Spectrophotometric Measurement of Minimal Erythema Dose Sites after Narrowband Ultraviolet B Phototesting: Clinical Implication of Spetrophotometric Values in Phototherapy

BACKGROUND: The spectrophotometer is well known to be a useful tool for estimating the objective minimal erythema dose (MED) during planning of phototherapy protocol. However, only a few spectrophotometric values are used to evaluate the erythema and pigmentation of the MED site during phototesting. OBJECTIVE: To determinea new meaning of the relationships among spectrophotometric values during phototesting. METHODS: Twenty-five patients with psoriasis and 23 patients with vitiligo were selected before undergoing narrowband ultraviolet B phototherapy. We interpreted the gross findings of erythema and measured the L(*)a(*)b(*) values using a spectrophotometer at each phototest spot. We compared MEDs, basic spectrophotometric values (L(*)a(*)b(*)), and b(*)/L(*) values separately according to skin type, and determined the correlation of each spectrophotometric value and the correlation between a(*) and b(*)/L(*) values. RESULTS: Among L(*)a(*)b(*) values, only b(*) values showed a statistically significant difference between the type III and IV groups (p=0.003). There was a positive correlation only between MEDs and b(*) values (p<0.05). The average b(*)/L(*)value in the type IV group was significantly higher than the type III group (p<0.05). CONCLUSION: The higher b(*) values in type IV skin indicates that skin tanning develops more prominently than type III. The correlation between MEDs and b(*) values may signify that the skin pigmentation status is deepened with the higher MEDs. The difference in b(*)/L(*)values between type III and IV skin reflects that the b(*)/L(*)value is thought to be an index of tanning. The a(*) value, known as an index of erythema, does not influence the degree of tanning.