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Vitiligo

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41. No Additional Benefit of Combining Fractional Carbon Dioxide Laser With Narrow-Band Ultraviolet B Phototherapy for Vitiligo: A Randomized Prospective Study With Half-Body Side Comparison. (PubMed)

No Additional Benefit of Combining Fractional Carbon Dioxide Laser With Narrow-Band Ultraviolet B Phototherapy for Vitiligo: A Randomized Prospective Study With Half-Body Side Comparison. Narrow-band ultraviolet B (nb-UVB) phototherapy constitutes the gold standard treatment for vitiligo. Whether carbon dioxide (CO2) laser might increase the efficacy of nb-UVB is still a topic of debate.To test the hypothesis that the addition of fractional CO2 laser to nb-UVB may enhance (...) repigmentation.Fractional CO2 laser was applied with an interval of 2 weeks for 7 sessions, only to 1 of the 2 symmetrical vitiligo patches located on 2 different half-body sides. Patients received whole-body nb-UVB phototherapy 3 times a week, for at least 4 months. Repigmentation was scored with a quartile grading scale, with the help of a computer program using the photographs taken by the digital dermatoscope.Fifty-one symmetrical vitiligo patches of 30 patients were included. No statistically significant

2019 Dermatologic Surgery

42. Systematic Review of Clinimetric Instruments to determine the severity of Non-segmental Vitiligo. (PubMed)

Systematic Review of Clinimetric Instruments to determine the severity of Non-segmental Vitiligo. This systematic review of measurement instruments for vitiligo outcomes included validation articles published from 2011 to May 2018. According to the PRISMA statement, the search was carried out in EMBASE (via OvidSP); MEDLINE (via OvidSP and PubMed). The COSMIN taxonomy will be used to define the measurement properties. Inclusion criteria were original studies reporting measuring properties (...) . Exclusion criteria were clinical trials using scales whose measurement properties were not assessed, studies of cross-cultural adaptation, scales focused on other aspects of the disease such as quality of life, satisfaction, disease's burden. Fourteen studies were identified, which described 15 instruments to measure vitiligo outcomes. Nine of them, measured properties related to the severity of the disease: Vitiligo extent score (VES), Self-Assessment Vitiligo Extent Score (SA-VES), Self-Assessed

2019 Australasian Journal of Dermatology

43. T-cell responses against 4-tertiarybutylphenol-exposed pigmented cells in a patient with occupational vitiligo. (PubMed)

T-cell responses against 4-tertiarybutylphenol-exposed pigmented cells in a patient with occupational vitiligo. Several case studies on contact/occupational vitiligo after skin contact with 4-tertiairybutylphenol (4-TBP) have been reported. Biochemical and cellular effects of 4-TBP on melanocytes have been shown in vitro, but immunological analyses explaining the immunising ability of 4-TBP leading to wide-spread vitiligo lesions beyond areas of primary contact are still lacking. We report here (...) the presence of a systemic T-cell response to 4-TBP-exposed pigmented cells in a patient with chemically-induced vitiligo. This article is protected by copyright. All rights reserved.This article is protected by copyright. All rights reserved.

2019 British Journal of Dermatology

44. Circulating CCL20: A potential biomarker for active vitiligo together with the number of Th1/17 cells. (PubMed)

Circulating CCL20: A potential biomarker for active vitiligo together with the number of Th1/17 cells. Vitiligo is an autoimmune disease with varying pathological features. Activation of the CCL20-CCR6 axis plays an important role in chronic inflammatory diseases. However, whether CCL20-CCR6 and Th1/17 cells are indicative of active vitiligo is unclear.To investigate the potential role of CCL20 and the involvement of Th1/17 and Tc1/17 cells in the mechanism in vitiligo.One hundred patients (...) with vitiligo, and 20 healthy controls were included. The serum and blister fluid IL-17, IFN-γ, CCL20, and CXCL10 were studied using enzyme-linked immunosorbent assays. The numbers of Th1/17 cells and Tc1/17 cells in circulation were quantified using flow cytometry. CCR6 mRNA in peripheral blood mononuclear cells (PBMCs) was analyzed by real-time polymerase chain reaction and the protein level was confirmed by western blotting. CCR6 and CCL20 expression in lesions was analyzed by immunohistochemistry.The

