Results:
This study was carried out on 60 patients with CLP; the mean age of all included patients was 34.3 ± 2 years. There were no significant differences between the patients in the two treatment groups regarding age, sex, marital status, special habits, occupation, and residence (P>0.05).
Regarding the level of clinical response; there were no significant differences between NB-UVB group and MTX group (P=0.149). The level of clinical response to the different treatment models was illustrated in table 1. Among NB-UVB group, about two-thirds of cases (36.7% each) showed either complete response to treatment or no response and only one quarter (26.6%) showed partial response to treatment. For the MTX group, half (50%) of cases showed partial response to treatment, about one-third (30%) showed complete response and only one-fifth (20%) of them showed no response to treatment. This relationship was a statistically insignificant (P >0.05). Table 1, Fig 1, 2
Regarding level of TNF-α, there were no significant differences between NB-UVB group and MTX group before treatment (P=0.147), while a significant difference was between NB-UVB group and MTX group after treatment (P=0.024). There were no statistically significant differences between the two groups in the median TNF-α level before treatment (P>0.05). Table 2
On the other hand, there were statistically significant differences between the two groups in the median TNF-α levels after treatment (P=0.024). Furthermore, for repeated measure analysis (before vs. after treatment); the median level of TNF-α decreased significantly after treatment in the MTX group by 12 pg/ml (P=0.001). Notwithstanding the median TNF-α increased insignificantly after treatment in the NB-UVB group by 1.5 pg/ml (P>0.05). In respect to the percent change in the level of TNF-α in response to treatment, the level of TNF-α decreased significantly after treatment in the MTX group by 41% compared with only 0.8% in the NB-UVB group (P= 0.021). Table 2
In the NB-UVB group; a significant high positive correlation was between TNF-α levels before and after treatment (r=0.60; P<0.001). In the MTX group; there was a significant mild positive correlation between TNF-α levels before and after treatment (r=0.22; P=0.039). In the NB-UVB group; there was a significant high positive correlation between TNF-α levels before and after treatment (r=0.60; P<0.001). In the same way, In the MTX group; there was a significant mild positive correlation between TNF-α levels before and after treatment (r=0.22; P=0.039). Fig 3, 4
In the NB-UVB group; there were no statistically significant differences in the median TNF-α levels between different clinical response groups neither overall (P>0.05) nor pairwise (complete (35 (39) pg/ml), partial (21 (33) pg/ml) and (40 (76) pg/ml), respectively. In the MTX group; there was no statistically significant difference in the median TNF-α levels between different clinical response groups neither overall (P>0.05) nor pairwise (complete (20 (26) pg/ml), partial (28 (16) pg/ml) and (25 (16) pg/ml), respectively. In respect to the percent change in the level of TNF-α in response to treatment for different clinical response levels, in the NB-UVB group; there was statistically significant difference in the median percent change of TNF-α levels between different clinical response groups overall (P= 0.016). For pairwise comparisons, patients with complete response had 2% changes vs. 22% change in cases with partial response and this was statistically insignificant (P>0.05). Unlike, patients with partial response had 22% change vs. -25% change in cases with no response and this was a statistically significant (P=0.009). Likewise, patients with complete response had 2% change vs. -25% change in cases with no response and this was a statistically significant (P= 0.001).