Current concepts of evidence-based medicine in phototherapy and photochemotherapy in psoriasis
Part II. Narrow band UVB in psoriasis
DOI:
https://doi.org/10.29176/2590843X.263Keywords:
phototherapy, psoriasis, NB-UVBAbstract
Phototherapy has immunomodulatory properties and this is why it is used for treating some inflammatory skin diseases. Broadband UVB (BB-UVB), narrow band UVB (NB-UVB) and UVA have been used for the treatment of psoriasis. NB-UVB has been shown to be effective and safe and nowadays it is considered the first line phototherapy in patients with psoriasis. It is considered for patients with psoriasis whom are not candidates for topical therapy alone. Multiple protocols for administering NB-UVB phototherapy have been used, including initial doses, percentage of dose increase after each session, number of doses recommended each week, maintenance regimes and maximum number of sessions. We reviewed the literature and different protocols published with the evidence showing their advantages and disadvantages so that the clinician can decide which regime is the best one for treating his/her patients.
Author Biographies
Catalina Santa
Médica, residente de Dermatología, Universidad CES, Medellín, Colombia
Manuela Cadavid
Médica, residente de Dermatología, Universidad CES, Medellín, Colombia
Sol Beatriz Jiménez
Médica dermatóloga; jefe, Servicio de Dermatología, Grupo Dermatología CES, Universidad CES, Medellín, Colombia
References
5. Lapolla W, Yentzer BA, Bagel J, Halvorson CR, Feldman SR. A review of phototherapy protocols for psoriasis treatment. J Am Acad Dermatol. 2011;64:936-49.
6. Menter A, Korman NJ, Elmets CA, Feldman SR, Gelfand JM, Gordon KB, et al. Guidelines of care for the management of psoriasis and psoriatic arthritis. J Am Acad Dermatol. 2011;65:137-74.
7. Callen JP, Krueger GG, Lebwohl M, McBurney EI, Mease P, Menter A, et al. AAD consensus statement on psoriasis therapies. J Am Acad Dermatol. 2003;49:897-9.
8. Guenther L, Langley RG, Shear NH, Bissonnette R, Ho V, Lynde C, et al. Integrating biologic agents into management of moderateto-severe psoriasis: A consensus of the Canadian Psoriasis Expert Panel. J Cutan Med Surg. 2004;8:321-37.
9. Sterry W, Barker J, Boehncke W-H, Bos JD, Chimenti S, Christophers E, et al. Biological therapies in the systemic management of psoriasis: International Consensus Conference. Br J Dermatol. 2004;151(Suppl.69):3-17.
10. Delrosso G, Bornacina C, Farinelli P, Bellinzona F, Leigheb G, Colombo E. Bath PUVA and psoriasis: Is a milder treatment a worse treatment? Dermatology (Basel). 2008;216:191-3.
11. Zanolli M. Phototherapy treatment of psoriasis today. J Am Acad Dermatol. 2003;49(Suppl.2):S78-86.
12. Feldman SR, Koo JY, Lebwohl MG, Menter A, van Voorhees A. The psoriasis and psoriatic arthritis pocket guide: Treatment algorithms and management options. Third edition. The National Psoriasis Foundation. New York, 2009. pag 84-91
13. Lim HW, Hönigsmann H, Hawk JLM. Photodermatology. Informa healthcare USA, New York, 2007. pag 319-335.
14. Hönigsmann H. Phototherapy for psoriasis. Clin Exp Dermatol. 2001;26:343-50.
15. DeSilva B, McKenzie RC, Hunter JAA, Norval M. Local effects of TL01 phototherapy in psoriasis. Photodermatol Photoimmunol Photomed. 2008;24:268-9.
16. Gläser R, Navid F, Schuller W, Jantschitsch C, Harder J, Schröder JM, et al. UV-B radiation induces the expression of antimicrobial peptides in human keratinocytes in vitro and in vivo. J Allergy Clin Immunol. 2009;123:1117-23.
