Narrowband UVB Phototherapy Improves Pediatric Vitiligo

Narrowband ultraviolet B phototherapy (nbUVB) is well-tolerated and effective in pediatric patients with vitiligo, according to study findings published in Journal of the American Academy of Dermatology.

Researchers conducted a retrospective chart review of pediatric patients with vitiligo who were treated between January 1, 2009, and December 31, 2020.

A total of 324 participants were identified (median age at first visit, 8.7 years [SD, 4.3]; 50% men), and the median follow-up was 20 months (IQR, 8-39). The researchers used nbUVB as part of clinical management in 126 participants (38.9%), with a mean duration of 18 months (SD, 13). The youngest participant who received nbUVB was aged 3 years, and 58 participants (46%) used home nbUVB.

Improved or resolved vitiligo was associated with nonsegmental vitiligo, fewer signs of active disease, involvement of the face, head, or neck and extremities, and more areas of involvement. According to logistic regression analysis, the odds of having improved or resolved disease were 6.3 times greater in those who had nbUVB compared with those who did not, 3.3 times greater for topical calcineurin inhibitors, and 7.3 times greater for melanocyte-keratinocyte transplant procedure (c-statistic=0.80).

Among the cohort, 33 participants had sunburn, 10 used home units, 4 had blistering, and none had documented scarring or skin malignancy. Treatment was discontinued in 31 patients, with 1 case attributed to adverse effects (ie, pruritus) and the others to visit inconvenience, the COVID-19 pandemic, or satisfaction or dissatisfaction with treatment response.

Study limitations include the retrospective design, reliance on clinician documentation, and relatively short follow-up duration.

“nbUVB should be utilized in the management of pediatric vitiligo when clinically appropriate and with consideration of individual ability to cooperate,” conclude the study authors.