Comparison study of NB-UVB alone Vs combination of topical agents with NB-UVB in the treatment of psoriasis.

Sowmiya, R (2010) Comparison study of NB-UVB alone Vs combination of topical agents with NB-UVB in the treatment of psoriasis. Masters thesis, Madras Medical College, Chennai.


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INTRODUCTION : Psoriasis is a common, genetically determined, inflammatory and proliferative disease of the skin, the most characteristic lesions consisting of chronic, sharply demarcated, dull red, scaly plaques, particularly on the extensor prominences and in the scalp. The earliest description of what appears to represent psoriasis are given at the beginning of medicine in the Corpus Hippocraticum. Hippocrates used the terms psora and lepra for the conditions that can be recognized as psoriasis. Willan separated two diseases as psoriasis entities, a discoid lepra graecorum and a polycyclic confluent psora leprosa, which later was called psoriasis. Von Hebra definitely distinguished the clinical picture of psoriasis from that of Hansen’s disease. Psoriasis continues to be a therapeutic challenge in spite of our growing knowledge of its pathogenesis. Various forms of treatment have been developed in the past several decades and new regimens are constantly being tried. Narrowband ultraviolet-B phototherapy has become an increasingly popular modality in the treatment of psoriasis. Many studies have documented improved efficacy and therapeutic index for narrow band UVB in comparison with conventional broad band UVB irradiation. However the long term side effects of narrowband UVB therapy have not been fully documented. As a result, there has been a great deal of interest in photocombination therapies that are capable of both reducing the cumulative UVB doses and accelerating resolution of skin lesions. Phototherapy can be combined with topical or systemic agents. Topical agents include anthralin, vitamin D analogues, retinoids, glucocorticoids, emollients, salt water baths and tar. This study was designed to study the efficacy and safety of narrowband UVB and to study the advantages and disadvantages of photo combination with a topical steroid and topical tazarotene. AIM OF THE STUDY : This study was conducted in patients with chronic plaque type of psoriasis involving less than 20% of body surface area to evaluate the efficacy and safety of 1. Narrow Band UVB, 2. Narrow Band UVB with topical betamethasone valerate, 3. Narrow Band UVB with topical tazarotene. CONCLUSION * Narrow Band UVB phototherapy is an effective modality of treatment in plaque type of psoriasis. * Narrow Band UVB is safe and well tolerated in our patients with very few side effects. * Combining NB-UVB phototherapy and topical betamethasone valerate confers little advantage in treating psoriasis and appears to have no substantial effect on the time to clearing or the mean cumulative dose. * Combination of tazarotene and NB-UVB phototherapy is significantly more effective than NB-UVB phototherapy alone for the treatment of psoriasis. * The addition of tazarotene to NB-UVB therapy promotes faster clearing of psoriasis when compared with NB-UVB monotherapy. * The cumulative dose of NB-UVB is reduced when tazarotene is combined with it which means a lower risk for long term complications. * Irritation due to tazarotene is mild and combination of tazarotene with NB-UVB is well tolerated. * Photocombination therapies can broaden the therapeutic options for the treatment of patients with psoriasis.

Item Type: Thesis (Masters)
Uncontrolled Keywords: NB-UVB alone ; combination of topical agents ; NB-UVB ; treatment of psoriasis ; Comparison study.
Subjects: MEDICAL > Dermatology Venereology and Leprosy
Depositing User: Subramani R
Date Deposited: 05 Jul 2017 05:02
Last Modified: 05 Jul 2017 09:12

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