17. Yoshimura M, Namura S, Akamatsu H, Horio T. Antimicrobial effects of phototherapy and photochemotherapy in vivo and in vitro. Br J Dermatol. 1996;134:528-32.
18. Parrish JA, Jaenicke KF. Action spectrum for phototherapy of psoriasis. J Invest Dermatol. 1981;76:359-62.
19. Storbeck K, Hölzle E, Schürer N, Lehmann P, Plewig G. Narrowband UVB (311 nm) versus conventional broad-band UVB with and without dithranol in phototherapy for psoriasis. J Am Acad Dermatol. 1993;28(Pt.1):227-31.
20. Walters IB, Burack LH, Coven TR, Gilleaudeau P, Krueger JG. Suberythemogenic narrow-band UVB is markedly more effective than conventional UVB in treatment of psoriasis vulgaris. J Am Acad Dermatol. 1999;40(Pt.1):893-900.
21. Coven TR, Burack LH, Gilleaudeau R, Keogh M, Ozawa M, Krueger JG. Narrowband UV-B produces superior clinical and histopathological resolution of moderate-to-severe psoriasis in patients compared with broadband UV-B. Arch Dermatol. 1997;133:1514-22.
22. Yones SS, Palmer RA, Garibaldinos TT, Hawk JLM. Randomized double-blind trial of the treatment of chronic plaque psoriasis: Efficacy of psoralen-UV-A therapy Vs. narrowband UV-B therapy. Arch Dermatol. 2006;142:836-42.
23. Markham T, Rogers S, Collins P. Narrowband UV-B (TL-01) phototherapy Vs. oral 8-methoxypsoralen psoralen-UV-A for the treatment of chronic plaque psoriasis. Arch Dermatol. 2003;139:325-8.
24. Gordon PM, Diffey BL, Matthews JN, Farr PM. A randomized comparison of narrow-band TL-01 phototherapy and PUVA photochemotherapy for psoriasis. J Am Acad Dermatol. 1999;41(Pt.1):728-32.
25. Jury CS, McHenry P, Burden AD, Lever R, Bilsland D. Narrowband ultraviolet B (UVB) phototherapy in children. Clin Exp Dermatol. 2006;31:196-9.
26. Pasic A, Ceovic R, Lipozencic J, Husar K, Susic SM, Skerlev M, et al. Phototherapy in pediatric patients. Pediatr Dermatol. 2003;20:71-7.
27. Valkova S. UVB phototherapeutic modalities. Comparison of two treatments for chronic plaque psoriasis. Acta Dermatovenerol Alp Panonica Adriat. 2007;16:26-30.
28. Kleinpenning MM, Smits T, Boezeman J, van de Kerkhof PCM, Evers AWM, Gerritsen MJP. Narrowband ultraviolet B therapy in psoriasis: Randomized double-blind comparison of high-dose and low-dose irradiation regimens. Br J Dermatol. 2009;161:1351-6.
29. Boztepe G, Akinci H, Sahin S, Karaduman A, Evans SE, Erkin G, et al. In search of an optimum dose escalation for narrowband UVB phototherapy: Is it time to quit 20% increments? J Am Acad Dermatol. 2006;55:269-71.
30. Ibbotson SH, Bilsland D, Cox NH, Dawe RS, Diffey B, Edwards C, et al. An update and guidance on narrowband ultraviolet B phototherapy: A British Photodermatology Group Workshop Report. Br J Dermatol. 2004;151:283-97.
31. Wainwright NJ, Dawe RS, Ferguson J. Narrowband ultraviolet B (TL-01) phototherapy for psoriasis: Which incremental regimen? Br J Dermatol. 1998;139:410-4.
32. Olson RL, Sayre RM, Everett MA. Effect of anatomic location and time on ultraviolet erythema. Arch Dermatol. 1966;93:211-5.
33. Schneider LA, Hinrichs R, Scharffetter-Kochanek K. Phototherapy and photochemotherapy. Clin Dermatol. 2008;26:464-76.
