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.

钙泊三醇倍他米松乳膏联合窄谱中波紫外线治疗稳定期寻常型银屑病的疗效分析

目的:观察钙泊三醇倍他米松软膏、卡泊三醇软膏和糠酸莫米松乳膏分别与窄谱中波紫外线(NB-UVB)照射联合治疗寻常型银屑病的效果与不良反应。方法:将90例稳定期寻常型银屑病患者随机分为3组,每组30例。治疗组予钙泊三醇倍他米松软膏,对照组A予卡泊三醇软膏,对照组B予糠酸莫米松乳膏。3组均将药物涂擦于皮肤损伤部位,每日1次;均在治疗过程中接受NB-UVB照射,3次/周;3组患者的疗程均为4周。治疗过程中每周观察1次疗效。结果:治疗2周时,治疗组的有效率(36.67%)高于对照组A(13.33%)和对照组B(13.33%),差异有统计学意义(P<0.05);治疗4周时,治疗组有效率(93.33%)高于对照组A(73.33%)与对照组B(66.67%),差异有统计学意义(P<0.05)。钙泊三醇倍他米松的主要不良反应为灼热和红斑,但患者可耐受。结论:钙泊三醇倍他米松软膏、卡泊三醇软膏和糠酸莫米松乳膏与NB-UVB联合应用治疗寻常型银屑病均安全有效,其中以钙泊三醇倍他米松软膏的起效最快、疗效最好、不良反应最少。

窄谱中波紫外线辐射联合万乃洛韦治疗老年带状疱疹35例临床观察

目的 观察窄谱中波紫外线辐射联合万乃洛韦治疗老年带状疱疹的临床疗效。方法 采用窄谱中波紫外线辐射联合万乃洛韦治疗老年带状疱疹35例,并与单用万乃洛韦治疗老年带状疱疹4 0例做对照,观察两组病人皮损好转时间、水疱结痂时间、疼痛缓解时间、疼痛消失时间、一般情况恢复期和睡眠改善时间。结果 除疼痛消失时间外,其余5个指标治疗组明显优于对照组。结论 窄谱中波紫外线辐射联合万乃洛韦是治疗老年带状疱疹较理想的方法。