Asawanonda Pravit, Kijluakiat Jirasin, Korkij Wiwat, Sindhupak Wannasri
Department of Medicine, Division of Dermatology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Acta Derm Venereol. 2008;88(4):376-81. doi: 10.2340/00015555-0469.
Narrowband ultraviolet B (NB-UVB) phototherapy, with a 308-nm xenon chloride excimer laser, and targeted UVB phototherapy have produced encouraging therapeutic results for vitiligo. However, very few studies employing broadband UVB exist. Moreover, there has been no direct comparison study between broadband UVB and NB-UVB for the treatment of vitiligo. The aims of this study were to compare the repigmenting efficacy of targeted broadband UVB phototherapy with that of NB-UVB in an equi-erythemogenic manner. Twenty identical vitiliginous lesions from 10 patients were randomly allocated to receive either targeted broadband UVB or targeted NB-UVB phototherapy. UV fluences were started at 50% of the minimal erythema dose detected within the vitiliginous patches, then increased gradually, in the same manner, to ensure equi-erythemogenic comparison. Treatments were carried out twice weekly for 12 weeks. The results show that grade 1, i.e. 1-25% repigmentation, to grade 2, 26-50% repigmentation, occurred in 6 of 10 subjects. Responses in terms of repigmentation, de-pigmentation, or lack thereof, were similar between lesions receiving broadband and NB-UVB phototherapy. Onset of repigmentation occurred as early as 4 weeks of treatment in most subjects. Treatments were well tolerated, with only minimal erythema and hyperpigmentation.
The study was carried out in a small number of patients with skin types III, IV and V. The irradiation device was a targeted UVB device and thus the results may not be applicable to other light sources, such as the excimer laser or total-body irradiation cabinets. In conclusion, targeted broadband UVB produces similar clinical responses to targeted NB-UVB in the treatment of the non-segmental type of vitiligo.
窄谱中波紫外线(NB-UVB)光疗、使用308纳米氯化氙准分子激光的光疗以及靶向UVB光疗对白癜风均产生了令人鼓舞的治疗效果。然而,采用宽谱UVB的研究极少。此外,尚无关于宽谱UVB与NB-UVB治疗白癜风的直接对比研究。本研究的目的是以产生同等红斑量的方式比较靶向宽谱UVB光疗与NB-UVB的色素再生疗效。将10例患者的20个相同白癜风皮损随机分为两组,分别接受靶向宽谱UVB或靶向NB-UVB光疗。紫外线辐照剂量从白癜风皮损内检测到的最小红斑量的50%开始,然后以相同方式逐渐增加,以确保进行同等红斑量的比较。治疗每周进行两次,共12周。结果显示,10名受试者中有6名出现了1级(即色素再生1%-25%)至2级(色素再生26%-50%)的变化。接受宽谱UVB和NB-UVB光疗的皮损在色素再生、色素脱失或无变化方面的反应相似。大多数受试者在治疗4周时就开始出现色素再生。治疗耐受性良好,仅出现轻微红斑和色素沉着。
本研究在少数皮肤类型为III、IV和V型的患者中进行。辐照设备为靶向UVB设备,因此结果可能不适用于其他光源,如准分子激光或全身照射箱。总之,靶向宽谱UVB在治疗非节段型白癜风时产生的临床反应与靶向NB-UVB相似。