Paediatric psoriasis--narrowband UVB treatment

J Eur Acad Dermatol Venereol. 2010 Apr;24(4):415-9. doi: 10.1111/j.1468-3083.2009.03425.x. Epub 2009 Sep 14.

Abstract

Narrowband UV-B is a safe and efficacious option for the treatment of adult psoriasis. However, the use of this therapy has been limited in children due to its long-term carcinogenic potential. It has proven to be an adequate alternative in patients whose condition is refractory to topical treatment.

Aims: To evaluate the efficacy and short-term safety of narrowband UV-B in the treatment of paediatric psoriasis, and to compare our results with those obtained in other studies on paediatric psoriasis.

Materials and methods: Over a period of 2 years and 4 months, we administered narrowband UV-B to 20 children diagnosed with psoriasis that was refractory to topical therapy. The therapeutic response was measured using the Psoriasis Area and Severity Index (PASI).

Results: Between August 2005 and December 2007, 20 children received narrowband UV-B. Their median age was 13 years (range, 5-17 years), and the median initial PASI score was 8.25 (2.7-22.2). A median of 28 (10-59) sessions was required to achieve clearance, reaching almost complete or total remission (median final PASI) in all but two patients. Six patients required a new therapeutic course because of relapse, and the mean duration of remission was 8 months (4-18). No patients experienced severe adverse events during therapy, and only one discontinued treatment, for unrelated reasons.

Discussion and conclusion: Narrowband UV-B for the treatment of paediatric psoriasis has received little attention in the literature. This treatment has been limited in children because of its potential long-term carcinogenic effects, and most information has been extrapolated from adults. Nevertheless, narrowband UV-B phototherapy is an effective and well-tolerated therapeutic alternative in paediatric patients with severe psoriasis.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Psoriasis / radiotherapy*
  • Recurrence
  • Remission Induction
  • Retrospective Studies
  • Severity of Illness Index*
  • Skin / radiation effects*
  • Skin Pigmentation
  • Treatment Outcome
  • Ultraviolet Therapy / adverse effects
  • Ultraviolet Therapy / methods*