34. Karrer S, Eholzer C, Ackermann G, Landthaler M, Szeimies RM. Phototherapy of psoriasis: Comparative experience of different phototherapeutic approaches. Dermatology (Basel). 2001;202:108-15.
35. Zanolli, MD, Feldman SR. Phototherapy treatment protocols: For psoriasis an other phtotherapy responsive dermatoses. New York: Taylor and Francis Group; 2004.
36. Calle J, Rivas AM, Ruiz MC, Sánchez MA, Trujillo MC, Jiménez SB, et al. Manejo de la psoriasis con luz ultravioleta A más psoraleno (PUVA) y luz ultravioleta B (UVB). Rev Asoc Colomb Dermatol. 2009;17:162-71.
37. Haddican MM, Bhutani T, McClelland PB, Koo JYM. Why are there significant differences in published narrowband ultraviolet B dosimetry recommendations? The need for national standardization of phototherapy treatment. J Am Acad Dermatol. 2011;65:411-4.
38. Cameron H, Dawe RS, Yule S, Murphy J, Ibbotson SH, Ferguson J. A randomized, observer-blinded trial of twice Vs. three times weekly narrowband ultraviolet B phototherapy for chronic plaque psoriasis. Br J Dermatol. 2002;147:973-8.
39. Dawe RS, Wainwright NJ, Cameron H, Ferguson J. Narrow-band (TL-01) ultraviolet B phototherapy for chronic plaque psoriasis: Three times or five times weekly treatment? Br J Dermatol. 1998;138:833-9.
40. Boztepe G, Karaduman A, Sahin S, Hayran M, Kölemen F. The effect of maintenance narrow-band ultraviolet B therapy on the duration of remission for psoriasis: A prospective randomized clinical trial. Int J Dermatol. 2006;45:245-50.
41. Stern RS, Armstrong RB, Anderson TF, Bickers DR, Lowe NJ, Harber L, et al. Effect of continued ultraviolet B phototherapy on the duration of remission of psoriasis: A randomized study. J Am Acad Dermatol. 1986;15:546-52.
42. Kragballe K. Vitamin D and UVB radiation therapy. Cutis. 2002;70(Suppl.5):9-12.
43. Guenther LC. Optimizing treatment with topical tazarotene. Am J Clin Dermatol. 2003;4:197-202.
44. Koo JY, Lowe NJ, Lew-Kaya DA, Vasilopoulos AI, Lue JC, Sefton J, et al. Tazarotene plus UVB phototherapy in the treatment of psoriasis. J Am Acad Dermatol. 2000;43(Pt.1):821-8.
45. Meola T Jr, Soter NA, Lim HW. Are topical corticosteroids useful adjunctive therapy for the treatment of psoriasis with ultraviolet radiation? A review of the literature. Arch Dermatol. 1991;127:1708-13.
46. Morison WL, Parrish JA, Fitzpatrick TB. Controlled study of PUVA and adjunctive topical therapy in the management of psoriasis. Br J Dermatol. 1978;98:125-32.
47. Schmoll M, Henseler T, Christophers E. Evaluation of PUVA, topical corticosteroids and the combination of both in the treatment of psoriasis. Br J Dermatol. 1978;99:693-702.
48. Marcil I, Stern RS. Squamous-cell cancer of the skin in patients given PUVA and ciclosporin: Nested cohort crossover study. Lancet. 2001;358:1042-5.
49. Kaya TI, Tiftik N, Tursen U, Ikizoglu G, Yalcin A. Ultraviolet recall phenomenon associated with methotrexate and cytarabine. J Eur Acad Dermatol Venereol. 2006;20:353-4.
50. Paul BS, Momtaz K, Stern RS, Arndt KA, Parrish JA. Combined methotrexate--ultraviolet B therapy in the treatment of psoriasis. J Am Acad Dermatol. 1982;7:758-62.
51. Lebwohl M, Drake L, Menter A, Koo J, Gottlieb AB, Zanolli M, et al. Consensus conference: Acitretin in combination with UVB or PUVA in the treatment of psoriasis. J Am Acad Dermatol. 2001;45:544-53.
