Comparison of the effectiveness of psoralen plus ultraviolet A light (PUVA) and ultraviolet B narrow band (UVB-NB) in the treatment of psoriasis

Authors

  • Angela M. Londoño G. Pontifical Bolivarian University
  • Claudia E. Gaviria V. University CES
  • Maria A. Sánchez S. University CES
  • Jaime E. Ordóñez M. University CES

DOI:

https://doi.org/10.17533/udea.rfnsp.695

Keywords:

psoriasis, phototherapy, PUVA

Abstract

Psoriasis is a chronic inflammatory disease characterized by keratinocyte hyperproliferation in response to activation of the immune system. The management of this condition is varied, but the therapeutic options decrease as the severity increases, and we must resort to medications or therapies that bring more unwanted side effects. Phototherapy is part of the treatments used in severe forms, the first to be introduced was the use of psoralen plus ultraviolet A light (PUVA), but it is not entirely safe therapy that can cause cataracts or even skin cancer, which precludes their use in some patients. With the advent of light therapy narrow band ultraviolet B (UVB-NB) in 1997, it opened a new spectrum of treatment alternatives for these
patients, with similar characteristics in terms of effectiveness. By comparing these two types of therapies, the literature is not conclusive and leaves a host of questions about which of the two therapies is more effective. With the advent of new therapies, it is important to know the most effective, they are less expensive treatments compared with those who are coming to market.
|Abstract
= 235 veces | PDF (ESPAÑOL (ESPAÑA))
= 49 veces|

Downloads

Download data is not yet available.

Author Biographies

Angela M. Londoño G., Pontifical Bolivarian University

dermatologist

Claudia E. Gaviria V., University CES

Second year dermatology resident

Maria A. Sánchez S., University CES

First Year Dermatology Resident

Jaime E. Ordóñez M., University CES

Research Coordinator of the Faculty of Medicine

References

(1). Krueger J. The immunologic basic for the treatment of psoriasis with new biologic agents. J Am Acad Dermatol. 2002; 46: 1-23. DOI: https://doi.org/10.1067/mjd.2002.120568

(2). Veale DJ, Fitzgerald O. Psoriatic Arthritis: Pathogenesis and epi-demiology. Clin Exp Rheumatol. 2002; 20: 27-33.

(3). Torre J. Artritis Psoriatica. En: Rodríguez A. Reumatología lati-noamericana. Buenos Aires: Ed. Buenos Aires; 2000. p. 356-378.

(4). Hohler T, Marker E. Psoriatic arthritis: clinical aspects, genetic and role of T cells. Curr Opin Rheumatol. 2001; 13: 273-279. DOI: https://doi.org/10.1097/00002281-200107000-00005

(5). Gladman D, Farewell V, Kopciuuk K, Cook R. HLA Markers and progression in psoriatic arthritis. J Rheumatol 1998; 25: 730-733.

(6). Parsch G, Steiner G, Leeb B, Dunky A, Broll H, Smolen J. Highly Increased Levels of Tumor Necrosis Factor-α and other Proinflammatory cytokines in Psoriatic Arthritis Synovial Fluid. J Rheumatol. 1997; 24: 518-523.

(7). Mease P. Cytokine blockers in psoriatic arthritis. Ann Rheum Dis 2001; 7: 37-40.

(8). Gottlieb AB. Psoriasis: Immunopathology and immunomodula-tion. Dermatol Clin. 2001; 19(4): 649-657. DOI: https://doi.org/10.1016/S0733-8635(05)70306-5

(9). Krueger JG, Bowcock A. Psoriasis pathophysiology: current con-cepts of patogenesis. Ann Rheum Dis 2005; 64(Suppl II); 30-36 DOI: https://doi.org/10.1136/ard.2004.031120

(10). Lebwolhl M. Psoriasis. Lancet. 2003; 361: 1197-1204. DOI: https://doi.org/10.1016/S0140-6736(03)12954-6

(11). Li J, Chen X, Liu Z, Yue Q, Liu H. “Expression of Th17 cytoki-nes in skin lesions of patients with psoriasis.” J Huazhong Univ Sci Technolog Med.Sci. 2007;27(3): 330-332. DOI: https://doi.org/10.1007/s11596-007-0329-1

