Generic selectors
Exact matches only
Search in title
Search in content
Filter by Categories
15th National Conference of the IAOMFP, Chennai, 2006
Abstract
Abstracts from current literature
Acne in India: Guidelines for management - IAA Consensus Document
Addendum
Announcement
Art & Psychiatry
Article
Articles
Association Activities
Association Notes
Award Article
Book Review
Brief Report
Case Analysis
Case Letter
Case Letters
Case Notes
Case Report
Case Reports
Clinical and Laboratory Investigations
Clinical Article
Clinical Studies
Clinical Study
Commentary
Conference Oration
Conference Summary
Continuing Medical Education
Correspondence
Corrigendum
Cosmetic Dermatology
Cosmetology
Current Best Evidence
Current Issue
Current View
Derma Quest
Dermato Surgery
Dermatopathology
Dermatosurgery Specials
Dispensing Pearl
Do you know?
Drug Dialogues
e-IJDVL
Editor Speaks
Editorial
Editorial Remarks
Editorial Report
Editorial Report - 2007
Editorial report for 2004-2005
Errata
Erratum
Focus
Fourth All India Conference Programme
From Our Book Shelf
From the Desk of Chief Editor
General
Get Set for Net
Get set for the net
Guest Article
Guest Editorial
History
How I Manage?
IADVL Announcement
IADVL Announcements
IJDVL Awards
IJDVL AWARDS 2015
IJDVL Awards 2018
IJDVL Awards 2019
IJDVL Awards 2020
IJDVL International Awards 2018
Images in Clinical Practice
In Memorium
Inaugural Address
Index
Knowledge From World Contemporaries
Leprosy Section
Letter in Response to Previous Publication
Letter to Editor
Letter to the Editor
Letter to the Editor - Case Letter
Letter to the Editor - Letter in Response to Published Article
LETTER TO THE EDITOR - LETTERS IN RESPONSE TO PUBLISHED ARTICLES
Letter to the Editor - Observation Letter
Letter to the Editor - Study Letter
Letter to the Editor - Therapy Letter
Letter to the Editor: Articles in Response to Previously Published Articles
Letters in Response to Previous Publication
Letters to the Editor
Letters to the Editor - Letter in Response to Previously Published Articles
Letters to the Editor: Case Letters
Letters to the Editor: Letters in Response to Previously Published Articles
Medicolegal Window
Messages
Miscellaneous Letter
Musings
Net Case
Net case report
Net Image
Net Letter
Net Quiz
Net Study
New Preparations
News
News & Views
Obituary
Observation Letter
Observation Letters
Oration
Original Article
ORIGINAL CONTRIBUTION
Original Contributions
Pattern of Skin Diseases
Pearls
Pediatric Dermatology
Pediatric Rounds
Perspective
Presedential Address
Presidential Address
Presidents Remarks
Quiz
Recommendations
Regret
Report
Report of chief editor
Report of Hon : Treasurer IADVL
Report of Hon. General Secretary IADVL
Research Methdology
Research Methodology
Resident page
Resident's Page
Resident’s Page
Residents' Corner
Residents' Corner
Residents' Page
Retraction
Review
Review Article
Review Articles
Revision Corner
Self Assessment Programme
SEMINAR
Seminar: Chronic Arsenicosis in India
Seminar: HIV Infection
Short Communication
Short Communications
Short Report
Special Article
Specialty Interface
Studies
Study Letter
Supplement-Photoprotection
Supplement-Psoriasis
Symposium - Contact Dermatitis
Symposium - Lasers
Symposium - Pediatric Dermatoses
Symposium - Psoriasis
Symposium - Vesicobullous Disorders
SYMPOSIUM - VITILIGO
Symposium Aesthetic Surgery
Symposium Dermatopathology
Symposium-Hair Disorders
Symposium-Nails Part I
Symposium-Nails-Part II
Systematic Reviews and Meta-analyses
Systematic Reviews and Meta-analysis
Tables
Technology
Therapeutic Guidelines
Therapeutic Guidelines - IADVL
Therapeutics
Therapy
Therapy Letter
View Point
Viewpoint
What’s new in Dermatology

Translate this page into:

Original Article
2001:67:5;251-252
PMID: 17664763

Med estimation for narrow band UV-B on type IV and type V skin in India

Ganesh S Pai
 Department of Dermatology, Kasturba Medical College, Mangalore, India

Correspondence Address:
Ganesh S Pai
Department of Dermatology, Kasturba Medical College, Mangalore
India
How to cite this article:
Pai GS. Med estimation for narrow band UV-B on type IV and type V skin in India. Indian J Dermatol Venereol Leprol 2001;67:251-252
Copyright: (C)2001 Indian Journal of Dermatology, Venereology, and Leprology

Abstract

With an aim to determine minimum erythema dose of narrow band UV-B, 30 subjects, 20 with type I V skin and 10 with type V skin were subjected to graded incremental doses of 311-narrow band UV-B phototherapy cabinet by Daavlin. Barely perceptible erythema 24 hrs after exposure was taken as MED. 33.3% developed erythema at 745mj, 26.6% at 620mj, 23.3% at 1075mj, and 10% at 1290mj. The average MED for narrow band UV-B exposure for type I V skin was 600mj, [range 515-755mj] and for type V skin 1100 mj [range 895-1290mj] Better therapeutic response can be obtained by approximately 360 -450mj as initial irradiation dose for type IV skin and 600-825mj for type V skin.
Keywords: WED, Narrow band LJB

