Narrow-band ultraviolet B and broad-band ultraviolet A phototherapy in adult atonic eczema: a randomised controlled trial

Background Narrow-band ultraviolet B (UVB) is an effective treatment for ps oriasis, and open studies suggest that this phototherapy might improve atop ic eczema. We did a randomised controlled trial to compare narrow-band UVB, UVA, and visible light phototherapy as second-line, adjunctive treatments in adult patients with moderate to severe atopic eczema. Methods Phototherapy was administered twice a week for 12 weeks. 26 patient s were randomly assigned narrow-band UVB, 24 were assigned UVA, and 23 visi ble fluorescent light. The primary endpoints were change in total disease a ctivity (sum of scores at six body sites) and change in extent of disease a fter 24 treatments compared with baseline. Data were analysed by the method of summary measures. Findings 13 patients withdrew or were excluded from analysis. Mean reductio ns in total disease activity over 24 treatments in patients who received na rrow-band UVB and UVA, respectively, were 9.4 points (95% CI 3.6 to 15.2)an d 4.4 points ( - 1.0 to 9.8) more than in patients who received visible lig ht. Mean reductions in extent of disease after 24 treatments with narrow-ba nd UVB and UVA were 6.7% (1.5 to 11.9) and -1.0% (-5.3 to 3.3)compared with visible light. A small proportion of patients developed erythema after pho totherapy or had a flare in their eczema sufficient to withdraw from treatm ent. Interpretation Narrow-band UVB is an effective adjunctive treatment for mod erate to severe atopic eczema, and the treatment is well tolerated by most patients.