2019 Journal of dermatological science

45. Patient satisfaction and physician productivity in shared medical appointments for vitiligo. (PubMed)

Patient satisfaction and physician productivity in shared medical appointments for vitiligo. The Shared Medical Appointment (SMA) allows patients with a similar diagnosis to be simultaneously cared for and educated by one provider, which has had success in dermatology and other fields of specialty. The SMA provides a potential solution to improve patient access to dermatologists.The purpose of this study was to implement SMA for vitiligo patients and compare it to traditional appointments (...) with regard to patient satisfaction, time to appointment, number of new patients seen per month, and generated revenue.A vitiligo SMA was implemented and a 12-question survey used to assess satisfaction in both SMA and traditional appointment settings. Satisfaction, revenue, and appointment logistical data for SMA was compared to traditional appointments for new patients.Patients were highly satisfied with both SMA and traditional appointments (p>0.05). Time to appointment was faster for SMA

2019 Journal of American Academy of Dermatology

46. Can we consider silymarin as a treatment option for vitiligo? A double-blind controlled randomized clinical trial of phototherapy plus oral Silybum marianum product versus phototherapy alone. (PubMed)

Can we consider silymarin as a treatment option for vitiligo? A double-blind controlled randomized clinical trial of phototherapy plus oral Silybum marianum product versus phototherapy alone. Vitiligo is a chronic skin disorder caused by destruction of the skin melanocytes, which presents as a depigmented area in the skin. This study examined the effect of Phototherapy plus oral Silybummarianum on the treatment of skin lesions of Vitiligo.In this randomized controlled clinical trial, 34 (...) patients with vitiligo who were referred to Dermatology Clinic of Shahid Faghihi Hospital, Shiraz, Iran, were randomly divided into two groups. The first group was treated with phototherapy plus Narrowband UVB plus oral silymarin and the other group was treated with phototherapy with placebo. The patients in both groups were evaluated with vitiligo area severity index (VASI) at the beginning and end of the study. SPSS software version 23 was used for statistical analyses.The mean of the VASI score

2019 Journal of Dermatological Treatment

47. Childhood Vitiligo. (PubMed)

Childhood Vitiligo. Vitiligo is a common acquired depigmenting skin disease characterized by a progressive loss of functional melanocytes. It may appear from the first years of life to late adulthood. Childhood vitiligo (CV), defined as vitiligo that begins before the age of 12 years, is common and may differ from post-CV in terms of epidemiology, clinical presentation, comorbidities, and treatment options. Taking into consideration the potential significant psychosocial impact of the disease (...) on both children and their parents, all available therapeutic options must be offered to patients who desire treatment. According to the most recent guidelines, topical corticosteroids, topical calcineurin inhibitors, and narrowband ultraviolet B phototherapy are the most commonly used treatment modalities for vitiligo in children. This review presents recent data regarding the whole spectrum of CV. Differences between CV and post-CV are also discussed.

2019 American journal of clinical dermatology

48. Oxidative stress-induced HMGB1 release from melanocytes: a paracrine mechanism underlying the cutaneous inflammation in vitiligo. (PubMed)

Oxidative stress-induced HMGB1 release from melanocytes: a paracrine mechanism underlying the cutaneous inflammation in vitiligo. Vitiligo is a cutaneous depigmentation disorder caused by the destruction of epidermal melanocytes. The generation and the skin infiltration of autoreactive CD8+ cytotoxic T cells triggered by oxidative stress play a critical role in vitiligo. High-mobility group protein B1 (HMGB1) is a classic damage-associated molecular pattern (DAMP) molecule with strong (...) proinflammatory effects in inflammatory reactions. A previous study had reported an enhanced expression of HMGB1 in vitiligo lesion, but the role of HMGB1 in cutaneous inflammation of vitiligo was still unknown. In the present study, we initially found that HMGB1 was released from the nucleus of melanocytes in vitiligo perilesional skin. Furthermore, cultured normal human melanocytes (NHMs) could release HMGB1 under the treatment with hydrogen peroxide. Moreover, HMGB1 facilitated the secretion of CXCL16

