Narrowband-Ultraviolet B Phototherapy for Psoriasis Treatment in Skin of Color: A Systematic Review and Meta-Analysis.

BACKGROUND

Narrowband-ultraviolet B (NB-UVB) phototherapy is an effective treatment for psoriasis in patients who have failed topical regimens or those who desire to avoid systemic treatment. Despite its regular use in non-white individuals, NB-UVB treatment response for psoriasis in skin of color (SOC) has not been systematically reviewed.

METHODS

We conducted a systematic review on the basis of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) on all available studies to date assessing NB-UVB for psoriasis treatment in skin of color (SOC) (up to 15 November 2024). The primary outcome was qualitative data on clinical outcomes of UVB (PASI 75). Random-effects meta-analysis was performed to assess treatment responses. Secondary outcomes of biochemical and immunologic mechanisms of NB-UVB, NB-UVB in combination with other treatments, and NB-UVB compared to other forms of phototherapy were assessed.

RESULTS

Of 1283 articles initially identified, 54 were ultimately included for formal review. We identified 43 articles assessing clinical outcomes of NB-UVB phototherapy in patients with Fitzpatrick skin type III-IV for a total of 1322 patients with chronic plaque psoriasis and 12 patients with palmoplantar psoriasis. Nine studies were included for meta-analysis of PASI75 response; 70.5% of patients achieved PASI75, and all studies demonstrated statistically significant PASI improvement after treatment. NB-UVB demonstrated a higher rate of complete clearance when compared to BB-UVB but did not result in a statistically significant difference in the proportion of the patient population achieving PASI75 when compared to PUVA.

CONCLUSIONS

Phototherapy is effective for the treatment of psoriasis in SOC patients and remains a valuable treatment option despite the advent of various topical, systemic, and biologic treatments for psoriasis.