BRIEF COMMUNICATION Broadband targeted UVB phototherapy for localized vitiligo: a retrospective study Ahmet Akar, Mustafa Tunca, Erol Koc & Zafer Kurumlu Dermatology, GulhaneMilitary Medical Academy, Ankara, Turkey Key words: vitiligo; treatment; UVB; targeted phototherapy Correspondence: Ahmet Akar, Dermatology, Gulhane Military Medical Academy, Ankara, Turkey. Tel: 190 31 2304 4456 Fax: 190 31 2304 4450 e-mail: aakar@gata.edu.tr Accepted for publication: 7 January 2009 Conflicts of interest: None declared. Summary Phototherapy with ultraviolet B (UVB) or PUVA has been used in the treatment of vitiligo for many years. The aim of this study was to analyze retrospectively the efficacy and safety of targeted broadband UVB phototherapy in patients with localized vitiligo. Thirty-two patients (14 male, 18 female), aged 18–65 years, were treated with Daavlin T500x High Dose Targeted Phototherapy System. Patients were treated twice or thriceweekly, totaling 20 to 60 sessions. Out of 32 total patients, only four patients (12.5%) showed visible repigmentation. In two patients, repigmentation was more than 75%. Other two patients showed mild repigmentation (less than 25%). All the lesions responsive to treatment were facial lesions. Mild adverse events recorded in 3 of 32 patients. Although safety of targeted broadband UVB phototherapy in the treatment of localized vitiligo is good, its therapeutic effectiveness is limited and depends on the locations of vitiligo lesions. P hototherapy with ultraviolet B (UVB) or PUVA has been used in the treatment of widespread vitiligo for many years. New phototherapy devices have been developed recently which allows phototherapy to be targeted onto the lesion to be treated. The selective exposure of the skin areas to be treated undoubtedly represents significant benefits for patients in terms of safety and efficacy.Targeted broadband UVB (TB-UVB) (1, 2) and targeted narrowband UVB (TN-UVB) (3, 4) have been recently studied in several trials. We have also analyzed, retrospectively, the results of our treatments with a TB-UVB device to determine if this treatment could be a safe and effective treatment option for localized vitiligo. Materials and Methods Daavlin T500 x High Dose Targeted Phototherapy System (Daavlin, Bryan, OH, USA) was used as the irradiation source in this study. The UVB spectral output of this light source peaks at 302 and 312 nm. UV radiation is delivered through a square aperture, measuring 1.9  1.9 cm. Thirty-two patients (14 male, 18 female), aged 18–65 years (mean  SD = 33.8  12.9) were treated. All the patients had localized vitiligo with skin involvement o 20%, unresponsive to topical therapies (such as steroids, calcipotriol, and pimecrolimus). Patients’ skin types were Fitzpatrick II or III, and minimal erythema doses were determined before treatments. Patients were treated twice or thriceweekly. UVB fluencies were started at 70–80% of the minimal erythema doses, and then increased by 10–20% in every session until the development of erythema was noted. When erythema developed, the dose of the next session was diminished by 10–20% in the erythematous area or the next session was skipped. All of the patients had targeted phototherapy as monotherapy. Response to treatment was assessed by evaluating the photographs taken before and after the treatment, by the same investigator. Response to phototherapy is classified according to the percentage of repigmentation of the total vitiliginous area in any given patient; a repigmentation 4 75% was considered as ‘excellent,’ arepigmentation between 75% and 50% as ‘good,’ a repigmentation between 50% and 25% as ‘moderate,’ and a repigmentation o 25% as ‘mild.’ If there is not any visible repigmentation, it is considered ‘no response.’ This study was approved by a local ethical committee. Results The minimal erythema doses of patients ranged from 70 to 150 mJ/cm 2 (mean  SD = 113.7  24.3). The number of treatment sessions ranged from 20 to 60 (mean  SD = 29.1  9.7). Out of 32 total patients, only four patients (12.5%) (two female and two male patients) showed visible repigmentation. All of the lesions responsive to treatment were facial lesions. In 28 of patients there was no response. 161 r 2009 John Wiley & Sons A/S  Photodermatology, Photoimmunology & Photomedicine 25, 161–163