Title: Comparative Study of Safety and Efficacy of Narrow Band Ultraviolet B (NBUVB) and Psoralen Ultraviolet A (PUVA) Therapy in Psoriasis Vulgaris
Abstract: Introduction:Psoriasis is a group of chronic, inflammatory and proliferative condition of skin, associated with systemic manifestations in many organ systems.The most characteristic lesions consist of erythematous, scaly, sharply demarcated indurated plaques, present particularly over the extensor surfaces and scalp).Phototherapy is one of the most efficacious treatment options for psoriasis.New, emerging studies are beginning to define the biological mechanisms by which phototherapy improves psoriasis-with NBUVB and psoralen ultraviolet A (PUVA) as the most widely used applications.Material and methods: This prospective study was carried out on 76 patients attending OPD of Rohilkhand medical college and hospital in one year from November 2017 to October 2018.The patients were randomly divided into two groups;Systemic PUVA (Trimethylpsoralen+UVA) and NBUVB groups and therapy will be administered thrice per week on non-consecutive days. Results:The initial mean PASI score was 17.43 and 17.01 in group A and group B patients respectively, while post treatment PASI score was 3.08 and 2.01 in respective groups.The average cumulative dose for 80% clearance with PUVA was found to be 60.51 J/cm 2 while with NBUVB it was found to be 6.76 J/cm 2 .Side effects were observed in 28.94% patients in group A while 5.2% patientsin group B. Amongst group A 18.42%, 7.8% and 2.6% patients presented with erythema, burning and vesiculations respectively while under group B 2.6% patients in each group presented with erythema and burning.Conclusion: Both PUVA and NBUVB are effective for the treatment of psoriasis vulgaris.However, NBUVB has a distinct edge over PUVA in terms of efficacy and lesser side effects.The advantages of NBUVB therapy over PUVA therapy includes lack of psoralen-related side effects and less mean cumulative dose for clearance and so, good adherence.