Dear Colleagues,
I am Dr. Faraz Ali, from Cardiff, Wales. I am conducting a small survey, the purpose of which is to identify the practices in phototherapy for vitiligo across the UK.
In completing the survey I can confirm that in accordance with the
National Research Ethics Service published guidance that the survey has been authorised by Cardiff & Vale University Health Board as meeting Service Evaluation Criteria. Service evaluation is typically designed and conducted solely to define or judge current care.
Typically the health professional and patient have chosen intervention before service evaluation. Patients therefore expect health professionals to undertake audit and service evaluation as part of the quality assurance process to ensure that the needs of the service user are being met. In completing this survey we intend to use your feedback to assess current practices in Vitiligo phototherapy in the
UK.
Only those with at least one year experience in dermatology should answer the questionnaire, and preferrably a Consultant, or those working in liaison with Consultants.
(Please give your answers according to your actual practice not according to the "Ideal practice")
Estimated time to fill up this questionnaire will be 10-15 minutes. Your help by filling this questionnaire is highly appreciated.
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1. Do you use phototherapy to treat your vitiligo patients?
Yes
No
I refer them to other center to receive it
2. Overall, what is the percentage of your vitiligo patients you treat with different phototherapy modalities?
%
3. Overall, please give the percentage of using the following modalities in your vitiligo patients:
(Abbr: PUVA; Psoralen and UVA, BBUVB; Broadband UVB, NBUVB;
Narrowband UVB)
Oral PUVA %
Topical outdoor PUVA %
BB-UVB
NB-UVB
%
%
Excimer laser
%
4. On an average how many vitiligo patients per week undergo phototherapy under your care?
0-5
6-10
11-20
≥ 20
5. What is your first choice phototherapy for treating the following types of Vitiligo (please choose one answer only for each)
2

Focal:
Oral PUVA
Segmental:
Generalized:
Topical PUVA BB-UVB NB-UVB
6. What is the commonest method you use to determine starting dose for
NBUVB? (Please choose one answer only)
1-By skin phototype (Fitzpatrick skin typing)
2- By determining minimal erythema dose (MED)
3- Giving fixed starting dose to all skin types
4- You are not using this modality
Excimer laser
7. What is the commonest method you use to determine starting dose for oral PUVA? (Choose one answer only)
1- By skin phototype (Fitzpatrick skin typing)
2- By determining minimal phototoxic dose (MPD)
3- Giving fixed starting dose to all skin types
4- You are not using this modality
8. How frequently do you PROTECT the uninvolved areas during phototherapy?
Eyes
Always
Male genitalia
Female genitalia
Moles frequently sometimes Rarely Never
Nipple
Non vitiligo skin
9. Do you calculate the cumulative doses for the following modalities?
3

Always frequently sometimes Rarely Never
PUVA
BB-UVB
NB-UVB
10. From your practice in vitiligo phototherapy please fill in this table: for oral PUVA a. Starting dose (J/cm2) b. Max dose (J/cm2) c. Average dose increments (J/cm2) d. Average dose increments (%) e. Max number of continuous course
11. From your practice in vitiligo phototherapy, for NBUVB: a. Starting dose (mJ/cm2) b. Max dose (mJ/cm2) c. Average dose increments (mJ/cm2) d. Average dose increments (%) e. Max number of continuous course
12. During the phototherapy treatment your vitiligo patients are evaluated by a doctor:
Not using this modality
4

Weekly
Every 2 weeks
Every 2-4 weeks
Every 4-8 weeks
Unfixed interval
13. From your experience in vitiligo treatment comparing PUVA and NBUVB
(Please tick one answer only for each):
PUVA NBVUB Cannot judge a. Better color matching
with surrounding skin b. More stable (long lasting)
pigmentation c. Faster repigmentation d. Overall more effective
14. From your experience: local NBUVB efficacy in treating hands and feet
(acral) vitiligo is best described as (please chose one answer only):
A. Very effective
B. Effective
C. Sometimes effective
D. Not effective
E. Cannot judge
15. When do you consider that phototherapy is ineffective and stop the treatment ( After how many sessions without good repigmentation)
5

PUVA (after how many sessions)
NB-UVB (after how many sessions)
16. When do you consider the addition of adjuvant to phototherapy?
A. At the beginning
B. If no response after 2 months of using phototherapy alone.
C. If new lesions develop.
D. If early stage of vitiligo.
E. Others
17. If you do use adjuvant which ones do you prefer
Topical low potency steroid: Yes No Site
Topical mid potency steroid: Yes No Site
Topical high potency steroid: Yes No Site
Topical tacrolimus: Yes No Site
Topical pimecrolimus: Yes No Site
18. Do you combine Oral medications with phototherapy?
Yes
A. Oral steroid
B. Oral Gingko biloba
C. Oral Antioxidants
D. Oral Multivitamins
No
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E. Others
19.
Do you limit the number of phototherapy sessions for your vitiligo patients because due to concerns about SKIN CANCER:
Yes
No
20. During your entire dermatology practice, has any VITILGO patient developed SKIN CANCER after phototherapy?
Yes
No
21. If yes, Please provide the details
Number of patients
Type of phototherapy
Type of skin cancer BCC/SCC/Melanoma/Other
After how many sessions/cummulative light does/years do you limit your treatments?
22. During the last 12 months: What is the % of your vitiligo patients who had the following side effects from phototherapy?
A. Mild burn %
B. Moderate burn %
C. Severe burn %
D. Pruritus %
E. PUVA lentigo %
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F. Others (specify) %
23. What is your immediate treatment recommendation(s) (i.e. within 24 hours) for severe accidental UVB overdose?
Oral non-steroidal antiinflammatory drugs
Topical steroids:
Yes
IM or Oral steroids:
Cool or wet compresses:
Emollients:
Wet dressings:
Hospital admission
24. What is your role in your current health board:
No
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