Narrowband-UVB Phototherapy Effective for Psoriasis in Skin of Color

Narrowband-ultraviolet B (NB-UVB) phototherapy is an effective treatment alternative for patients with skin of color who have psoriasis and have failed topical regimens, according to recent data.1

NB-UVB phototherapy was highlighted in a recent systematic review looking at patients with skin of color. The treatment is known to be especially ideal as an option for those with multiple comorbidities or individuals seeking alternatives to systemics or biologics. Mio Nakamura, MD, from the Department of Dermatology at the University of Michigan, Ann Arbor, led a team of investigators in authoring this review exploring NB-UVB.

Nakamura et al noted that prior data suggest that approximately 62% of those treated with UVB attained at least 75% improvement in their Psoriasis Area and Severity Index scores (PASI75).2 They further pointed to the need for enhancement of the representation of non-White patients in related research into this form of psoriasis therapy.

“Given the regular use of NB-UVB in psoriasis patients, information regarding its efficacy and biochemical mechanisms of action in psoriasis patients with skin of color...is invaluable,” Nakamura and coauthors wrote.1 “Therefore, we performed a systematic review of all available studies to date assessing NB-UVB for psoriasis treatment in [skin of color].”

Systematic Review Details

The investigators conducted their systematic review in alignment with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Two independent reviewers implemented the PubMed and MEDLINE databases for their search of relevant publications. These would have been published up to November 15, 2024.

Nakamura and colleagues' aim was to collect primary studies assessing UVB phototherapy as a psoriasis treatment option among those with skin of color. Specifically, they looked at patients with Fitzpatrick skin types III–VI. The team's search strategy combined the terms “UVB AND psoriasis” with the names of countries in which patients with Fitzpatrick skin types III–VI are the predominant population.

They also made queries such as “UVB AND psoriasis AND Fitzpatrick III, IV, V, or VI” to ensure their review of available data was complete. Nakamura et al screened abstracts of all retrieved data. They also searched reference lists by hand for further research that would qualify for the review. The investigators would only include peer-reviewed, English-language publications presenting original findings on clinical outcomes of UVB use or mechanistic insights into NB-UVB in psoriasis among patients with skin of color.

Nakamura and coauthors also carried out a meta-analysis of studies that reported PASI75 as an endpoint. In each of these analyses, the proportion of patients achieving PASI75 was extracted by the investigative team as the effect size. Clopper-Pearson 95% confidence intervals (CIs) were computed by the team. Pooled PASI75 response rates and 95% CIs were estimated by the investigators via a generalized linear mixed-effects model with logistic transformation.

Findings on NB-UVB Phototherapy

Nakamura et al found that 54 of 1283 initially identified publications met their inclusion criteria. Among these, clinical outcomes of NB-UVB phototherapy in 1322 individuals with chronic plaque psoriasis and 12 individuals with palmoplantar psoriasis were found in 43 studies. All included subjects in these studies were shown to have Fitzpatrick types III–IV. The investigators then determined 9 studies were suitable for their meta-analysis.

Overall, the team concluded that 70.5% of patients assessed in these studies had attained PASI75 after use of NV-UVB. Nakamura and colleagues found that each analysis reported statistically significant improvements in participants' post-treatment PASI scores. When compared to broad band (BB)-UVB, NB-UVB was linked in these studies to a greater likelihood of complete disease clearance. However, the investigators did not identify a statistically significant difference in participants' PASI75 responses between those given NB-UVB versus PUVA therapy.

“Phototherapy is effective for the treatment of psoriasis in [skin of color] patients and remains a valuable treatment option despite the advent of various topical, systemic, and biologic treatments for psoriasis, especially in those who have a desire to avoid or do not have access to such treatments,” the investigative team wrote.1

References

1. Hauptman M, El Othmani A, Nakamura M, et al. Narrowband-Ultraviolet B Phototherapy for Psoriasis Treatment in Skin of Color: A Systematic Review and Meta-Analysis. Photodermatol Photoimmunol Photomed. 2025 Sep;41(5):e70051. doi: 10.1111/phpp.70051. PMID: 40908513; PMCID: PMC12411661. Accessed September 8, 2025.

2. Almutawa F, Alnomair N, Lim HW, et al. Systematic review of UV-based therapy for psoriasis. Am J Clin Dermatol. 2013 Apr;14(2):87-109. doi: 10.1007/s40257-013-0015-y. PMID: 23572293. Accessed September 8, 2025.