Narrowband-ultraviolet B vs Broadband-ultraviolet B in Treatment of Chronic Pruritus: A Randomized, Single-blinded, Non-inferiority Study

Narrowband-ultraviolet B has shown increased efficacy over broadband-ultraviolet B in pruritic skin diseases, such as psoriasis and atopic dermatitis. In patients with chronic pruritus, e.g. in end-stage renal disease, broadband-ultraviolet B is recommended, but narrowband-ultraviolet B has also shown efficacy in reducing pruritus. This randomized, single blinded, non-inferiority study investigated the effects of narrowband-ultraviolet B compared with broadband-ultraviolet B. Patients with chronic pruritus were treated with either broadband- or narrowband-UVB 3 times a week for 6 weeks and clinical response was monitored. Pruritus, sleep disturbance, and the patients’ subjective overall response to treatment were evaluated by the patients on a visual analogue scale (0–10). Skin excoriations were evaluated by investigators on a 4-point scale (0–3). Both phototherapeutic modalities showed significant antipruritic activity (itch reduction 48% and 66.4%, respectively) by broadband-ultraviolet B and narrowband-ultraviolet B. Narrowband-ultraviolet B proved to be not inferior to broadband-ultraviolet B in treating pruritus in patients with chronic pruritus, assuming a 20% non-inferiority margin. SIGNIFICANCE Phototherapy is an important treatment modality in inflammatory skin diseases such as psoriasis, atopic dermatitis and cutaneous T-cell lymphoma (e.g. mycosis fungoides/Sézary syndrome). In patients with chronic pruritus, with or without pruriginous skin lesions, ultraviolet light therapy is capable of reducing pruritus. However, it remains unclear whether narrowband-ultraviolet B or broadband-ultraviolet B treatment is more effective to combat chronic pruritus. This study investigated the effects of narrowband-ultraviolet B and broadband-ultraviolet B on chronic pruritus, patients’ sleep quality and subjective treatment effects, as well as on skin excoriations. Narrowband-ultraviolet B was found to be not inferior to broadband-ultraviolet B in the treatment of patients with chronic pruritus.