Investigating the course of atopic eczema up to 1 year following completion of narrowband ultraviolet B phototherapy

BACKGROUND: Narrowband (NB)-ultraviolet B (UVB) is a second-line treatment for chronic moderate-to-severe atopic eczema unresponsive to adequate topical therapy, and is known to induce good short-term improvement of eczema severity. However, it is unclear how adult patients fare with their eczema severity long after completion of a course of NB-UVB. OBJECTIVES: To investigate the severity of atopic eczema in adults, 1 year following completion of NB-UVB, using validated clinical activity measures. METHODS: We undertook a multicentre prospective observational study of adults with moderate-to-severe atopic eczema who were prescribed NB-UVB as part of their standard clinical care. Assessments were made at baseline prior to starting NB-UVB, at the end of NB-UVB and at 4, 8 and 12 months after completion of NB-UVB. RESULTS: Eighty participants with moderate-to-severe atopic eczema [mean Objective SCORing Atopic Dermatitis (SCORAD) 39.2 (SD 12.8), Patient-Oriented Eczema Measure (POEM) 18.5 (SD 6.4) and Investigator Global Assessment (IGA) 3.2 (SD 0.5)] underwent NB-UVB therapy. Significant reductions were observed post-treatment: Objective SCORAD decreased to 17.8 (SD 11.4), POEM to 8.2 (SD 6.2) and IGA to 1.7 (SD 1.0) (P < 0.001 achieved for all timepoints). These therapeutic effects were sustained at 4, 8 and 12 months post-treatment (n = 27 at 12 months). Loss to follow-up was attributed to nonattendance exacerbated by the COVID-19 pandemic and patient relocation. Mild adverse events (n = 5), including erythema and eczema flares, were reported, with no serious events. CONCLUSIONS: These findings indicate that NB-UVB may provide a long-lasting effect for patients who complete a course, helping to diminish their eczema severity to a more manageable level.