To Observe The Efficacy Of NB-UVB In Vitiligo And To Explore The Factors Affecting The Therapeutic Effects

Background Vitiligo is a depigmentation disease, NB-UVB has been widely used in the treatment of vitiligo because of its good curative effect, little side effect, simple operation. Previous researches had showed that the therapy efficacy was related to many factors, such as type, location, color of skin, age, disease duration. The present study shows that the efficacy of NB-UVB in vitiligo and the incidence of vitiligo was associated with cytokines and chemokines. But some vitiligo patients in stable stage had poor treatment effect, the specific reasons were little reported; After NB-UVB used in vitiligo a period of time, efficacy were stop, the platform appeared, the relationship between efficacy and phototherapy number of initial repigmention 、 phototherapy number when platform stage began were not reported; after NB-UVB used for a period of time, white spot will appear light resistance, patients had to have a rest for a period of time until white spots return to initial light sensitivity, but how long it will recover has not been reported. This study is to explore these problems.Objective To observe the relationship between efficacy and phototherapy number of intial repigmention、phototherapy number when platform stage began; To test how long did the lesion will return to initial light sensitivity; To explore the difference of related cytokines and chemokines levels between patients with poor efficacy and good efficacy,to explore the reasons why the efficacy of part patients were poor.Methods Selected 66 patients who meet the requirements of this study, recorded the patients’ situations of repigmention throw photograph during phototherapy, compared differences between efficacy and phototherapy number of initial repigmention 、phototherapy number when platform stage began. After the lesions entered the platform stage, selected the 2 x 2 cm areas of lesion, used the lesion ’ s minimal erythema doses to test sensitive regularly, if the lesion became red,we thought it has recover sensitive, record the time. Selected 20 patients who had completed phototherapy, ten of them the repigmention is less than 10% and ten of them the repigmention is more than 75%,used Luminex to test the level of GM-CSF,IL-4,IL-6, IL-10, TNF-α、IFN-γ, IP-10.Results The efficacy of patients whose initial repigmention was appeared before the ninth phototherapy were better( P < 0.05); The efficacy of patients whose total phototherapy number during effective phototherapy were more than 17 times was better(P<0.05); the time when platform stage appeared had no relationship with efficacy. The duration of the light resistance was during 30 days and 75 days. There are differences between patients with good efficacy and poor efficacy in the lever of TNF-α, IFN-γ,IL-10.Conclusion 1. To the patient who treated with NB-UVB, if his initial repigmention was appeared before the ninth phototherapy, his effective total phototherapy numbers were more, and his efficacy was better. 2.All patients have platform stage, it has no relationship with efficacy and the time when initial repigmention appeared.3.After entered platform stage, have a rest for more than 75 days before the next phototherapy,in order to get good efficacy under less cumulative energy..4.The reason why part patients have poor efficacy may be due to the secretion of TNF-α, IFN-γ, IL-10,IP-10.