Evaluation of narrowband ultraviolet B phototherapy in patients with generalized lichen planus

Background: Lichen planus (LP) is a chronic inflammatory pruritic dermatosis affecting people of all ages and both sexes. Various therapeutic modalities have been tried in acute generalized LP with limited success. Currently, narrowband ultraviolet B (NB-UVB) therapy is being used to treat various inflammatory diseases. There are limited published studies in the literature to evaluate the efficacy of NB-UVB therapy in LP. Aim: To evaluate the efficacy, tolerability, and safety of NB-UVB therapy in acute generalized LP in both children and adults clinically and to observe relapse on follow-up. Materials and Methods: This was a prospective, open, and nonrandomized study. The study group included 70 patients of both sexes with a mean age group of 5–65 years. For the purpose of the study, a template of 5 × 5 cm with a high density of lesions was taken in addition to general response and photographic evaluation before and after treatment. A starting dose of 150 mJ/cm2 was started given twice weekly on nonconsecutive days with a 20% increment on every third exposure. The clinical response was graded on a four-point scale (excellent to poor). All cases who responded were observed for a period of 6 months for relapse. Appropriate statistical methods were employed. Results: In this study, excellent response was seen in 35 patients (mean: 25.7 exposures), good response in 11 patients (25.3 exposures), fair response in 9 patients (50 exposures), and poor response in 5 patients (50 exposures) (P-value = 0.000). A relapse rate of 9% after 6 months of follow-up and 36% after 1-year follow-up was observed (P-value = –0.002). Limitations: As the sample size of this study is small, large studies are needed to establish the efficacy of NB-UVB therapy in acute generalized LP. Conclusion: NB-UVB therapy is an effective and safe modality of treatment for acute generalized LP in both children and adults. Approximately, 20–25 exposures are needed to get good response. Prolonged remission is obtained with NB-UVB therapy