Introduction

311 nm narrow band UV-B is being effectively used in the treatment of various skin disorders. Determining MED helps in administering appropriate initial irradiation dose there by enhancing therapeutic efficacy. Based on clinical trials comparing PUVA and narrow band UV-B utilizing TL-01 lamps, TL-01 should be considered the first line treatment for psoriasis. TL-01 lamps have a relatively monochromatic spectrum of emission at 311+2 nm and has a reduced incidence of burning episodes, increased efficacy and longer remission which are distinct advantages over conventional broad band UVB sources. General advantages include safe use in children and pregnant women, no need for post treatment eye photoprotection, no drug induced nausea and absent drug costs. 311-nm narrow band UV-B is also widely used as an effective modality of therapy for atopic dermatitis, vitiligo, and photodermatoses.

As MED reaction becomes the primary basis for comparing therapeutic efficacy, other outcome comparisons eg: relative safety or toxic effects must be considered as a function of MED. In the absence of established data in literature regarding irradiation regimens, determining MED for different skin types helps in administering appropriate initial doses.

Materials and Methods

Spectra 311 narrow band UVB phototherapy cabinet by Daavlin containing 16 TL-01 lamps with a built in 2001 dose control system was used to determine MED. Of the 30 subjects in the study, 20 subjects [11 males and 9 females] had type IV skin and 10 subjects [3 males and 7 females] had type V skin.

Those with history of photosensitivity, any intake of systemic antibiotic or antiinflammatory drugs during the study and any inflammatory skin disorders like psoriasis,atopic dermatitis were excluded from the study. The preferred MED test site was the upper back where the template containing 8 windows [1.5x1.5] was put. The rest of the body was covered and photoprotective glasses were used. All of them were subjected to a test dose ladder of 300, 360,430.515,620,745,895,1075,1290,1550mj/cm of 311-nmUV-B radiation.

Results

Barely perceptible erythema 24 hrs after exposure was taken as MED. Of the 20 subjects with type IV skin 10[33.3%] developed erythema at 745mj,8[26.6%] at 620mj, 2[3.3%] of them developed erythema at 360mj and 515mj respectively. Of the 10 subjects with type V skin, 7 [23.3%] developed erythema at 1075mj and 3[10%] at 1290mj.

The average MED for narrow band UVB exposures for type IV skin was 600mj[range 515-755] and for type V skin 1100mj[range 895-1290mj]

Discussion

In our study, we noticed erythema as early as 3-4 hrs in 66.6% of the subjects, associated with mild tenderness in individuals with type IV skin. Average MED has been mentioned as 1000mj [range 400-1200mj/cm]. Though the average MED for type IV and type V skin falls within this range there can be individual variation as seen in one individual who developed erythema at 360mj. It has been noted that individuals with fair skin had MED that was higher or equal to those with more darkly pigmented skin. On the contrary in our study we found that subjects with fair skin developed erythema much earliar and at a lower dose than needed by individuals with type V skin. Therapy protocols should now be tailored to start the initial doses at 360-450mj for type IV skin 600-825mj for type V skin and gradually stepped up by 20% depending on the patients erythema response.

References
1.
British Photodermatology Group. An appraisal of Narrow Band [TL-01] Phototherapy. British photodermatology group workshop report [April 1996]. Br J Dermatol 1997; 137:327-330.
[Google Scholar]
2.
Van Weelden H, Baart de la Faille H, Young E, et al. A new development in UVB phototherapy of psoriasis. Br 3 Dermatol 1998; 119:11-19.
[Google Scholar]
3.
George SA, Bilsland DJ, Johnson BE, et al. Narrow Band [TL-01] UVB air conditioned phototherapy for chronic severe adult atopic dermatitis. Br. Ludmila Nieuweboer-Krobatova J Dermatol 1993; 128: 49-56.
[Google Scholar]
4.
Wiete Westerhof Ludmila Nieuweboer - Krobatova. Treatment of vitiligo, UVB radiation with topical psoralen plus UV-A. Arch Dermatol 1997; 133: 1525-1528.
[Google Scholar]
5.
Collins P, Ferguson J. Narrow band[TL-01] phototherapy: an effective and preventive treatment for photodermatoses. Br J Dermatol 1995; 132: 956-963.
[Google Scholar]
6.
Todd R Coven, Lauren H Burrack, Patricia Gilleau, et al. Narrow band UV-B produces superior clinical and histopathological resolution of moderate to severe psoriasis in patients compared with Broadband UV-B. Arch Dermatol 1997; 133:1514-1522.
[Google Scholar]
7.
Hofer A, Fink-Puches R, Kerl H, et al Comparison of phototherapy with near vs far erythemogenic doses of narrow band UV-B in patients with psoriasis. Br J Dermatol 1998;138: 96-100.
[Google Scholar]
Show Sections