Review of narrowband ultraviolet B radiation in vitiligo

Table 1 Fitzpatrick’s skin phototypes

Phototype	Sunburn and tanning history (defines the photo type)	Immediate pigment darkening	Delayed tanning	Constitutitve color(unexposed) buttock skin	UVA MED(mJ/cm2)	UVB MED (mJ/cm2)
I	Burns easily, never tans	None	None	Ivory White	20-35	15-30
II	Burns easily, tans minimally with difficulty	Weak	Minimal to weak	White	30-45	35-40
III	Burns moderately, tans moderately and uniformly	Definite	Low	White	40-55	30-50
IV	Burns minimally, tans moderately and easily	Moderate	Moderate	Beige-olive, lightly tanned	50-80	40-60
V	Rarely burns, tans profusely	Intense brown	Strong, intense brown	Moderate brown or tanned	70-100	60-90
VI	Never burns, tans profusely	Intense (dark brown)	Strong, intense brown	Dark brown or black	100	90-150

UVA: Ultraviolet A; UVB: Ultraviolet B; MED: Minimum erythema dose.

Table 2 Studies of narrowband ultraviolet B in treatment of vitiligo (monotherapy)

Ref.	Study component	Study design	Patient's No.	Mode of each treatment	Dosimetry	Degree of pigmentation	Incidence of side effects
Njoo et al[134]	NB-UVB	Prospective, open, uncontrolled	51	Twice a week	0.25 J/cm2 followed by 20% increments until minimal erythema	After a maximum of 1-yr treatment: > 75% repigmentation in 53%	Pruritus: 8% Xerosis: 4%
Scherschun et al[16]	NB-UVB	Retrospective	7	Three-times a week	280 mJ/cm2; followed by 15% increments until mild erythema or pruritus	70% patients achieved > 75% repigmentation after a mean 19 treatments	Mild asymptomatic erythema: 58% Pruritus: 14%
Hamzavi et al[19]	NB-UVB	Randomized, controlled side to side	22	Three-times a week	70% of MED on depigmented skin followed by 10% increments until onset of repigmentation	Mean improvement after 6 mo or 80 exposures: 42.9% (treatment side) vs 3.3% (control side)
Kanwar et al[17]	NB-UVB	Open uncontrolled	14	Three-times a week	280 mJ/cm2 followed by 20% increments	After 1 yr: > 75% repigmentation in 71.4%	Burning and pruritus: 28.6% Xerosis 3nd thickening of lesional skin: 21.4%
Kanwar and Dogra[27]	NB-UVB	Prospective, open, uncontrolled	20	Three-times a week	280 mJ/cm2 followed by 20% increments	After a maximum of 1 yr treatment: > 75% repigmentation in 75% patients	Lesional burning and pruritus: 20%. Xerosis 3nd thickening of skin: 15%
Brazzelli et al[18]	NB-UVB	Open, uncontrolled	60	Twice or three times a week	180-200 mJ/cm2 followed by 50 mJ/cm2 increments until mild erythema	Complete repigmentation or up to maximum 2 yr: 68% (face) 57.9% (neck). 50% (trunk), limbs poorer results
Kishan Kumar et al[20]	NB-UVB	Prospective, open, non-randomized	150	Twice a week	250 mJ/cm2 (150 mJ/cm2 for children) followed by 20% increments until perceptible erythema	> 75% repigmentation after maximum 1 yr treatment: 17.4%	Erythema, burning, pruritus: 7%. Xerosis: 6%

NB-UVB: Narrowband ultraviolet B.