Low-dose narrow-band UVB phototherapy combined with topical therapy is effective in psoriasis and does not inhibit systemic T-cell activation

Topical tar: back to the future

The use of medicinal tar for dermatologic disorders dates back to the ancient times. Although coal tar is utilized more frequently in modern dermatology, wood tars have also been widely employed. Tar is used mainly in the treatment of chronic stable plaque psoriasis, scalp psoriasis, atopic dermatitis, and seborrheic dermatitis, either alone or in combination therapy with other medications, phototherapy, or both. Many modifications have been made to tar preparations to increase their acceptability, as some dislike its odor, messy application, and staining of clothing. One should consider a tried and true treatment with tar that has led to clearing of lesions and prolonged remission times. Occupational studies have demonstrated the carcinogenicity of tar; however, epidemiologic studies do not confirm similar outcomes when used topically. This article will review the pharmacology, formulations, efficacy, and adverse effects of crude coal tar and other tars in the treatment of selected dermatologic conditions.

Narrow-band ultraviolet B radiation: a review of the current literature

BACKGROUND

Narrow-Band radiation (NB-UVB) is a relatively new treatment modality for psoriasis and many practitioners may be unaware of its effectiveness and applications.

OBJECTIVE

The purpose of this study is to review the literature and compare NB-UVB to both broad-band ultraviolet B radiation (BB-UVB) and psoralen plus ultraviolet A radiation (PUVA) for the treatment of psoriasis and other dermatoses.

METHODS

A comprehensive Medline search of the literature was done on all citations electronically cataloged since the mid 1960s.

RESULTS

NB-UVB is superior to BB-UVB, but less effective than PUVA for the treatment of psoriasis, and is beneficial for the treatment of many other dermatoses.

CONCLUSION

NB-UVB is a useful and important adjust to the treatment of psoriasis.

No additional effect of calcipotriol ointment on low-dose narrow-band UVB phototherapy in psoriasis

BACKGROUND

Broad-band UVB phototherapy has appeared to be effective in clearing psoriatic lesions. After the advent of calcipotriol ointment, promising results have been obtained by combining these two therapeutic modalities. Also, an additional effect of narrow-band UVB phototherapy on treatment with calcipotriol ointment has been demonstrated.

OBJECTIVE

Our purpose was to compare treatment with low-dose narrow-band UVB phototherapy both with and without calcipotriol ointment.

METHODS

We included 53 patients suffering from plaque-type psoriasis. All patients underwent low-dose narrow-band UVB phototherapy. Nearly half of the patients were randomized to apply calcipotriol ointment (50 microg/g) twice daily on the affected skin. The Psoriasis Area and Severity Index (PASI) was used to evaluate psoriatic lesions.

RESULTS

In this study we showed that low-dose narrow-band UVB phototherapy is effective in the treatment of psoriasis and that calcipotriol ointment does not improve treatment outcome.

CONCLUSION

Calcipotriol ointment does not improve treatment with low-dose narrow-band UVB phototherapy.