BACKGROUND: Hand eczema is a chronic skin disorder characterized by a poor 
response to conventional therapies. Although local PUVA has been proven to be 
effective in the treatment of chronic hand eczema, little is known about the 
efficacy and safety of local narrowband UVB (TL-01) for this condition. The aim 
of our study was to compare the efficacy and safety of local narrowband UVB 
phototherapy with paint-PUVA in patients with chronic hand eczema of dry and 
dyshidrotic types unresponsive to conventional therapies.
PATIENTS/METHODS: Fifteen patients (nine men and six women) with chronic hand 
eczema of dry and dyshidrotic types was included in this prospective, 
comparative study based on a left to right comparison pattern. The treatments 
were administered with local narrowband UVB irradiation on one hand and local 
paint-PUVA using 0.1% 8-methoxypsoralen gel on the other hand three times a week 
over a 9-week period. The NB-UVB irradiation was administered using a local 
NB-UVB system equipped with TL-01 lamps. The initial dose was 150 mJ/cm(2) for 
each patient. An increasing percentile dose schedule based on an increase of 20% 
was used in every session, until a final dose of 2000 mJ/cm(2) was reached. 
Evaluation of clinical scores was carried out every 3 weeks during the treatment 
period.
RESULTS: Twelve of the 15 recruited patients completed the study. There was a 
statistically significant decrease in the mean clinical score at the third, 
sixth and nineth week in both groups. The difference in clinical response 
between the two treatment modalities was not statistically significant at the 
end of the 9-week treatment period. In the narrowband UVB-treated side, the 
tolerance of all the patients to the treatment was good all patients 
well-tolerated the treatment with the exception of mild xerosis that responded 
to topical emollients.
CONCLUSION: Local narrowband UVB phototherapy regimen is as effective as 
paint-PUVA therapy in patients with chronic hand eczema of dry and dyshidrotic 
types.