Clinical evaluation of Asian skin type patients with plaque-type psoriasis receiving narrowband ultraviolet-B phototherapy and methotrexate: Retrospective study from tertiary hospital in Indonesia

Introduction Psoriasis is a chronic autoimmune disease manifested as recurrent thick red scaly patches on the skin. Narrowband ultraviolet B have been widely used as first-line treatment of extensive plaque type psoriasis since its relatively safe and effective, including for Asian skin type. Methotrexate is one of systemic agent considered for severe psoriasis treatment. Few studies conclude that the combination of NBUVB and MTX is more favourable. This study aims to evaluate clinical improvement of plaque type psoriasis, which is presented by Psoriasis Area and Severity Index (PASI) score, after NBUVB combination with MTX treatment in Indonesian patients. Methods Data in this retrospective study were collected from medical records of plaque type psoriasis patients in dermatology and venereology outpatient clinic Dr. Soetomo General Academic Hospital in Surabaya, Indonesia. Improvement of PASI score is considered as the main outcome evaluated in this study. Results Twenty-eight patients were included with male to female ratio was 3:1 and average age were 43.6 years old. The mean PASI score before treatment was 15.79 (±7.12), and it reduces significantly into 9.74 (±7.16) (P <0.001). Among them, 20 patients underwent combination treatment of narrowband ultraviolet B and methotrexate. This group achieved PASI score reduction of 7.11 (±5.27), which was greater when compared to patients who got narrowband ultraviolet B monotherapy that achieved 3.31 (±7.62) PASI score reduction in average. Conclusion Narrowband ultraviolet B phototherapy is considered as effective in reducing clinical severity of plaque type psoriasis in Indonesian patients. Combination with methotrexate is more advantageous to achieve greater clinical improvement.