Background: Many emollients have been used in combination with Narrow Band-Ultraviolet-B (NB-UVB) phototherapy in psoriasis. Aim of the work: was to evaluate whether the pre-irradiation use of mineral oil with NB-UVB phototherapy is superior to NB-UVB monotherapy in treatment of wide spread psoriasis vulgaris in adults. Patients and methods: Thirty psoriatic patients aged 20-55 years with wide spread, symmetrical psoriasis vulgaris involving > 20% body surface area were enrolled in this study. Mineral oil applied prior to irradiation over one half of the body (Rt.side) and the other half was the emollient free control. Narrow-band ultraviolet–B phototherapy was administered to whole body three times a week on nonconsecutive days with initial dose of 260 mJ/cm2(for skin type III) and 330mJ/cm2 (for skin type IV) and increased by 40mJ/cm2 – 45mJ/ cm2 respectively at each session up to a maximum of 3000mJ/cm2. Clinical response was evaluated as grades of erythema, scaling, and infiltration, area of involvement and modified psoriasis area severity index (MPASI) score on each body side at base line and at 4, 8, 12, and 16 weeks after treatment. Results: Significantly greater improvement (p>0.001) in scaling , infiltration, area of involvement and MPASI were seen on the mineral oil pretreated side as early as 4 weeks and was maintained throughout the study. Significant difference in erythema was noticed later at 8 weeks. The cumulative dose for clearance and number of exposures to NB-UVB were significantly lower on the mineral oil pretreated side (p>0.001). Minimal adverse effects were observed on both sides of the body. We conclude that pre-irradiation use of mineral oil enhances the therapeutic efficacy of NB-UVB phototherapy in adults with widespread psoriasis vulgaris.
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