Narrowband-Ultraviolet B Phototherapy for Psoriasis Treatment in Skin of Color: A Systematic Review and Meta-Analysis

Abstract

Background: Narrowband-ultraviolet B (NB-UVB) phototherapy is an effective treatment for psoriasis in patients who have failed topical regimens or those who desire to avoid systemic treatment. Despite its regular use in non-white individuals, NB-UVB treatment response for psoriasis in skin of color (SOC) has not been systematically reviewed. Methods: We conducted a systematic review on the basis of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) on all available studies to date assessing NB-UVB for psoriasis treatment in skin of color (SOC) (up to 15 November 2024). The primary outcome was qualitative data on clinical outcomes of UVB (PASI 75). Random-effects meta-analysis was performed to assess treatment responses. Secondary outcomes of biochemical and immunologic mechanisms of NB-UVB, NB-UVB in combination with other treatments, and NB-UVB compared to other forms of phototherapy were assessed. Results: Of 1283 articles initially identified, 54 were ultimately included for formal review. We identified 43 articles assessing clinical outcomes of NB-UVB phototherapy in patients with Fitzpatrick skin type III–IV for a total of 1322 patients with chronic plaque psoriasis and 12 patients with palmoplantar psoriasis. Nine studies were included for meta-analysis of PASI75 response; 70.5% of patients achieved PASI75, and all studies demonstrated statistically significant PASI improvement after treatment. NB-UVB demonstrated a higher rate of complete clearance when compared to BB-UVB but did not result in a statistically significant difference in the proportion of the patient population achieving PASI75 when compared to PUVA. Conclusions: Phototherapy is effective for the treatment of psoriasis in SOC patients and remains a valuable treatment option despite the advent of various topical, systemic, and biologic treatments for psoriasis.