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Randomized Double
Blind Trial of Treatment of Vitiligo
Efficacy of Psoralen-UVA Therapy vs
Narrowband UVB Therapy
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Randomized Double
Blind Trial of Treatment of Vitiligo:
Efficacy of Psoralen-UVA Therapy vs
Narrowband UVB Therapy.
Yones SS, Der D, Palmer RA, Garibaldinos TM, Hawk JLM. Arch Dermatol 2007;
143:578-84.
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OBJECTIVE: To compare the efficacy of
oral psoralen- UV-A (PUVA) with that of narrowband- UV-B (UVB de Banda Estrecha) phototherapy
in patients with nonsegmental vitiligo.
DESIGN: Double-blind randomized study.
SETTING: Phototherapy unit in a university hospital.
PATIENTS: Fifty-six patients with nonsegmental vitiligo.
INTERVENTIONS: Twice-weekly therapy with PUVA or UVB de Banda Estrecha.
MAIN OUTCOME MEASURES: The change in body surface area affected by vitiligo
and the color match of repigmented skin compared with unaffected skin were
assessed after 48 sessions of therapy, at the end of the therapy course, and 12
months after the end of therapy.
RESULTS: The results in the 25 patients each in the PUVA and UVB de Banda Estrecha
groups who began therapy were analyzed. The median number of treatments
was 47 in the PUVA-treated group and 97 in the UVB de Banda Estrecha group (P=.03); we
suspect this difference was because of differences in efficacy and adverse
effects between the two modalities, such that patients in the UVB de Banda Estrecha group
wanted a longer course of treatment. At the end of therapy, 16 (64%) of 25
patients in the UVB de Banda Estrecha group showed greater than 50 % improvement in body surface
area affected compared with 9 (36%) of 25 patients in the PUVA group.
The color match of repigmented skin was
excellent in all patients in the UVB de Banda Estrecha group but in only 11 (44%) of
those in the PUVA group (P<.001). In patients who completed 48 sessions,
the improvement in body surface area affected by vitiligo was greater with UVB de Banda Estrecha
therapy than with PUVA therapy (P<.007). Twelve months after the
cessation of therapy, the superiority of UVB de Banda Estrecha tended to be maintained.
CONCLUSIONS: In the treatment
of nonsegmental vitiligo, UVB de Banda Estrecha therapy is superior to oral PUVA therapy.
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