Hauptman Megan, El Othmani Amjad, Pazhyanur Svati, Nakamura Mio
Department of Dermatology, University of Miichigan, Ann Arbor, Michigan, USA.
School of Medicine, Wayne State University, Detroit, Michigan, USA.
Photodermatol Photoimmunol Photomed. 2025 Sep;41(5):e70051. doi: 10.1111/phpp.70051.
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.
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.
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.
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.
窄谱中波紫外线（NB-UVB）光疗是一种有效的治疗方法，适用于局部治疗方案失败或希望避免全身治疗的银屑病患者。尽管NB-UVB在非白人个体中经常使用，但尚未对其在有色人种皮肤（SOC）中治疗银屑病的反应进行系统评价。
我们根据系统评价和Meta分析的首选报告项目（PRISMA），对迄今为止所有评估NB-UVB治疗有色人种皮肤（SOC）银屑病的可用研究进行了系统评价（截至2024年11月15日）。主要结局是关于UVB临床结局（PASI 75）的定性数据。采用随机效应Meta分析评估治疗反应。评估了NB-UVB的生化和免疫机制、NB-UVB与其他治疗联合应用以及NB-UVB与其他形式光疗相比的次要结局。
在最初识别的1283篇文章中，最终纳入54篇进行正式审查。我们确定了43篇评估NB-UVB光疗对Fitzpatrick皮肤III-IV型患者临床结局的文章，共有1322例慢性斑块状银屑病患者和12例掌跖银屑病患者。纳入9项研究进行PASI75反应的Meta分析；70.5%的患者达到PASI75，所有研究均显示治疗后PASI有统计学意义的改善。与宽谱中波紫外线（BB-UVB）相比，NB-UVB的完全清除率更高，但与补骨脂素紫外线A光化学疗法（PUVA）相比，在达到PASI75的患者人群比例上没有统计学意义的差异。
光疗对SOC患者的银屑病治疗有效，尽管出现了各种治疗银屑病的局部、全身和生物治疗方法，但光疗仍然是一种有价值的治疗选择。