2019 Journal of Investigative Dermatology

49. Clinical visible signs of disease activity in vitiligo: a systematic review and meta-analysis. (PubMed)

Clinical visible signs of disease activity in vitiligo: a systematic review and meta-analysis. Vitiligo is an unpredictable depigmenting disorder for which a static method to assess disease activity is lacking. Presence of certain skin manifestations may be indicative of disease activity. Here, we evaluated the current evidence for an association between clinical signs and reported disease activity in vitiligo. A systematic review and meta-analysis was performed based on a search in PubMed (...) , Embase and Cochrane Library. Literature reporting skin manifestations and disease activity was analysed based on descriptive analyses and, if applicable, odd ratios. Forty-six observational studies were selected and analysed, including 28 case reports. Reported clinical signs in relation to active vitiligo were as follows: Koebner's phenomenon, confetti-like depigmentations, tri- and hypochromic lesions (including poorly defined borders), inflammatory borders/areas, itch and leukotrichia. Based

2019 Journal of the European Academy of Dermatology and Venereology

50. Catalase but not vitamin D receptor gene polymorphisms are associated with nonsegmental vitiligo in Northwestern Mexicans. (PubMed)

Catalase but not vitamin D receptor gene polymorphisms are associated with nonsegmental vitiligo in Northwestern Mexicans. Vitiligo is an acquired pigmentation disorder characterized by melanocyte loss via autoimmune mechanisms triggered by oxidative stress. Gene polymorphisms in antioxidant enzymes and immunomodulators such as catalase (CAT) and vitamin D receptor (VDR), respectively, have been linked to vitiligo in European and Asian populations. Our aim was to evaluate the role of CAT (...) and VDR gene polymorphisms as well as CAT and vitamin D in nonsegmental vitiligo in Northwestern Mexicans.A total of 357 subjects, 173 nonsegmental vitiligo patients and 184 age-gender matched healthy controls, were genotyped by PCR-restriction fragment length polymorphism. CAT activity was determined in 39 patients and in 39 controls and vitamin D (VitD) levels in 35 individuals per group.CAT 419 C/T gene polymorphism was not informative, -89 A/T was associated with risk (P = 0.02), and 389 C/T

2019 International Journal of Dermatology

51. The incidence and survival of melanoma and nonmelanoma skin cancer in patients with vitiligo: a nationwide population-based matched cohort study in Korea. (PubMed)

The incidence and survival of melanoma and nonmelanoma skin cancer in patients with vitiligo: a nationwide population-based matched cohort study in Korea. While studies report a lower incidence of skin cancer in Caucasian vitiligo patients with controls, the skin cancer incidence in Asian vitiligo patients is unknown.We quantified the incidence of melanoma and nonmelanoma skin cancer (NMSC) in Korean vitiligo patients and compare it with their matched non-vitiligo controls.A retrospective (...) , matched cohort study was performed with 131,245 incident vitiligo cases and 2,624,900 age and sex-matched (1:20) controls at index date, who were selected between January 2005 and December 2017 from the Korean National Health Insurance database. Stratified Cox proportional hazards regression (stratified on gender, birth year, and index year) was used to calculate the hazard ratio (HR) of skin cancer in vitiligo patients.Vitiligo patients were followed up for a mean duration of 6·34 years compared

2019 British Journal of Dermatology

52. The clinical efficacy of treatment using the autologous non-cultured epidermal cell suspension technique for stable vitiligo in 41 patients. (PubMed)

The clinical efficacy of treatment using the autologous non-cultured epidermal cell suspension technique for stable vitiligo in 41 patients. Background: Vitiligo is an acquired depigmentation skin disorder mainly caused by the destruction of melanocytes. There are many therapeutic options available for vitiligo, but the options are not uniformly effective. Objectives: This study aimed to explore the clinical effect of the autologous non-cultured epidermal cell suspension (NCES) technique (...) in the treatment of patients with stable vitiligo. Methods: A retrospective study of before-after comparisons was undertaken with 41 patients with stable vitiligo who received treatment with the NCES technique. The percentage of repigmentation area was evaluated using image analysis of the appearance before and 6-9 months after operation. Results: A total of 41 patients (18 males and 23 females) with a duration of clinical stability for ranging from 1 to 10 years (mean 1.6 ± 1.9) were included. The mean age

