Response Predictors in Psoriatic Patients Undergoing Narrowband Ultraviolet B Phototherapy | PracticeUpdate

Response Predictors in Psoriatic Patients Undergoing Narrowband Ultraviolet B Phototherapy

Journal Scan / Research · May 24, 2018

International Journal of Dermatology

Response Predictors in Psoriatic Patients Undergoing Narrowband Ultraviolet B Phototherapy

International Journal of Dermatology

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• The authors of this study examined local characteristics of 98 target psoriatic lesions to assess their response to NB-UVB treatment. Participants were treated three times weekly along with daily emollient application. Participants who required additional topical or systemic treatments were not included in the study. After 8 weeks of therapy, plaques located on the legs and plaques with globular vessels on dermoscopy were more likely to be resistant to NB-UVB treatment. Lesions on the trunk and upper arm, lesions with less scale, and lesions that were less infiltrated/thick were more likely to show a good response to NB-UVB therapy.

• These results suggest that local and dermoscopic features of psoriasis plaques can be helpful in determining likelihood of response to NB-UVB therapy.

Abstract

BACKGROUND

Although disease severity, gender, body weight, and previous treatments have all been reported to affect clinical response of psoriasis vulgaris to narrowband ultraviolet B (NB-UVB) therapy, little information about possible local (lesional) influencing factors is available.

OBJECTIVE

To assess correlations between clinical/dermoscopic findings of psoriatic plaques and therapeutic response to NB-UVB phototherapy in order to find positive and/or negative response predictor factors to such a treatment.

METHODS

For each target lesion, we calculated local psoriasis severity index and assessed dermoscopic findings at the baseline. After 8 weeks of treatment, we evaluated clinical improvement of each lesion, correlating the therapeutic outcome with initial clinical and dermoscopic features.

RESULTS

Ninety-eight target lesions from 27 patients were included in the study. After 8 weeks of therapy, 31 lesions experienced no/limited improvement, while partial response was observed in 40 plaques and optimal response in 27 lesions. Regarding clinical variables, we found an association between poor therapeutic outcomes and both legs localization and more marked lesion scaling/infiltration. Similarly, globular vessels on dermoscopy were more commonly associated with no/limited response as well as lesions localized on the legs, particularly those showing treatment resistance. Conversely, the presence of dotted vessels carried a higher probability for getting improvement.

CONCLUSION

Therapeutic response of psoriasis vulgaris to NB-UVB treatment may be negatively affected by local clinical factors, that is, significant scaling/infiltration and legs localization, and dermoscopy may be useful in highlighting possible response predictors, with globular and dotted vessels associated with bad and good outcomes, respectively.

Benjamin Hidalgo-Matlock

Skin Care Physicians of Costa Rica

4000-1054

2101-9574

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