52. Kircik L, Bagel J, Korman N, Menter A, Elmets CA, Koo J, et al. Utilization of narrow-band ultraviolet light B therapy and etanercept for the treatment of psoriasis (UNITE): Efficacy, safety, and patient-reported outcomes. J Drugs Dermatol. 2008;7:245-53.
53. Lucas A, Belinchón I, Pérez-Crespo M, Mataix J, Betlloch I. Successful response to narrow-band UVB in a patient undergoing concomitant treatment with adalimumab for psoriasis. Australas J Dermatol. 2008;49:173-4.
54. Legat FJ, Hofer A, Wackernagel A, Salmhofer W, Quehenberger F, Kerl H, et al. Narrowband UV-B phototherapy, alefacept, and clearance of psoriasis. Arch Dermatol. 2007;143:1016-22.
55. Ibbotson SH, Bilsland D, Cox NH, Dawe RS, Diffey B, Edwards C, et al. An update and guidance on narrowband ultraviolet B phototherapy: A British Photodermatology Group Workshop Report. Br J Dermatol. 2004;151:283-97.
56. Calzavara-Pinton PG, Zane C, Candiago E, Facchetti F. Blisters on psoriatic lesions treated with TL-01 lamps. Dermatology (Basel). 2000;200:115-9.
57. Wolff K, Goldsmith LA, Katz SI, Gilchrest BA, Baller AS, Leffell DJ. Fitzpatrick’s Dermatology in General Medicine. Seventh edition, Volume two. McGraw Hill, New York, 2008. pag 2243-2262
58. Lee E, Koo J, Berger T. UVB phototherapy and skin cancer risk: A review of the literature. Int J Dermatol. 2005;44:355-60.
59. Diffey BL. Factors affecting the choice of a ceiling on the number of exposures with TL01 ultraviolet B phototherapy. Br J Dermatol. 2003;149:428-30.
60. Stern RS. The risk of squamous cell and basal cell cancer associated with psoralen and ultraviolet A therapy: A 30-year prospective study. J Am Acad Dermatol. 2012;66:553-62.
61. Mudigonda T, Dabade TS, Feldman SR. A review of targeted ultraviolet B phototherapy for psoriasis. J Am Acad Dermatol. 2012;66:664-72.
6. Menter A, Korman NJ, Elmets CA, Feldman SR, Gelfand JM, Gordon KB, et al. Guidelines of care for the management of psoriasis and psoriatic arthritis. J Am Acad Dermatol. 2011;65:137-74.
7. Callen JP, Krueger GG, Lebwohl M, McBurney EI, Mease P, Menter A, et al. AAD consensus statement on psoriasis therapies. J Am Acad Dermatol. 2003;49:897-9.
8. Guenther L, Langley RG, Shear NH, Bissonnette R, Ho V, Lynde C, et al. Integrating biologic agents into management of moderateto-severe psoriasis: A consensus of the Canadian Psoriasis Expert Panel. J Cutan Med Surg. 2004;8:321-37.
9. Sterry W, Barker J, Boehncke W-H, Bos JD, Chimenti S, Christophers E, et al. Biological therapies in the systemic management of psoriasis: International Consensus Conference. Br J Dermatol. 2004;151(Suppl.69):3-17.
10. Delrosso G, Bornacina C, Farinelli P, Bellinzona F, Leigheb G, Colombo E. Bath PUVA and psoriasis: Is a milder treatment a worse treatment? Dermatology (Basel). 2008;216:191-3.