(12). Learon U. Pathogenesis of Psoriatic Arthritis. Clin Exp Dermatol 2001; 26: 333-337. DOI: https://doi.org/10.1046/j.1365-2230.2001.00792.x

(13). Langley RGB, Krueger GG, Griffiths CEM. Psoriasis: epidemiology, clinical features, and quality of life. Ann Rheum Dis 2005; 64(Suppl II): 18-23. DOI: https://doi.org/10.1136/ard.2004.033217

(14). Feldman SR, Krueger GG. Psoriasis assessment tools in clinical trials. Ann rheum Dis 2005; 64 (suppl II): ii65-ii68. DOI: https://doi.org/10.1136/ard.2004.031237

(15). Eghlieb AM, Davies EEG, Finlay AY. Psoriasis has a major secondary impact on the lives of family members and partners. Br J Dermatol. 2007; 156: 1245-1250. DOI: https://doi.org/10.1111/j.1365-2133.2007.07881.x

(16). Neimann A, Shin D, Wang X, Margolis D, Troxel A, Gelfand J. Prevalence of cardiovascular risk factors in patients with psoria-sis. J Am Acad Dermatol 2006; 55: 829-835. DOI: https://doi.org/10.1016/j.jaad.2006.08.040

(17). Gelfand J, Neimann A, Shin D, Wang X, Margolis D, Troxel A. Risk of myocardial infarction in patients with psoriasis. j a m a2006; 296: 1735-1741. DOI: https://doi.org/10.1001/jama.296.14.1735

(18). Lebwohl M, Ting PT, Koo JM. Psoriasis treatment: traditional therapy. Ann Rheum Dis 2005; 64(Suppl II): 83-86. DOI: https://doi.org/10.1136/ard.2004.030791

(19). Aaronson D, Lebwohl M. Review of therapy of psoriasis: The prebiologic armamentarium. Dermatol Clin 2004; 22: 379-388. DOI: https://doi.org/10.1016/j.det.2004.03.012

(20). Chandraratna RA. Tazarotene first of a new generation of receptor selective retinoids. Br J Dermatol. 1996; 135 (Suppl 49): 18-25. DOI: https://doi.org/10.1111/j.1365-2133.1996.tb15662.x

(21). Roenigk H, Auerbach R, Maibach H, Weinstein G, Lebwohl M. Methotrexate in psoriasis: consensus conference. J Am Acad Dermatol 1998; 38: 478-485. DOI: https://doi.org/10.1016/S0190-9622(98)70508-0

(22). Ellis CN, Gorsulowsky DC, Hamilton TA, Billings JK, Brown MD, Heading JT, et al.. Cyclosporine improves psoriasis in a double blind study. j a m a 1986; 256: 3110-3116. DOI: https://doi.org/10.1001/jama.256.22.3110

(23). Mrowietz Ulrich. Advances in systemic therapy for psoriasis. Clin Exp Dermatol 2001; 26: 362-367. DOI: https://doi.org/10.1046/j.1365-2230.2001.00835.x

(24). Riddle C, Young M, Menter A. Practical considerations in future psoriasis therapies. Dermatol Clin. 2004; 22: 487-492. DOI: https://doi.org/10.1016/S0733-8635(03)00128-1

(25). Cañarte C. Consenso del tratamiento de Psoriasis, Encuentro Internacional de Psoriasis, Quito, agosto 2004. Comunicación verbal. [Internet] [acesso 15 de julio 2009] Disponible en: http://www.fepso.org.ec/Psoriasis.aspx.

(26). Morison W. Nonionizing radiation and the skin. En: Photothe-rapy and Photochemotherapy of skin disease 2ª ed. New York: Raven press; 1991. p. 27-42.

