Effect of narrowband ultraviolet B phototherapy on melanocytic naevi

Phototherapy for Psoriasis in the Age of Biologics

Phototherapy has utility as a psoriatic therapy, given its relatively high clinical efficacy, low side effect profile, and lower cost compared to newer effective treatments like biologics and small molecules. Phototherapy has shown Psoriasis Area and Severity Index (PASI)-75 and PASI-90 rates comparable to those of biologics and small molecules, with similarly rapid onsets of action, rates of remission, and quality of life scores. Certain patients may particularly benefit from phototherapy, such as those with localized disease or contraindications to systemic immunomodulatory medication. Phototherapy can be more cost-effective than biologics and conveniently administered at home, making it a valuable therapeutic option for the right patient.

Phototherapy in the Pediatric Population

Phototherapy has been used successfully to treat a wide range of pediatric skin conditions. It is a viable option in children with severe dermatologic disease or who have failed first-line treatments, and several studies have demonstrated its efficacy and safety in the pediatric population. Despite the growing body of evidence on the use of phototherapy in children, large controlled trials and long-term studies are lacking. Moreover, special considerations must be taken when using phototherapy in children. This review highlights the recent evidence supporting the efficacy and safety of phototherapy in children, with focus on the common light-sensitive pediatric skin conditions.

Dermoscopic changes in melanocytic nevi covered with both opaque tape and sunscreen cream during narrowband ultraviolet B therapy

Background

Ultraviolet (UV) light may cause dermoscopic changes on melanocytic nevi (MN).

Objectives

To investigate the effects of sunscreen cream (SSc) application on dermoscopic changes in MN during narrowband UVB (NBUVB) therapy.

Methods

Half of the randomly selected MN in each patient were covered with opaque tape and SSc [SSc(+)], and the rest were covered with only opaque tape [SSc(−)] during NBUVB treatment sessions.

Results

More SSc(−) MN displayed dermoscopic changes at end of NBUVB therapy compared to the start of therapy (p=0.035). The number of the MN that decreased in size and showed loss of structure was significantly higher in SSc(−) MN (p=0.04 and p=0.026, respectively).

Conclusions

Sunscreen in combination with opaque tape may contribute to some dermoscopic changes in melanocytic nevi, including decrease in size and loss of structure.

Dermoscopic and Immunohistochemical Changes in Acquired Melanocytic Nevi following Narrow-Band Ultraviolet B Therapy

BACKGROUND

Acquired melanocytic nevi (AMN) have been reported to undergo morphological and dermoscopic changes following exposure to narrow-band ultraviolet B (NB-UVB) radiation.

OBJECTIVE

To study the morphological, dermoscopic and immunohistochemical changes in AMN following NB-UVB radiation.

METHODS

Suberythemogenic NB-UVB sessions were delivered to 40 patients with AMN. For each patient, a minimum of 2 nevi were selected. One nevus was surgically removed from each patient prior to sessions as control; for the other nevus, dermoscopic images were captured before and after NB-UVB sessions. The images were evaluated for changes. At the end, another nevus was surgically removed for immunohistochemical assessment of Ki-67 and melan-A.

RESULTS

Our study showed a statistically significant increase in the size of AMN following NB-UVB radiation. Benign dermoscopic changes were observed. Statistically significant positive correlations were found between some dermoscopic findings and the total cumulative dose of NB-UVB. Immunohistochemical analysis did not show any significant change in the exposed AMN.

CONCLUSION

AMN irradiated with repeated suberythemogenic doses of NB-UVB showed benign morphological and dermoscopic changes, and this was confirmed by our immunohistochemical study.

An observational case series on dermatoscopic patterns of fading melanocytic naevi

BACKGROUND/OBJECTIVES

The prevalence of melanocytic naevi falls with age. It has been postulated that this could be due to spontaneous involution (fading). Our objective was to provide dermatoscopic evidence of fading naevi and to describe the patterns of fading observed.

METHODS

Serial dermatoscopic images of naevi demonstrating fading were collected from a set of 25 000 images. Any naevi that showed significant fading, as compared to previous imaging of the same lesion, were included in the analysis.

RESULTS

A total of 47 naevi in 21 patients were found to have significantly faded over a span of 2-11 years. The dermatoscopic fading was observed to occur in two patterns. The most common pattern observed was generalised fading (n = 45), where fading was present over all the naevus. There were two cases of focal fading (n = 2) where fading was present only over one area of the naevus.

CONCLUSIONS

Fading melanocytic naevi are uncommon. Melanocytic naevi fade in recognisable patterns, with generalised fading most commonly observed in our series.