11. Zanolli M. Phototherapy treatment of psoriasis today. J Am Acad Dermatol. 2003;49(Suppl.2):S78-86.
12. Feldman SR, Koo JY, Lebwohl MG, Menter A, van Voorhees A. The psoriasis and psoriatic arthritis pocket guide: Treatment algorithms and management options. Third edition. The National Psoriasis Foundation. New York, 2009. pag 84-91
13. Lim HW, Hönigsmann H, Hawk JLM. Photodermatology. Informa healthcare USA, New York, 2007. pag 319-335.
14. Hönigsmann H. Phototherapy for psoriasis. Clin Exp Dermatol. 2001;26:343-50.
15. DeSilva B, McKenzie RC, Hunter JAA, Norval M. Local effects of TL01 phototherapy in psoriasis. Photodermatol Photoimmunol Photomed. 2008;24:268-9.
16. Gläser R, Navid F, Schuller W, Jantschitsch C, Harder J, Schröder JM, et al. UV-B radiation induces the expression of antimicrobial peptides in human keratinocytes in vitro and in vivo. J Allergy Clin Immunol. 2009;123:1117-23.
17. Yoshimura M, Namura S, Akamatsu H, Horio T. Antimicrobial effects of phototherapy and photochemotherapy in vivo and in vitro. Br J Dermatol. 1996;134:528-32.
18. Parrish JA, Jaenicke KF. Action spectrum for phototherapy of psoriasis. J Invest Dermatol. 1981;76:359-62.
19. Storbeck K, Hölzle E, Schürer N, Lehmann P, Plewig G. Narrowband UVB (311 nm) versus conventional broad-band UVB with and without dithranol in phototherapy for psoriasis. J Am Acad Dermatol. 1993;28(Pt.1):227-31.
20. Walters IB, Burack LH, Coven TR, Gilleaudeau P, Krueger JG. Suberythemogenic narrow-band UVB is markedly more effective than conventional UVB in treatment of psoriasis vulgaris. J Am Acad Dermatol. 1999;40(Pt.1):893-900.
21. Coven TR, Burack LH, Gilleaudeau R, Keogh M, Ozawa M, Krueger JG. Narrowband UV-B produces superior clinical and histopathological resolution of moderate-to-severe psoriasis in patients compared with broadband UV-B. Arch Dermatol. 1997;133:1514-22.
22. Yones SS, Palmer RA, Garibaldinos TT, Hawk JLM. Randomized double-blind trial of the treatment of chronic plaque psoriasis: Efficacy of psoralen-UV-A therapy Vs. narrowband UV-B therapy. Arch Dermatol. 2006;142:836-42.
23. Markham T, Rogers S, Collins P. Narrowband UV-B (TL-01) phototherapy Vs. oral 8-methoxypsoralen psoralen-UV-A for the treatment of chronic plaque psoriasis. Arch Dermatol. 2003;139:325-8.
24. Gordon PM, Diffey BL, Matthews JN, Farr PM. A randomized comparison of narrow-band TL-01 phototherapy and PUVA photochemotherapy for psoriasis. J Am Acad Dermatol. 1999;41(Pt.1):728-32.
25. Jury CS, McHenry P, Burden AD, Lever R, Bilsland D. Narrowband ultraviolet B (UVB) phototherapy in children. Clin Exp Dermatol. 2006;31:196-9.
26. Pasic A, Ceovic R, Lipozencic J, Husar K, Susic SM, Skerlev M, et al. Phototherapy in pediatric patients. Pediatr Dermatol. 2003;20:71-7.
27. Valkova S. UVB phototherapeutic modalities. Comparison of two treatments for chronic plaque psoriasis. Acta Dermatovenerol Alp Panonica Adriat. 2007;16:26-30.
28. Kleinpenning MM, Smits T, Boezeman J, van de Kerkhof PCM, Evers AWM, Gerritsen MJP. Narrowband ultraviolet B therapy in psoriasis: Randomized double-blind comparison of high-dose and low-dose irradiation regimens. Br J Dermatol. 2009;161:1351-6.
29. Boztepe G, Akinci H, Sahin S, Karaduman A, Evans SE, Erkin G, et al. In search of an optimum dose escalation for narrowband UVB phototherapy: Is it time to quit 20% increments? J Am Acad Dermatol. 2006;55:269-71.
