alexa Treatment of Non-Segmental Vitiligo with Narrowband UVB Phototherapy (311 Nm): Clinical Efficacy and Mechanisms of Action
ISSN: 2155-9554

Journal of Clinical & Experimental Dermatology Research
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Research Article

Treatment of Non-Segmental Vitiligo with Narrowband UVB Phototherapy (311 Nm): Clinical Efficacy and Mechanisms of Action

Diana Proshutinskaia*, Vladimir Volnukhin and Oksana Katunina

Department of Dermatology, State Research Center for Dermatovenereology and Cosmetology, Ministry of Health of Russian Federation, 3 Korolenko street, bldg. 6, Moscow, 107076, Russia

*Corresponding Author:
Diana Proshutinskaia
Department of Dermatology
State Research Center for Dermatovenereology and Cosmetology
Ministry of Health of Russian Federation
3 Korolenko street, bldg. 6
Moscow, 107076, Russia
Tel: +7(985)2318903
Fax: +7 (499)7852016
E-mail: [email protected]

Received date: July 24, 2014; Accepted date: September 26, 2014; Published date: October 03, 2014

Citation: Proshutinskaia D, Volnukhin V, Katunina O (2014) Treatment of Non- Segmental Vitiligo with Narrowband UVB Phototherapy (311 Nm): Clinical Efficacy and Mechanisms of Action. J Clin Exp Dermatol Res 5:240 doi:10.4172/2155-9554.1000240

Copyright: © 2014 Proshutinskaia D, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, whichpermits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

 

Abstract

Objective: To estimate efficacy of narrowband UVB phototherapy (311 nm) in non-segmental vitiligo and its effect on subpopulations of T-cells and dendritic cells in vitiligo lesions. Methods: 56 patients with progressive non-segmental vitiligo underwent narrowband UVB phototherapy (311 nm). 11 patients had biopsies before and after therapy from lesional (depigmentation area), marginal, and perilesional skin for immunohistochemical studies of CD4+, CD8+, CD1a+ and CD83+ cells in epidermis and derma. Results: Median number of UVB procedures per course was 71, median total radiation dose-91.8 J/cm2, median percent of repigmentation-49%. Repigmentation of >25% of the affected area was reached in 67.9% of patients and repigmentation of 76-100% in 19.6% . VIDA index decreased from 2 to 1 post-treatment (P<0.035). In a subgroup who underwent immunohistochemical studies median number of UVB procedures per course was 88, median total dose of radiation-140.2 J/cm2, and median percent of repigmentation-50%. Significant activation of T-cellular immune reactions was found in lesions before treatment. There was a statistically significant increase in CD8+ lymphocytes and CD1a+ dendritic cells in marginal and perilesional normally pigmented skin in epidermis. There was an increase in CD4+ and CD8+ lymphocytes and CD83+ dendritic cells in all three zones in derma. Normalization of CD8+ and CD1+ cells in epidermis of the affected skin was observed post-treatment. There was only partial reduction of CD4+, CD8+ and CD1+ cells in dermis. Conclusions: Narrowband UVB phototherapy (311 nm) is an effective method of treatment of nonsegmental vitiligo. T-lymphocytes and Langerhans cells play a critical immunoregulatory role in narrowband UVB phototherapy (311 nm)-induced immune suppression. Lack of full normalization of immunological parameters in the skin after treatment indicates a need for optimization of narrowband UVB phototherapy (311 nm): conduction of longer courses including 150-200 procedures, or combinations of this treatment with immunosuppressive drugs.

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