Review of narrowband ultraviolet B radiation in vitiligo

Vitiligo is a common, acquired pigmentary disorder of unknown etiology with great impact on patient's appearance and quality of life. It presents a therapeutic challenge to many dermatologists. Photochemotherapy using psoralen and ultraviolet A(UVA) therapy, topical and oral immunosuppresants, as well as cosmetic camouflage are also commonly employed with varying clinical efficacy. Phototherapy is a popular treatment option, which includes both of the generalized ultraviolet B(UVB) therapies, broadband UVB and narrowband UVB(NB-UVB). It has been used favorably, both alone as well as in combination with other agents like topical calcineurin inhibitors, vitamin-D analogs. Combination therapies are useful and may provide quicker regimentation and treat vitiligo with an additive mechanism of action than UVB phototherapy. Advances in technology may lead to the continuing use of UVB phototherapy as a treatment for vitiligo through the development of sophisticated devices and delivery systems as well as innovative application methods. These will provide increased therapeutic options for all vitiligo patients, particularly those with refractory disease. In this article, I have reviewed the available data pertaining to efficacy and safety issues for NB-UVB as monotherapy, its comparison with psoralen plus UVA and other modes of phototherapy, combination regimens that have been tried and future prospects of NB-UVB in vitiligo.

Changes of HSPs family expression in psoriasis lesions and their correlation with inflammatory response before and after NB-UVB treatment

Objective:To study the changes of HSPs family expression in psoriasis lesions and their correlation with inflammatory response before and after narrow-band ultraviolet B (NB-UVB) treatment.Methods: Patients who were newly diagnosed with psoriasis vulgaris and treated in Dermatology Department of our hospital between March 2015 and May 2017 were selected and randomly divided into the NB-UVB group who received NB-UVB combined with conventional treatment and the control group who received conventional treatment. Before treatment and 20 d after treatment, proper amount of psoriasis lesion was collected to determine the expression of HSPs family molecules and lymphocyte transcription factors as well as the levels of inflammatory cytokines.Results: Compared with those before treatment, HSP27, HSP60, HSP90 , HSP90β, T-bet and Foxp3 mRNA expression as well as MCP-1, IFN-γ and IL-17 levels in psoriasis lesion of both groups significantly decreased whereas GATA-3 and RORγt mRNA expression as well as IL-10 and TGF-β1 levels significantly increased after treatment, and HSP27, HSP60, HSP90 , HSP90β, T-bet and Foxp3 mRNA expression as well as MCP-1, IFN-γ and IL-17 levels in psoriasis lesion of NB-UVB group were significantly lower than those of control group whereas GATA-3 and RORγt mRNA expression as well as IL-10 and TGF-β1 levels were significantly higher than those of control group;HSP27, HSP60, HSP90 and HSP90β mRNA expression in psoriasis lesion of NB-UVB group after treatment were positively correlated with MCP-1, IFN-γ and IL-17 levels as well as T-bet and Foxp3 mRNA expression, and negatively correlated with IL-10 and TGF-β1 levels as well as GATA-3 and RORγt mRNA expression.Conclusion: NB-UVB treatment of psoriasis can reduce the expression of HSPs family members and inhibit the inflammatory response mediated by HSPs.

窄谱中波紫外线对慢性荨麻疹患者血清组胺与白三烯的意义

目的:探讨窄谱中波紫外线对慢性荨麻疹患者血清组胺与白三烯的意义。方法:将40例慢性荨麻疹患者随机数字表法分为治疗组与对照组,治疗组口服盐酸非索非那定片60 mg,bid,连续2个月,同时辅以NB-UVB治疗2次/周,连续2个月;对照组口服盐酸非索非那定片60 mg,bid,连续2个月。检测血清组胺与白三烯治疗前后的浓度变化情况,监测荨麻疹疾病活动程度(即USA评分)以及皮肤病生活质量指数(即DLQI)。结果:(1)对照组和研究组治疗前USA评分及DLQI评分比较差异无统计学意义,治疗后1个月和2个月USA评分及DLQI评分比较,差异均有统计学意义(P<0.05)。(2)两组治疗前后血清组胺水平比较,差异均有统计学意义(P<0.05),但治疗后比较差异无统计学意义。两组治疗前后血清白三烯B4水平比较,差异均有统计学意义(P<0.05),但治疗后比较差异无统计学意义。结论:NB-UVB联合抗组胺药物可有效改善慢性荨麻疹患者的生活质量,提高疗效。