30. Ibbotson SH, Bilsland D, Cox NH, Dawe RS, Diffey B, Edwards C, et al. An update and guidance on narrowband ultraviolet B phototherapy: A British Photodermatology Group Workshop Report. Br J Dermatol. 2004;151:283-97.
31. Wainwright NJ, Dawe RS, Ferguson J. Narrowband ultraviolet B (TL-01) phototherapy for psoriasis: Which incremental regimen? Br J Dermatol. 1998;139:410-4.
32. Olson RL, Sayre RM, Everett MA. Effect of anatomic location and time on ultraviolet erythema. Arch Dermatol. 1966;93:211-5.
33. Schneider LA, Hinrichs R, Scharffetter-Kochanek K. Phototherapy and photochemotherapy. Clin Dermatol. 2008;26:464-76.
34. Karrer S, Eholzer C, Ackermann G, Landthaler M, Szeimies RM. Phototherapy of psoriasis: Comparative experience of different phototherapeutic approaches. Dermatology (Basel). 2001;202:108-15.
35. Zanolli, MD, Feldman SR. Phototherapy treatment protocols: For psoriasis an other phtotherapy responsive dermatoses. New York: Taylor and Francis Group; 2004.
36. Calle J, Rivas AM, Ruiz MC, Sánchez MA, Trujillo MC, Jiménez SB, et al. Manejo de la psoriasis con luz ultravioleta A más psoraleno (PUVA) y luz ultravioleta B (UVB). Rev Asoc Colomb Dermatol. 2009;17:162-71.
37. Haddican MM, Bhutani T, McClelland PB, Koo JYM. Why are there significant differences in published narrowband ultraviolet B dosimetry recommendations? The need for national standardization of phototherapy treatment. J Am Acad Dermatol. 2011;65:411-4.
38. Cameron H, Dawe RS, Yule S, Murphy J, Ibbotson SH, Ferguson J. A randomized, observer-blinded trial of twice Vs. three times weekly narrowband ultraviolet B phototherapy for chronic plaque psoriasis. Br J Dermatol. 2002;147:973-8.
39. Dawe RS, Wainwright NJ, Cameron H, Ferguson J. Narrow-band (TL-01) ultraviolet B phototherapy for chronic plaque psoriasis: Three times or five times weekly treatment? Br J Dermatol. 1998;138:833-9.
40. Boztepe G, Karaduman A, Sahin S, Hayran M, Kölemen F. The effect of maintenance narrow-band ultraviolet B therapy on the duration of remission for psoriasis: A prospective randomized clinical trial. Int J Dermatol. 2006;45:245-50.
41. Stern RS, Armstrong RB, Anderson TF, Bickers DR, Lowe NJ, Harber L, et al. Effect of continued ultraviolet B phototherapy on the duration of remission of psoriasis: A randomized study. J Am Acad Dermatol. 1986;15:546-52.
42. Kragballe K. Vitamin D and UVB radiation therapy. Cutis. 2002;70(Suppl.5):9-12.
43. Guenther LC. Optimizing treatment with topical tazarotene. Am J Clin Dermatol. 2003;4:197-202.
44. Koo JY, Lowe NJ, Lew-Kaya DA, Vasilopoulos AI, Lue JC, Sefton J, et al. Tazarotene plus UVB phototherapy in the treatment of psoriasis. J Am Acad Dermatol. 2000;43(Pt.1):821-8.
45. Meola T Jr, Soter NA, Lim HW. Are topical corticosteroids useful adjunctive therapy for the treatment of psoriasis with ultraviolet radiation? A review of the literature. Arch Dermatol. 1991;127:1708-13.
46. Morison WL, Parrish JA, Fitzpatrick TB. Controlled study of PUVA and adjunctive topical therapy in the management of psoriasis. Br J Dermatol. 1978;98:125-32.
47. Schmoll M, Henseler T, Christophers E. Evaluation of PUVA, topical corticosteroids and the combination of both in the treatment of psoriasis. Br J Dermatol. 1978;99:693-702.