2019 Journal of Dermatological Treatment

53. Treatment Outcomes of Topical Calcineurin Inhibitor Therapy for Patients With Vitiligo: A Systematic Review and Meta-analysis. (PubMed)

Treatment Outcomes of Topical Calcineurin Inhibitor Therapy for Patients With Vitiligo: A Systematic Review and Meta-analysis. Topical calcineurin inhibitors (TCIs), including tacrolimus and pimecrolimus, have been widely used for the treatment of vitiligo; however, the efficacy of TCI monotherapy is often underestimated.To estimate the treatment responses to both TCI monotherapy and TCI accompanied by phototherapy for vitiligo, based on relevant prospective studies, and to systematically (...) review the mechanism of action of TCIs for vitiligo treatment.A comprehensive search of the MEDLINE, Embase, Web of Science and Cochrane Library databases from the date of database inception to August 6, 2018, was conducted. The main key words used were vitiligo, topical calcineurin inhibitor, tacrolimus, pimecrolimus, and FK506.Of 250 studies initially identified, the full texts of 102 articles were assessed for eligibility. A total of 56 studies were identified: 11 studies on the TCI mechanism, 36

2019 JAMA dermatology (Chicago, Ill.)

54. Harnessing the Power of Regenerative Therapy for Vitiligo and Alopecia Areata. (PubMed)

Harnessing the Power of Regenerative Therapy for Vitiligo and Alopecia Areata. Vitiligo and alopecia areata (AA) are common autoimmune conditions characterized by white spots on the skin (vitiligo) and bald spots on the scalp (AA), which significantly impact patients' lives by damaging their appearance and function. Melanocytes are the target of immune destruction in vitiligo and are hypothesized to be the site of immune attack in AA. This inflammatory process can be partially reversed (...) by immunosuppressive drugs. Both conditions demonstrate regenerative components that are just now being identified. In this review, we focus on the regenerative medicine aspects of vitiligo and AA, using experimental data from human, mouse, and in vitro models, summarizing the key pathways involved in repopulation of the epidermis with melanocytes in vitiligo and in regrowth of hair follicles in AA. We also discuss treatments that may activate these pathways. Of the regenerative treatments, JAK inhibitors

2019 Journal of Investigative Dermatology

55. UV light set-ups for vitiligo photography, a comparative study on image quality and ease of use. (PubMed)

UV light set-ups for vitiligo photography, a comparative study on image quality and ease of use. Ultraviolet (UV) light is an essential tool to assess the extent, spreading and staging of vitiligo. Different UV light set-ups are used for vitiligo photography, including the following: (i) hand-held Wood's lamps; (ii) soft boxes with UV lamps; (iii) UV flash attached to the camera; and (iv) high output UV flash.Our objective was to compare UV light set-ups for vitiligo photography regarding image (...) quality and ease of use.Patients with vitiligo lesions with unclear borders were included. Two images were made with all four UV set-ups per patient, for a large and a small area. Image quality was scored separately by three blinded vitiligo experts on five criteria: overall quality, clearness of borders, contrast and sharpness and for larger areas the shadows. The two professional medical photographers were asked to score the ease of use for each set-up.A total of 88 photos were assessed from 11

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2019 Journal of the European Academy of Dermatology and Venereology

56. Treatment responses in patients with vitiligo to very potent topical corticosteroids combined with vitaminotherapy in Madagascar. (PubMed)

Treatment responses in patients with vitiligo to very potent topical corticosteroids combined with vitaminotherapy in Madagascar. Vitiligo is a refractory disease in which treatment modalities are not yet established. We aim to assess results obtained 10 years after the initiation of a therapeutic protocol which combines very potent topical corticosteroids (TCS), vitaminotherapy (B12 and C), and suppression of microtraumas in the management of nonsegmental vitiligo in Madagascar.It (...) was a prospective and descriptive study over a period of 6 years (2011-2016) in the Department of Dermatology, Joseph Raseta Befelatanana, Antananarivo, Madagascar. The diagnosis of vitiligo was based on clinical data. Patients who agreed to follow the treatment protocol, which combined very potent TCS (two applications/day for 10 days, and then one application/day for the following 10 days), oral vitamin C 500 mg/day for 20 days, and oral vitamin B12 100 mg/day for 20 days, were included in the study. Two

