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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 (NB-UVB) 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 NB-UVB.
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 NB-UVB
groups who began therapy were analyzed. The median number of treatments
was 47 in the PUVA-treated group and 97 in the NB-UVB 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 NB-UVB group
wanted a longer course of treatment. At the end of therapy, 16 (64%) of 25
patients in the NB-UVB 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 NB-UVB 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 NB-UVB
therapy than with PUVA therapy (P<.007). Twelve months after the
cessation of therapy, the superiority of NB-UVB tended to be maintained.
CONCLUSIONS: In the treatment
of nonsegmental vitiligo, NB-UVB therapy is superior to oral PUVA therapy.
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