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Italian Journal of Dermatology and Venereology 2021 May 13

DOI: 10.23736/S2784-8671.21.06975-3


lingua: Inglese

Frequency of phototherapy for treating psoriasis: a systematic review

Giovanni DAMIANI 1, 2, 3, Alessia PACIFICO 4, Sherman CHU 3, Ching-Chi CHI 5, 6 , Young Dermatologists Italian Network (YDIN)

1 Clinical Dermatology, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy; 2 Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy; 3 Department of Dermatology, Case Western Reserve University, Cleveland, OH, USA; 4 San Gallicano Dermatological Institute, IRCCS, Rome, Italy; 5 Department of Dermatology, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan; 6 College of Medicine, Chang Gung University, Taoyuan, Taiwan


INTRODUCTION: Narrow band ultraviolet B (NB-UVB) and psoralen-ultraviolet A (PUVA) remain inexpensive and effective anti-psoriatic therapies adopted worldwide with different frequency protocols. We aimed to systematically assess the evidence on the effects of different frequency protocols of phototherapy in treating psoriasis.
EVIDENCE ACQUISITION: We used the following terms, namely “photochemotherapy”, “phototherapy”, “psoriasis”, “UVB”, “UVA” and “ultraviolet therapy”, to search the Cochrane Controlled Register of Trials, MEDLINE and Embase databases on August 1, 2019. We organized results using a PRISM diagram and analyzed bias risks with RoB-2 tool.
EVIDENCE SYNTHESIS: We included five randomized controlled trials (RCTs) on oral PUVA and three RCTs on NB-UVB. The five studies on PUVA included a total of 1452 patients with plaque psoriasis and did not find any significant difference in efficacy comparing two- vs. three- vs. four times weekly protocols. The three studies on NB-UVB included a total of 248 patients with plaque psoriasis. No differences in efficacy were reported in comparing different frequencies in delivering NB-UVB, namely twice vs. thrice weekly, twice vs. four times weekly, and thrice- vs. five times weekly protocols. Although protocols with higher treatments frequency per week achieved clearance faster than lower frequency ones, but they did not differ in terms of efficacy.
CONCLUSIONS: PUVA and NB-UVB remain an effective anti-psoriatic treatment; however further studies are needed to elucidate which protocol may be more effective in different skin phototypes.

KEY WORDS: Phototherapy; Psoriasis; Narrow band-ultraviolet B (NB-UVB), Psoralen-ultraviolet A (PUVA); Frequency

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