Use of narrowband-UVB phototherapy as long-term treatment of urticaria pigmentosa: a case series.

OBJECTIVES

Urticaria pigmentosa (UP) is the most common form of cutaneous mastocytosis. UP presents with pruritic, red-brown macules and papules, and can be associated with systemic involvement. Currently, there is no cure for UP. Treatment options have been historically limited to antihistamines, which are effective for symptoms but not cosmesis of the lesions. While phototherapy is a recognized treatment for cutaneous mastocytosis, there is sparse evidence addressing the efficacy of narrowband UVB (NB-UVB) phototherapy for UP specifically. We describe three cases of long-standing UP successfully treated with NB-UVB.

METHODS

A retrospective chart review was performed to collect demographic characteristics, disease features, prior treatments, phototherapy parameters, adverse events, pruritus severity, and clinical response using investigator global assessment.

RESULTS

All three patients demonstrated clinical improvement with NB-UVB despite differences in disease duration, prior treatment history, and phototherapy adherence. Pruritus resolved during therapy for all patients, and two patients had documented improvement in lesion appearance. Treatment was well tolerated, with adverse events limited to mild, transient erythema in two patients and no severe or long-term complications documented.

CONCLUSIONS

These cases support NB-UVB as a durable and well-tolerated treatment option for selected adult patients with UP, particularly those with inadequate response to conventional therapies or need for adjunctive treatment.