Comparison of suberythemogenic and maximally aggressive ultraviolet B therapy for psoriasis.

We prospectively compared the maximally aggressive erythemogenic ultraviolet B (UVB) schedule (Le Vine et al, 1979) and a suberythemogenic UVB schedule (Frost et al, 1979) in the treatment of psoriasis. Patients were treated with either the maximally aggressive erythemogenic UVB (MAEUVB) schedule or the suberythemogenic UVB (SEUVB) schedule. Each patient received daily topical treatment with 2% crude coal tar ointment on half of the body and the ointment vehicle on the other half of the body. All patients were hospitalized and treated 7 days a week. The treatment results were determined daily be grading preselected reference lesions for erythema, scaling, and thickness. With both UV schedules, no difference in response could be detected between the ointment vehicle side and the tar ointment side. In a comparison of the two UV schedules, patients treated with MAEUVB had no statistically significant difference in the resolution of their psoriasis, and the length of remission was similar. The average energy needed for the SEUVB-treated patients was 984 mjoules/cm2, whereas the average for the MAEUVB-treated patients was 984 mjoules/cm2. Our findings suggest that neither crude coal tar nor MAEUVB is needed for the optimal UVB treatment of psoriasis in the hospital.