Is narrow-band ultraviolet B (nbUVB) phototherapy contraindicated or recommended with caution in patients with a personal history of melanoma?

Although it is challenging to be definitive, our current literature suggests that nbUVB does not increase the risk of melanoma or nonmelanoma skin cancer.

Previous studies suggesting a possible increased risk with nbUVB included patients with a history of PUVA, which has been shown to increase risk. Those studies focusing on patients without a history of PUVA have failed to show an increased incidence of skin cancer.

However, since nbUVB has only been widely used as a treatment since the late 1990s/early 2000s, it could be that a low risk cannot be uncovered until more patient years are accumulated.

• Wang et al., PMID 38070541
• Min Bae et al., PMID 32159729
• Mimouni et al., PMID 38059681
• Chao et al., PMID 38056487

I agree that it can definitely be considered when needed. But you should consider other options first. It is definitely much safer than PUVA.

I agree with Dr. @Dr. First Last that the literature is reassuring. I often cite this literature when I would like to reassure someone that it is safe to do pursue NBUVB.

When confronted with patients who have a history of or new diagnosis of melanoma in addition to inflammatory disorders like psoriasis or atopic dermatitis, I typically do look to other alternatives besides NBUVB to treat their inflammatory disorder. I don't think we (or I) know what the risk of phototherapy would be in someone with a known history of melanoma.

Quite the irony, quite the enigma. With rare exception, Narrowband UVB appears to be safe for use in so many who have a history of skin cancer but the biggest obstacle to its use appears to be the US.