Review
Narrowband ultraviolet B phototherapy and 308-nm excimer laser in the treatment of vitiligo: A review

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Vitiligo is a common and chronic disease with a great impact on patients' quality of life. Phototherapy with narrowband ultraviolet B radiation and excimer laser are two treatment modalities that are used increasingly for the management of the disease with variable results. In this article, we review the efficacy, adverse effects, and possible mechanisms of action of narrowband ultraviolet B and excimer laser in the management of vitiligo. Available data concerning the follow-up of treated patients and some criteria for the selection of patients with a greater chance to respond satisfactorily to treatment are also presented.

Section snippets

Efficacy

There is no universally accepted protocol for NB-UVB, so treatment protocols differ from study to study. Sessions are performed twice or thrice weekly, on nonconsecutive days (Table I). The initial dose ranges from 100 to 280 mJ/cm2. The dose is subsequently increased in most studies by 10% to 20% per session. In many studies, the dose is stabilized when mild erythema develops. Generally, after the first few sessions, the rate of increase in UVB dose is individualized for each patient.

Overall

Efficacy

After the first case report by Baltas et al,36 several studies have assessed the efficacy of 308-nm excimer laser in vitiligo (Table II).37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50 Sessions are performed 2 to 3 times a week for a period of 4 to 36 weeks. Repigmentation occurs faster with the thrice weekly treatment, but the ultimate rate of repigmentation seems to depend on the total numbers on sessions and not on their frequency.48 Repigmentation greater than 75% is usually reported

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    Funding sources: None.

    Conflicts of interest: None declared.

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