The Use of Narrow-Band Ultra-Violet B Photo Therapy in Treatment of Dermatitis Herpetiformis in Iraqi Patients (A Pilot Study)

Abstract

Dermatitis herpetiformis (DH) is an intensely pruritic chronic and recurrent papulovesicular disease affecting patients mainly between the ages of 20 -55 years. Several drugs are used for treatment of DH mostly dapsone and sulfapyridine with side effects like hemolytic anemia and methaemo globulinemia. Narrow band UVB refers to a specific wave length of ultraviolet radiation 311 – 312 nm. It has been used for treatment of pruritus and some of skin diseases that associated with pruritus like lichen planus, atopic dermatitis, cutaneous lymphoma and dermographism. NB UVB was arranged as a trial therapy for treatment of DH. A total of 16 patients with D.H were enrolled in the study for a period extended from January 2011 to April 2013. Fourteen patients completed the study. Patients ages ranged from 24 – 55 years, mean  S.D ; 38.21  9.20 years. There were 12 males and 2 females, male : female ratio was 6:1.NB UVB was found to be very effective in reducing the severity of pruritus in D.H patients as there was dramatic reduction in VAS score in all 14 patients (100%). The number of patients responded to NB UVB therapy regarding reduction in number of lesions at the end of treatment was 13 patients (92.8%) , this included all grades of improvement ( mild 14.3 % , moderate 14.3% and dramatic 64.3% ). The number of sessions of NB UVB ranged from 24 – 32, mean  S.D 29.7  3.75 . The maximum irradiation time was 9 minutes (3000 mJ/ cm2).NB UVB was safe and effective for treatment of DH and it can be used as an alternative therapy for those patients who not respond to dapsone or developed side effects from it. To the best of our knowledge, this is the first study in Iraq and a broad to use NB UVB in the management of D.H.