2019 International Journal of Dermatology

57. Expression analysis of PD-1 and Tim-3 immune checkpoint receptors in Vitiligo patients; positive association with disease activity. (PubMed)

Expression analysis of PD-1 and Tim-3 immune checkpoint receptors in Vitiligo patients; positive association with disease activity. The contribution of immune checkpoint receptors in the immunopathogenesis of various autoimmune diseases has been addressed in previous reports. To investigate the expression profile of T-cell immunoglobulin and mucin-domain containing-3 (Tim-3) and programmed cell death-1 (PD-1) checkpoint molecules in CD8+ T-cells of Vitiligo patients. The association of Tim-3 (...) and PD-1 expression with disease activity was also explored. The frequency of Tim-3+ /PD-1+ /CD8+ T-cells in 30 Vitiligo patients and 30 sex- and age-matched controls was determined by flow cytometry. CD8+ T cells were then positively isolated by magnetic beads and the mRNA expression of PD-1 and Tim-3 was determined by TaqMan-based Real-Time PCR. To measure the cytokines production, PBMCs were stimulated with PMA/ionomycin and concentrations of IL-4, IFN-γ and TNF-α were measured in culture

2019 Experimental Dermatology

58. Extracellular fraction of adipose tissue as an innovative regenerative approach for vitiligo treatment. (PubMed)

Extracellular fraction of adipose tissue as an innovative regenerative approach for vitiligo treatment. Vitiligo is a common, disfiguring autoimmune disease that negatively affects patients' self-esteem and quality of life. Current treatments are moderately effective in reversing disease and promoting melanocyte regeneration. Thus, therapeutic advanced strategies are emerging from regenerative medicine. It has recently emerged that adipose tissue secretome may be used as a cell-free therapy (...) in skin regeneration since paracrine functions of adipose-derived stem cells (ADSCs) alone are responsible for most of the therapeutic effect of stem cells in several animal disease models. In this study, we tested the effect of adipose tissue extracellular fraction (AT-Ex) isolated from lipoaspirates on dermal and epidermal vitiligo cells in vitro. Using this experimental model, we demonstrated that molecules secreted by adipose tissue ameliorate the capability to counteract oxidative stress

2019 Experimental Dermatology

59. Identification of CD49a+ CD8+ resident memory T cells in vitiligo-like lesions associated with nivolumab treatment for melanoma. (PubMed)

Identification of CD49a+ CD8+ resident memory T cells in vitiligo-like lesions associated with nivolumab treatment for melanoma. Immune checkpoint inhibitor (ICI) has brought major therapeutic advances in melanoma care, but ICI can cause unique side effects, often termed immune-related adverse events (irAEs), such as skin rash, vitiligo, colitis, and pneumonitis. Several recent studies revealed a correlation between occurrence of vitiligo-like lesions and clinical responses in advanced melanoma

2019 Journal of the European Academy of Dermatology and Venereology

60. Antibiotics drive microbial imbalance and vitiligo development in mice. (PubMed)

Antibiotics drive microbial imbalance and vitiligo development in mice. Vitiligo is impacted by environmental triggers. We studied the contribution of the microbiome in FH mice, where depigmentation is mediated by tyrosinase-reactive T cells. Mice received oral antibiotics and were monitored for depigmentation. The microbiome was studied in fecal and skin samples by 16S rRNA analysis. Resulting T-cell distributions were evaluated. In untreated mice, pigment loss did not expand to the pelage (...) T cells and accumulation of skin Tregs. This treatment spurred a Bacteroides-dominated population of fecal bacteria. Reduced diversity is prominent especially after ampicillin treatment, when the gut is dominated by Pseudomonas species. In line with current concepts relating the microbiome and the immune system, we predict that dietary measures might promote skin health and delay vitiligo onset.Copyright © 2019 The Authors. Published by Elsevier Inc. All rights reserved.

2019 Journal of Investigative Dermatology

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