Indian Dermatol Online J. 2026 Jun 9. doi: 10.4103/idoj.idoj_80_25. Online ahead of print.
ABSTRACT
BACKGROUND: Narrowband ultraviolet B (NBUVB) phototherapy is an established treatment for vitiligo. However, real-world practices vary significantly, particularly in dosing strategies, maintenance schedules, and the use of minimal erythema dose (MED) testing, impacting treatment outcomes.
AIM AND OBJECTIVES: To assess NBUVB phototherapy practices among Indian dermatologists, evaluate patient characteristics and treatment outcomes, and identify variations in clinical protocols.
PATIENTS AND METHODS: An online, questionnaire-based survey was conducted among 80 Indian dermatologists who responded actively using NBUVB. The questionnaire was validated through expert review, pilot testing, and reliability assessment before deployment. Validation included content validation by three senior dermatologists with more than 15 years of phototherapy experience to ensure item relevance and clarity. A pilot test among 10 dermatologists confirmed internal consistency. Data were analyzed using descriptive statistics.
RESULTS: Among 80 respondents (response rate of 5%), 65% had >10 years’ experience. Most respondents (52.5%) used only NBUVB whole-body units, while others employed combination or targeted phototherapy devices. MED testing was performed by only 30%, typically using visual test dose methods; 70% used empirical starting doses. A 200 mJ/cm² starting dose was most common (60%). Maintenance therapy was administered every 1-2 weeks in 75%. Early clinical improvement was observed after 10-20 sessions, and >50% re-pigmentation in vitiligo occurred after 50-70 sessions in 85%. Acral vitiligo showed a mixed response, with poor or limited response in 60% of cases. Mild erythema (80%) and burning (60%) were the most reported side effects.
LIMITATIONS: The study is limited by self-reported data, possible recall bias, and lack of detail on MED testing procedures.
CONCLUSION: There is marked variability in NBUVB protocols among Indian dermatologists. Emphasizing standardized guidelines and MED-based personalized dosing could improve therapeutic outcomes and patient safety in vitiligo management.
PMID:42301666 | DOI:10.4103/idoj.idoj_80_25
