Targeted broadband UVB phototherapy

INTRODUCTION

Vitiligo is a disorder of cutaneous depigmentation and affects approximately 1% to 2% of the world’s population with no predilection for age, sex, or racial background. Vitiliginous patches are often psychologically distressing and in some societies can lead to a loss of social status. Various treatments have been proposed. Non-surgical modalities con¬sidered as first-line therapies, include corticosteroids (oral, topical, and intralesional), oral or topical pso¬ralen plus ultraviolet A (PUVA), and recently, narrow¬band ultraviolet B (NB-UVB) therapy. Surgical modalities consist of autologous transplantation and include split-thickness epidermal grafting, epidermal blister grafting, and grafting of cultured melano- cytes 3-5.

Thanks to its relatively high efficacy and excellent tolerance, NB-UVB is now considered the best treatment for extensive vitiligo. However, many conventional phototherapies are associated with skin burning and aging when administered long term, and thus the treatment of vitiligo covering less than 10% of the total body area with NB-UVB unnecessarily exposes healthy skin areas.
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However, newer targeted phototherapy units allow lesions to be selectively treated. Several reports have shown successful results for 308-nm excimer lasers, which are costly and difficult to maintain, or using light with a wavelength that lies close to that of NB-UVB. Our purpose in this study was to examine the feasibility of a targeted UVB light source to treat localized vitiligo.