Narrowband UVB phototherapy and PUVA photochemotherapy in psoriasis vulgaris

IntroductionPsoriasis is a common papulosquamous skin disease, which presents as a chronic, disfiguring, inflammatory condition of the skin and joints. Most patients require lifetime treatment. Different treatment modalities, both systemic and topical, are available for psoriasis, with varying degrees of effectiveness and safety. Phototherapy is a well-established treatment option for moderate to severe psoriasis. PUVA photochemotherapy is a time-tested treatment option. NBUVB is becoming an accepted modality of treatment.Methods30 psoriasis patients with PASI > 10, who attended a tertiary care centre, were randomized into two groups to receive PUVA photochemotherapy and NBUVB therapy, respectively to know whether NBUVB therapy was better than PUVA therapy. The outcome measures were PASI 75, number of treatment exposures, adverse effects and non-compliance. Non-parametric tests were used to analyze the data.Results75% of NBUVB-treated and 50% of PUVA-treated patients had disease clearance. The total number of treatment exposures required for disease clearance was 15 for the NBUVB group and 18 for the PUVA group. 25% patients in the NBUVB group and 75% patients in the PUVA group developed the adverse effects and this prevented the patients from continuing the treatment.ConclusionNBUVB can be considered as the treatment of choice in this particular group of patients taking into account the higher disease clearance rate, lower number of treatment exposures and lesser adverse effects.