UVB therapy (broadband and narrowband)
- Herbert Hönigsmann, MD
Herbert Hönigsmann, MD
- Professor of Dermatology, Emeritus Chairman
- Medical University of Vienna
Broadband ultraviolet B (UVB) radiation (280 to 320 nm), with or without topical tar, has been used for the treatment of moderate to severe psoriasis for decades. In the early 1980s, the observation that wavelengths around 311 nm were more effective than broad-spectrum UVB in clearing psoriasis led to a major advancement in phototherapy with the development of fluorescent lamps emitting selective UVB spectra in the range of 311 to 313 nm (narrowband UVB) [1,2].
Narrowband UVB has since become the type of phototherapy most frequently used for the treatment of psoriasis and a wide range of skin diseases, including atopic dermatitis, vitiligo, early stages of mycosis fungoides, and pruritic disorders (table 1) [3-5].
This topic will discuss the mechanism of action, treatment protocols, indications, and adverse effects of UVB therapy. PUVA therapy, UVA-1 therapy, and targeted phototherapy are discussed separately. The use of UVB for the treatment of specific skin conditions are discussed in the dedicated topics.
●(See "UVA1 phototherapy".)
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- Ada S, Sahin S, Boztepe G, et al. No additional effect of topical calcipotriol on narrow-band UVB phototherapy in patients with generalized vitiligo. Photodermatol Photoimmunol Photomed 2005; 21:79.
- Green C, Lakshmipathi T, Johnson BE, Ferguson J. A comparison of the efficacy and relapse rates of narrowband UVB (TL-01) monotherapy vs. etretinate (re-TL-01) vs. etretinate-PUVA (re-PUVA) in the treatment of psoriasis patients. Br J Dermatol 1992; 127:5.
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- Calzavara-Pinton PG, Sala R, Arisi M, et al. Synergism between narrowband ultraviolet B phototherapy and etanercept for the treatment of plaque-type psoriasis. Br J Dermatol 2013; 169:130.
- Wolf P, Hofer A, Weger W, et al. 311 nm ultraviolet B-accelerated response of psoriatic lesions in adalimumab-treated patients. Photodermatol Photoimmunol Photomed 2011; 27:186.
- Gambichler T, Tigges C, Scola N, et al. Etanercept plus narrowband ultraviolet B phototherapy of psoriasis is more effective than etanercept monotherapy at 6 weeks. Br J Dermatol 2011; 164:1383.
- Hönigsmann H. Synergism between narrowband ultraviolet B phototherapy and etanercept for the treatment of plaque-type psoriasis. Br J Dermatol 2013; 169:4.
- Richard EG, Hönigsmann H. Phototherapy, psoriasis, and the age of biologics. Photodermatol Photoimmunol Photomed 2014; 30:3.
- Inzinger M, Legat FJ, Hofer A, et al. Short- to intermediate-term follow-up in patients treated with the combination of 311-nm ultraviolet B phototherapy and biological agents. Br J Dermatol 2014; 171:915.
- Mehta D, Lim HW. Ultraviolet B Phototherapy for Psoriasis: Review of Practical Guidelines. Am J Clin Dermatol 2016; 17:125.
- Köllner K, Wimmershoff MB, Hintz C, et al. Comparison of the 308-nm excimer laser and a 308-nm excimer lamp with 311-nm narrowband ultraviolet B in the treatment of psoriasis. Br J Dermatol 2005; 152:750.
- Levin E, Nguyen CM, Danesh MJ, et al. An open label pilot study of supraerythemogenic excimer laser in combination with clobetasol spray and calcitriol ointment for the treatment of generalized plaque psoriasis. J Dermatolog Treat 2016; 27:210.
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- Archier E, Devaux S, Castela E, et al. Carcinogenic risks of psoralen UV-A therapy and narrowband UV-B therapy in chronic plaque psoriasis: a systematic literature review. J Eur Acad Dermatol Venereol 2012; 26 Suppl 3:22.
- PRINCIPLES AND MECHANISMS
- Effects on DNA
- Effects on the immune system
- DEVICES FOR BROADBAND AND NARROWBAND UVB
- CLINICAL INDICATIONS FOR UVB THERAPY
- DOSIMETRY AND TREATMENT PROTOCOLS
- Determination of the initial dose
- Treatment initiation, frequency, and dose increments
- Maintenance therapy
- Combination therapies
- TARGETED PHOTOTHERAPY WITH 308 NM DEVICES
- SAFETY MEASURES
- SHORT- AND LONG-TERM ADVERSE EFFECTS
- SUMMARY AND RECOMMENDATIONS