48. Marcil I, Stern RS. Squamous-cell cancer of the skin in patients given PUVA and ciclosporin: Nested cohort crossover study. Lancet. 2001;358:1042-5.
49. Kaya TI, Tiftik N, Tursen U, Ikizoglu G, Yalcin A. Ultraviolet recall phenomenon associated with methotrexate and cytarabine. J Eur Acad Dermatol Venereol. 2006;20:353-4.
50. Paul BS, Momtaz K, Stern RS, Arndt KA, Parrish JA. Combined methotrexate--ultraviolet B therapy in the treatment of psoriasis. J Am Acad Dermatol. 1982;7:758-62.
51. Lebwohl M, Drake L, Menter A, Koo J, Gottlieb AB, Zanolli M, et al. Consensus conference: Acitretin in combination with UVB or PUVA in the treatment of psoriasis. J Am Acad Dermatol. 2001;45:544-53.
52. Kircik L, Bagel J, Korman N, Menter A, Elmets CA, Koo J, et al. Utilization of narrow-band ultraviolet light B therapy and etanercept for the treatment of psoriasis (UNITE): Efficacy, safety, and patient-reported outcomes. J Drugs Dermatol. 2008;7:245-53.
53. Lucas A, Belinchón I, Pérez-Crespo M, Mataix J, Betlloch I. Successful response to narrow-band UVB in a patient undergoing concomitant treatment with adalimumab for psoriasis. Australas J Dermatol. 2008;49:173-4.
54. Legat FJ, Hofer A, Wackernagel A, Salmhofer W, Quehenberger F, Kerl H, et al. Narrowband UV-B phototherapy, alefacept, and clearance of psoriasis. Arch Dermatol. 2007;143:1016-22.
55. Ibbotson SH, Bilsland D, Cox NH, Dawe RS, Diffey B, Edwards C, et al. An update and guidance on narrowband ultraviolet B phototherapy: A British Photodermatology Group Workshop Report. Br J Dermatol. 2004;151:283-97.
56. Calzavara-Pinton PG, Zane C, Candiago E, Facchetti F. Blisters on psoriatic lesions treated with TL-01 lamps. Dermatology (Basel). 2000;200:115-9.
57. Wolff K, Goldsmith LA, Katz SI, Gilchrest BA, Baller AS, Leffell DJ. Fitzpatrick’s Dermatology in General Medicine. Seventh edition, Volume two. McGraw Hill, New York, 2008. pag 2243-2262
58. Lee E, Koo J, Berger T. UVB phototherapy and skin cancer risk: A review of the literature. Int J Dermatol. 2005;44:355-60.
59. Diffey BL. Factors affecting the choice of a ceiling on the number of exposures with TL01 ultraviolet B phototherapy. Br J Dermatol. 2003;149:428-30.
60. Stern RS. The risk of squamous cell and basal cell cancer associated with psoralen and ultraviolet A therapy: A 30-year prospective study. J Am Acad Dermatol. 2012;66:553-62.
61. Mudigonda T, Dabade TS, Feldman SR. A review of targeted ultraviolet B phototherapy for psoriasis. J Am Acad Dermatol. 2012;66:664-72.
How to Cite
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Santa C, Cadavid M, Jiménez SB. Current concepts of evidence-based medicine in phototherapy and photochemotherapy in psoriasis: Part II. Narrow band UVB in psoriasis. rev. asoc. colomb. dermatol. cir. dematol. [Internet]. 2013 Jan. 1 [cited 2024 Jul. 3];21(1):48-54. Available from: https://revista.asocolderma.org.co/index.php/asocolderma/article/view/263
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How to Cite
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Santa C, Cadavid M, Jiménez SB. Current concepts of evidence-based medicine in phototherapy and photochemotherapy in psoriasis: Part II. Narrow band UVB in psoriasis. rev. asoc. colomb. dermatol. cir. dematol. [Internet]. 2013 Jan. 1 [cited 2024 Jul. 3];21(1):48-54. Available from: https://revista.asocolderma.org.co/index.php/asocolderma/article/view/263
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