Psoralen-narrowband UVB Phototherapy for the Treatment of Vitiligo in Comparison to Narrowband UVB Alone

Background: The potential of psoralen-narrowband ultraviolet B (NBUVB) photochemotherapy has been investigated in vitiligo. The present study aims to evaluate the efficacy of psoralen-NBUVB (P-NBUVB) vs. NBUVB in vitiligo.

Methods: In a randomized study, 45 Indian patients (age above 13 years) with vitiligo involving more than 5% body surface area were randomly allocated to receive either NBUVB or P-NBUVB treatment. Both groups received NBUVB exposure thrice weekly, with a total of 60 sessions. The extent of repigmentation achieved was calculated on the basis of Vitiligo Area Severity Index (VASI) scoring.

Results: Forty patients were available for analysis at the end of the study. The extent of repigmentation in the P-NBUVB group was statistically significantly greater in face and neck (P = 0.006, t-test) and hands (P = 0.007, t-test) in comparison with the NBUVB group (t-test). Percentage reduction in VASI scores was statistically significantly greater in the P-NBUVB group (29.2% vs. 21.7%, P = 0.043, t-test). The response to P-NBUVB therapy started earlier than the response to NBUVB. After excluding sunlight as a confounding factor, treatment response was also significantly better in the P-NBUVB group (P = 0.005).

Conclusion: Addition of psoralen increased the extent of repigmentation due to NBUVB therapy in vitiligo. Further studies are required to determine the long-term efficacy and safety of P-NBUVB.