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Narrowband ultraviolet B phototherapy in children with moderate-to-severe eczema: a comparative cohort study
S Darné1, S N Leech, A E M Taylor
1Department of Dermatology, Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne, NE1 4LP, U.K.
Insights
Narrowband ultraviolet B (NB-UVB) therapy significantly improves eczema symptoms and quality of life in children. These positive effects on eczema management are sustained for at least six months post-treatment.
Area of Science:
- Dermatology
- Phototherapy
- Pediatric Atopic Dermatitis
Background:
- Limited retrospective data exists on the efficacy of narrowband ultraviolet B (NB-UVB) for childhood eczema.
- Prospective evidence is needed to validate NB-UVB's effectiveness in pediatric patients.
Purpose of the Study:
- To prospectively evaluate the clinical effectiveness of NB-UVB in children with eczema.
- To compare objective eczema severity scores and quality-of-life measures between NB-UVB treated and untreated children.
- To assess the durability of NB-UVB treatment effects at 3 and 6 months post-therapy.
Main Methods:
- A prospective study involving 29 children (aged 3-16) with indicated NB-UVB therapy.
- Eczema severity was assessed using the Six Area Six Sign Atopic Dermatitis (SASSAD) score and percentage of body surface area involvement.
- Comparison was made with a cohort of 26 children who declined NB-UVB treatment.
Main Results:
- NB-UVB treatment resulted in a 61% reduction in mean SASSAD scores, compared to a 6% increase in the untreated group.
- Mean SASSAD scores at treatment end were 11.6 (NB-UVB) vs. 24.8 (untreated), with a significant difference (P < 0.0001).
- Mean surface area involvement decreased to 11% in the NB-UVB group versus 36% in the untreated group (P < 0.0001). Quality-of-life scores also showed significant improvement.
Conclusions:
- NB-UVB therapy is a clinically effective treatment for moderate-to-severe eczema in children.
- The treatment significantly improves both objective measures of eczema severity and patient quality of life.
- The therapeutic benefits of NB-UVB for childhood eczema are maintained for up to six months after cessation of treatment.
Background:
There is only retrospective evidence for the efficacy of narrowband ultraviolet B (NB-UVB) in children with eczema.
Objectives:
To measure the difference in means for objective scores [Six Area Six Sign Atopic Dermatitis score (SASSAD), percentage surface area] and quality-of-life scores, between patients treated with NB-UVB and unexposed cohorts at the end of treatment, and 3 and 6 months post-treatment.
Methods:
Twenty-nine children aged 3-16 years for whom NB-UVB was indicated, were scored prospectively using SASSAD and percentage surface area involvement at baseline, at 12 weeks (end of treatment) and 3 and 6 months post-NB-UVB. Their scores were compared with those of unexposed children (n = 26) for whom NB-UVB phototherapy was indicated and offered, but who chose not to undertake treatment.
Results:
There was a 61% reduction in mean SASSAD score in the NB-UVB cohort compared with an increase of 6% in the unexposed cohort. Mean SASSAD score for the NB-UVB cohort at the end of treatment was 11.6 vs. 24.8 for the unexposed; difference in means -13.2 [95% confidence interval (CI) -18.7 to -7.7, P < 0.0001]. Mean surface area involvement at the end of treatment was 11% for the NB-UVB cohort vs. 36% for the unexposed cohort; difference in means -25% (95% CI -34% to -16%, P < 0.0001). Subjective and quality-of-life scores showed significant difference between cohorts at the end of treatment (P < 0.05). Objective scores remained significantly lower than in the unexposed cohort 3 and 6 months after treatment.
Conclusion:
NB-UVB is clinically effective and improves quality of life in children with moderate-to-severe eczema. The effect is maintained for 6 months after treatment.
