Nicolaidou E, Antoniou C, Stratigos A et al.
University of Athens School of Medicine, Athens, Greece.
J Am Acad Dermatol 2009;60:470–7.
Editor’s note: The authors of this article review the evidence regarding the use of narrowband ultraviolet B (UVB) and the excimer laser in vitiligo therapy. Most reported studies are of small sample size, are uncontrolled, and lack objective disease measurement scores. The original phototherapy used for vitiligo was psoralens with ultraviolet light A (PUVA), but narrowband UVB became established as a first-line treatment in adults and second-line treatment in children with vitiligo soon after its introduction. Small studies showed a better safety profile for narrowband UVB in relation to photo-aging and skin cancer risk and no reduction in efficacy in comparison with PUVA. Efficacy appeared greatest in type III–V skin and at the face and neck, with lesser efficacy at acral sites. Narrowband UVB has been used in combination with topical treatments and, of these, oral antioxidant supplementation (e.g. with vitamin E) is promising.