained during the 2 years of post-treatment follow-up period. Consequently, pruritus and sleep loss improved significantly from baseline to end of therapy and even during the 1st and 2nd year of follow-up.Study limitationOpen-label trial without control group.ConclusionsNarrow-band UVB is an efficacious and safe modality of treatment in childhood atopic dermatitis with good therapeutic index and minimal side effects.

Handlungsempfehlung zur Therapieumstellung von Immunsuppressiva auf Dupilumab bei Patienten mit atopischer Dermatitis

“…Sie stellt eine immun-vegetative Dysfunktion dar und ist durch eine Th2-mediierte Entzündung, eine epidermale Barrierefunktionsstörung sowie eine kutane Dysbiose charakterisiert. Für das therapeutische Management der entzündlichen Symptome werden in Abhängigkeit von der Schwere der Erkrankung eine konsequente barriereprotektive Basistherapie [1], eine UV(Ultraviolett)-Therapie [2][3][4] bzw. eine topische und/oder systemische Pharmakotherapie eingesetzt [5].…”

Approach to the Assessment and Management of Pediatric Patients With Atopic Dermatitis: A Consensus Document. Section III: Treatment Options for Pediatric Atopic Dermatitis

“…62 Small, non-randomized prospective studies have demonstrated reduction in both objective severity scores as well as patient-reported outcomes in pediatric AD. 63,64…”

Stellenwert der Phototherapie in der Behandlung des chronischen Pruritus

“…Neben dem breiten Indikationsspektrum der Phototherapie bei Erkrankungen, die mit chronischem Pruritus einhergehen, hat die Phototherapie auch den Vorteil, dass sie bei Patienten nahezu jeden Lebensalters durchgeführt werden kann. Bei atopischer Dermatitis ist der Einsatz bereits ab dem Kindesalter möglich und sehr gut wirksam [34,35] [37]. Daneben sind aber noch andere potenziell phototoxische Medikamente aus den Gruppen der Antibiotika, nichtsteroidale Antirheumatika (NSAID), Antihypertensiva, Diuretika und Chemotherapeutika zu berücksichtigen.…”