Long-term Narrowband UVB (NB-UVB) Use Safe in Treating Vitiligo
NB-UVB is an established, effective treatment for vitiligo. Its safety as a long-term treatment, however, has not been studied. For that reason, in the absence of established treatment caps for NB-UVB, the suggested limit for skin types I-III has arbitrarily been set at 200 treatments to minimize the risk of nonmelanoma skin cancer (NMSC).
This limit poses problems for many vitiligo patients, as more than 12-24 months of treatment, or more than 200 treatments, are often required for repigmentation. A recent review of patient experience by doctors at University of California, San Francisco (UCSF), now suggests that this limit may be unnecessarily low.
The doctors in this review have been treating vitiligo patients with NB-UVB for nearly a decade and conducted a retrospective review of 10 of their current NB-UVB vitiligo patients. Despite having received from 201 to 774 NB-UVB treatments over a period of 33 to 93 months, none of these patients have developed NMSC.
They pointed out that, after years of experience reviewing the available follow-up data drawn from all dermatology patients treated with NB-UVB, the general consensus is that NB-UVB does not significantly increase the risk of NMSC compared with the general population.
The UCSF physicians further commented that recent evidence suggests that topical pimecrolimus (Elidel) and/or tacrolimus (Protopic), which are commonly prescribed as adjuncts to NB-UVB, also have not shown an increased risk of NMSC. Therefore, the combination of NB-UVB with these topical agents should not have a cumulative carcinogenic effect.
The researchers concluded that NB-UVB is likely to be a safe long-term option, and because vitiligo patients will likely require more visits over a longer period of time, it is recommended that the NB-UVB guidelines be re-evaluated and that more long-term follow up data be gathered.
Courtesy of the Spring Newsletter – Vitiligo Support International