Treatment of psoriasis utilizes PUVA and NB-UVB therapy, but studies comparing both PUVA and NB-UVB are limited. 

Thus a study compared the efficacy and safety of PUVA and NB-UVB therapy in chronic plaque psoriasis. 

The study enrolled 50 patients with chronic plaque psoriasis, involving >20% of body surface area and of more than 2 years duration with Psoriasis Area Severity Index (PASI) score of >10, aged above 12 years. 

PASI score of the subjects was recorded and they were then randomized to either of the two groups. Each group contained 25 patients and administered therapy as per protocol: Group A: PUVA—psoralens + UVA or Group B: NB-UVB phototherapy. The therapeutic response of patients was followed up weekly and the PASI score was calculated at 0, 2, 4, 6, 8, 10, and 12 weeks. 

The following were observed-

• 31–40 years was the commonest age group in both the therapeutic group.
• A marked improvement from baseline to 12th week was observed in patients given PUVA as well as NB-UVB therapy.
• Minimum and maximum duration of treatment for PASI 75 were 5 and 11 weeks, respectively, in the PUVA group, while it was 6 and 12 weeks, respectively in the NB-UVB group.
• Minimum and the maximum number of exposures for PASI 75 were 10 and 22, respectively, in the PUVA group, while it was 18 and 36, respectively, in the NB-UVB group. 

Thus, both PUVA and NB-UVB are effective therapies. However, NB-UVB is superior as it is effective, with a good safety profile for treating plaque psoriasis with no or minimal long-term carcinogenic risk. Further, it can be safely used in children, pregnant women, and patients with hepatic and renal insufficiency, whereas, more exposures and less energy (joules) are required in NB-UVB to achieve the therapeutic target. 

Source- Gnaneshwar Rao A, Jagadevapuram K. Comparative study of PUVA and NB-UVB in the management of chronic plaque psoriasis. Indian J Drugs Dermatol 2021;7:79-83