(27). Zanolli M. Phototherapy arsenal in the treatment of psoriasis. Dermatol Clin. 2004; 22: 397-406. DOI: https://doi.org/10.1016/j.det.2003.12.003

(28). Honingmann H. Phototherapy for psoriasis. Clin Exp Dermatol 2001; 26: 343-350. DOI: https://doi.org/10.1046/j.1365-2230.2001.00828.x

(29). Walters IB, Burack LH, Coven TR, Guillendau P, Krueger JG. Suberithemogenic narrowband u v b is markedly more effective than convetional u v b in treatment of psoriasis vulgaris. J Am Acad Dermatol 1999; 40: 893-900.

(30). Dawes RS, Wainwrhigt NJ, Cameron H, Ferguson J. Narrowband ultraviolet B photherapy for chronic plaque psoriasis: three times or five times weekly treatment? Br J Dermatol 1998; 138: 833-839. DOI: https://doi.org/10.1046/j.1365-2133.1998.02221.x

(31). Ferguson J. What is the role of narrowband u v b in the treatment of psoriasis? Photodermatol Photoimmunol Photomed. 2002; 18:42-43. DOI: https://doi.org/10.1034/j.1600-0781.2002.180107.x

(32). Weischer M, Blum A, Eberhard F, Rocken M, Berneburg M. No evidence for increased skin cancer risk in psoriasis patients treated with broadband or narrowband UVB phototherapy: a first retrospective study. Acta Derm Venereol 2004; 84: 370-374.

(33). Weischer M, Blum A, Eberhard F, Rocken M, Berneburg M. No evidence for increased skin cancer with broadband and narrow-band u v b photherapy: a first restrospective study. Acta Derm Ve-nereol 2004; 84: 370-374. DOI: https://doi.org/10.1080/00015550410026948

(34). Asawanonda P, Nateetongrungsak Y. Methotrexate plus na-rrowband UVB phototherapy versus narrowband UVB pho-totherapy alone in the treatment of plaque type psoriasis. A randomized placebo controlled study. J Am Acad Dermatol. 2006; 54: 1013-1018. DOI: https://doi.org/10.1016/j.jaad.2006.01.004

(35). Walters IB, Burack LH, Coven TR. Suberythematogenic narrow-band UVB is markedly more effective than conventional u v b in treatment of psoriasis vulgaris, J Am Acad Dermatol 1999; 40: 893-900. DOI: https://doi.org/10.1016/S0190-9622(99)70076-9

(36). Trehan M, Taylor CR. Medium dose 308 nm excimer laser for the treatment of psoriasis. J Am Acad Dermatol 2002; 47: 701-708. DOI: https://doi.org/10.1067/mjd.2002.125075

(37). Morison Wl; Marwaha S, Beck L, p u v a-induced phototoxicity: Incidence and causes. J Am Acad Dermatol 1997; 36: 183-185. DOI: https://doi.org/10.1016/S0190-9622(97)70277-9

(38). Gasparro F. The role of PUVA in the treatment of psoriasis: Pho-tobiology issues related to skin cancer incidence. Am J Clin Der-matol 2000; 1(6): 337-348. DOI: https://doi.org/10.2165/00128071-200001060-00002

(39). Lauharanta J. Photochemotherapy. Clin Dermatol 1997; 15: 769-780. DOI: https://doi.org/10.1016/S0738-081X(97)00015-1

(40). Stern RS, Laird N, Melski J. Cutaneous squamous-cell carcinoma in patients treated with p u v a. N Engl J Med 1984; 310: 1156-1161. DOI: https://doi.org/10.1056/NEJM198405033101805

(41). Stern RS, Lange R and Members of the Photochemotherapy Follow-up Study. Malignant melanoma in patients treated for psoriasis with psoralen and ultraviolet A radiation (p u v a). N Eng J Med, 1997; 336: 1041-1045. DOI: https://doi.org/10.1056/NEJM199704103361501

(42). Boer J, Herman’s J, Schothorst AA, Surmond D. Comparison of phototherapy (UV-B) and photochemotherapy (p u v a) for clea-ring and maintenance therapy of psoriasis. Arch Dermatol 1984; 120(1): 52-57. DOI: https://doi.org/10.1001/archderm.120.1.52

(43). Gordon PM, Diffey BL, Matthews JN, Farr PM. A randomized comparison of narrow-band TL-01 phototherapy and p u v a photo-chemotherapy for psoriasis. J Am Acad Dermatol 1999; 41(5 Pt 1): 728-732. DOI: https://doi.org/10.1016/S0190-9622(99)70008-3

(44). Tahir R, Mujtaba G. Comparative efficacy of psoralen-u v a photo-chemotherapy versus narrow band u v b phototherapy in the treatment of psoriasis. J Coll Physicians Surg Pak. 2004; 14(10): 593-595.

