In the January issue of the Archives, Colbert and colleagues1 report on the successful use of narrowband (NB) UV-B phototherapy in a patient with widespread extragenital lichen sclerosus (LS). We fully agree that NB UV-B is an attractive alternative for patients with extragenital LS if UV-A1 devices are not available. After having treated several patients with NB UV-B, we believe that at least 30 irradiation sessions (similar to NB UV-B treatment for localized scleroderma) are necessary to produce significant changes in the clinical status.2 Importantly, patients must be advised that their skin disease might appear “deteriorated” during phototherapy because the healthy surrounding skin tans more strongly than LS lesions.
Kreuter A, Gambichler T. Narrowband UV-B Phototherapy for Extragenital Lichen Sclerosus. Arch Dermatol. 2007;143(9):1209-1226. doi:10.1001/archderm.143.9.1213-a