Broadband ultraviolet A vs. psoralen ultraviolet A in the treatment of vitiligo: a randomized controlled trial

Psoralen ultraviolet A (PUVA) and narrowband (NB)-UVB have been shown to be efficacious in the treatment of vitiligo. With large and repeated doses, UVA may lead to immediate skin darkening and to delayed tanning. Our previous experience with broadband (BB)-UVA in vitiligo showed encouraging results.

To test the efficacy of BB-UVA in vitiligo and to evaluate if it could provide an alternative treatment for this condition.

This prospective, randomized, controlled, comparative clinical trial enrolled 45 patients with vitiligo, who were randomly divided into three groups, with group A receiving UVA 15 J/cm(2) /session, group B receiving UVA 10 J/cm(2) /session, and group C receiving PUVA. The patients received three sessions/week for 5 months, with 60 sessions in total.

At the mid-point of treatment, clinical response was significantly higher in patients receiving PUVA than in the other two groups At the end of the study, clinical response was comparable for groups A and C (UVA 15 J/cm(2) and PUVA, respectively), and both were significantly higher than the group receiving UVA 10 J/cm(2) . Patients in the PUVA group responded mainly with perifollicular pigmentation, whereas those receiving UVA responded mainly with lesional tanning.

BB-UVA at a dose of 15 J/cm(2) /session gives results for vitiligo that are comparable to PUVA, suggesting it might be useful when oral psoralens are contraindicated.