Published online May 2, 2016. doi: 10.5314/wjd.v5.i2.93
Peer-review started: September 16, 2015
First decision: October 27, 2015
Revised: March 16, 2016
Accepted: April 7, 2016
Article in press: April 11, 2016
Published online: May 2, 2016
Vitiligo is a common, acquired pigmentary disorder of unknown etiology with great impact on patient’s appearance and quality of life. It presents a therapeutic challenge to many dermatologists. Photochemotherapy using psoralen and ultraviolet A (UVA) therapy, topical and oral immunosuppresants, as well as cosmetic camouflage are also commonly employed with varying clinical efficacy. Phototherapy is a popular treatment option, which includes both of the generalized ultraviolet B (UVB) therapies, broadband UVB and narrowband UVB (NB-UVB). It has been used favorably, both alone as well as in combination with other agents like topical calcineurin inhibitors, vitamin-D analogs. Combination therapies are useful and may provide quicker regimentation and treat vitiligo with an additive mechanism of action than UVB phototherapy. Advances in technology may lead to the continuing use of UVB phototherapy as a treatment for vitiligo through the development of sophisticated devices and delivery systems as well as innovative application methods. These will provide increased therapeutic options for all vitiligo patients, particularly those with refractory disease. In this article, I have reviewed the available data pertaining to efficacy and safety issues for NB-UVB as monotherapy, its comparison with psoralen plus UVA and other modes of phototherapy, combination regimens that have been tried and future prospects of NB-UVB in vitiligo.
Core tip: Vitiligo is a procured depigmentation issue with great effect on patient’s appearance and his satisfaction. Till date, the etiology of vitiligo remains elusive, which makes it difficult to have curative therapies. Narrowband ultraviolet B (UVB) phototherapy is generally utilized and delivers great clinical results. In this manuscript, I review the excursion of narrowband UVB from its prior days of advancement until this time as monotherapy, its comparison with psoralen and ultraviolet A and other modes of phototherapy and in combination with other therapies in the management of vitiligo.