(45). Yones SS, Palmer RA, Garibaldinos TT, Hawk JLM. Randomi-zed double-blind trial of the treatment of chronic plaque pso-riasis: efficacy of psoralen-UVA therapy vs. narrowband UV-B therapy. Arch Dermatol. 2006; 142(7): 836-842. DOI: https://doi.org/10.1001/archderm.142.7.836

(46). Berker DA, Sakuntabhai A, Diffey BL, Matthews JN, Farr PM. Comparison of psoralen-UVB and psoralen-UVA photochemo-therapy in the treatment of psoriasis. J Am Acad Dermatol 1997; 36(4): 577-581. DOI: https://doi.org/10.1016/S0190-9622(97)70246-9

(47). Khurshid K, Haroon TS, Hussain I, Pal SS, Jahangir M, Zaman T. Psoralen-ultraviolet A therapy vs. psoralen-ultraviolet B thera-py in the treatment of plaque-type psoriasis: our experience with Fitzpatrick skin type IV. Int J Dermatol 2000; 39(11): 865-867. DOI: https://doi.org/10.1046/j.1365-4362.2000.00913.x

(48). Markham T, Rogers S, Collins P. Narrowband UV-B (TL-01) phototherapy vs. oral 8-methoxypsoralen psoralen-UVA for the treatment of chronic plaque psoriasis. Arch Dermatol 2003; 139(3): 325-328. DOI: https://doi.org/10.1001/archderm.139.3.325

(49). Zurita G, Briones M, Uraga E. Fotoquimioterapia en psoriasis: comparación de dos esquemas terapéuticos metotrexate más u v bvs p u v a. Revista peruana de Dermatología [Internet] [acceso 1 de mayo de 2007]. Disponible en: http://sisbib.unmsm.edu.pe/BvRe-vistas/dermatologia/v12_n2/fotoquimioterapia_psoriasis.htm

(50). Dawe RS, Cameron H, Yule S, Man I, Wainwright NJ, Ibbotson SH, Ferguson J. A randomized controlled trial of narrowband ultraviolet B vs. bath-psoralen plus ultraviolet A photochemo-therapy for psoriasis. Br J Dermatol 2003; 148(6): 1194-1204. DOI: https://doi.org/10.1046/j.1365-2133.2003.05482.x

(51). Grundmann M, Ludwig R, Zollner TM, Ochsendorf F, Thaci D, Boehncke WH, et al.. Narrowband u v b and cream psoralen-UVA combination therapy for plaque-type psoriasis. J Am Acad Der-matol. 2004 May; 50(5): 734-739. DOI: https://doi.org/10.1016/S0190-9622(03)00792-8

(52). Tanew A, Radakovic S, Schemper M, Honigsmann H. Narrow-band UVB phototherapy vs phototherapy in the treatment of chronic plaque type psoriasis. A paired comparison study. Arch Dermatol 1999;135: 519-524. DOI: https://doi.org/10.1001/archderm.135.5.519

(53). Calzavara P. Narrowband u v b (311 nm) phototherapy: A combi-nation. J Am Acad Dermatol 1998; 38: 687-690. DOI: https://doi.org/10.1016/S0190-9622(98)70214-2

Published

2010-02-15

How to Cite

1.
Londoño G. AM, Gaviria V. CE, Sánchez S. MA, Ordóñez M. JE. Comparison of the effectiveness of psoralen plus ultraviolet A light (PUVA) and ultraviolet B narrow band (UVB-NB) in the treatment of psoriasis. Rev. Fac. Nac. Salud Pública [Internet]. 2010 Feb. 15 [cited 2025 Jan. 31];27(3):1-7. Available from: https://revistas.udea.edu.co/index.php/fnsp/article/view/695

Issue

Section

Revisión sistemática