Research Activities

Kishan Kumar YH, Rao GR, Gopal KV, Shanti G, Rao KV.

Source Department of Dermatology, King George Hospital/Andhra Medical College, Visakhapatnam, Andhra Pradesh, India.

Abstract BACKGROUND: Very few studies have been performed to evaluate the efficacy and safety of narrow-band ultraviolet B (NBUVB) therapy in Indian patients with vitiligo and are of small sample size. Aims: The purpose of this study is to know the efficacy and safety of NBUVB in 150 vitiligo patients of various age groups.

METHODS: One hundred fifty patients (69 males, 81 females), aged 3-70 years, with vitiligo were treated twice weekly with NBUVB. The starting dose was 250 mJ/cm2 in adults and 150 mJ/cm2 in children, with 20% dose increments at each subsequent visit given for a maximum period of 1 year and were followed-up for 6 months for stability of repigmentation. Statistical methods were employed to establish the relation between the response and the number of exposures, duration of treatment, cumulative dose and the compliance.

RESULTS: Analysis of our study showed that a majority of our cases, about 73, achieved 25-75% repigmentation, with an average of 51+/-19 exposures, 51 had <25% repigmentation, with an average of 19+/-11 exposures and 26 had >75% repigmentation, with an average of 74+/-24 exposures. Good response to therapy was directly associated with good compliance, more number of exposures and increasing cumulative dose, which was statistically significant (P<0.01). Adverse effects were minimal. Only three patients developed depigmentation of repigmented sites during follow-up.

CONCLUSION: Our study proves that NBUVB therapy is an effective and safe tool in the management of vitiligo, with good stability of repigmentation and cosmetic appearance.
Shahmoradi Z, Najafian J, Naeini FF, Fahimipour F.

Source Department of Dermatology, Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

Abstract BACKGROUND: Vitiligo is an acquired, idiopathic disorder characterized by circumscribed depigmented macules and patches. The exact etiology and pathogenesis of vitiligo is not clear. Many theories have been presented regarding this subject among them aautoimmune theory is the most important one. The association of vitiligo with other autoimmune disorders has been reported, but the relationship between vitiligo and celiac disease is controversial. The aim of this study was to study the frequency of celiac autoantibodies in a group of vitiligo patients compared with control.

METHODS: This was a cross sectional case control study that involved 128 individuals, 64 vitiligo patients and 64 individuals as control group. The means age of participants was 30.3 ± 14.4 years. IgA anti Endomysial antibody and IgA anti-glutaminase antibody were measured by ELISA method in the serum of all participants. Data were analyzed by SPSS software version 15.

RESULTS: The serum of two vitiligo patients (3.1%) was positive for antibodies. All control groups were seronegative for these antibodies (P < 0.05). There was no significant effect of sex and job on seropositivity.

CONCLUSION: There may be a relationship between celiac disease and vitiligo. This may indicate a common basic autoimmune mechanism that is an explanation for few case reports that gluten free diets were effective in the treatment of vitiligo patients. Both T test and exact fisher test showed no effect of age, sex and job on seropositivity of these patients (P = 0.56 and P = 0.74, respectively).
Kiprono S, Chaula B, Makwaya C, Naafs B, Masenga J.

Source

Regional Dermatology Training Center, Moshi, Tanzania. kipsam2@yahoo.com

Abstract

BACKGROUND:

Vitiligo is an acquired, predominantly asymptomatic, depigmenting disorder with profound psychological effects.

METHODS: This was a cross-sectional study conducted at the Regional Dermatology Training Center in Moshi, Tanzania. All 88 patients with vitiligo older than 15 years of age who attended the skin clinic from October 2009 to April 2010 were recruited. Data were collected using a structured questionnaire, Dermatology Life Quality Index questionnaire (DLQI), and Vitiligo European Task Force form.

RESULTS: Vitiligo moderately affects patient's quality of life, as indicated by a DLQI mean score of 7.2 ± 4.8. The mean age was 41 years with a male/female ratio of 1:1.7. The mean age of disease onset was 33.5 years (range 16-83 years); vitiligo vulgaris was the most common disease form seen (n = 49). None of the factors considered were found to be significantly associated with impaired quality of life on multivariate analysis. The majority of patients (73.8%) perceived that their disease was moderate to severe in contrast to the clinical grading in which only 49.2% patients were classified as having mild disease. This difference in classification of disease severity was statistically significant (Fishers exact test = 0.001).

CONCLUSION: Patients with vitiligo of African descent have a moderate impairment of quality of life.

© 2013 The International Society of Dermatology.

Yildirim M, Baysal V, Inaloz HS, Kesici D, Delibas N.

Source Department of Dermatology, Faculty of Medicine University of Suleyman Demirel, Isparta, Turkey.

Abstract Oxidative stress may be induced by increasing the generation of reactive oxygen species (ROS) and other free radicals. The generation of ROS is known to be associated with a decrease in antioxidant levels. In the present study, the role of oxidative stress was assessed in the pathogenesis of generalized vitiligo. Superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), and glutathione (GSH) levels in erythrocytes and serum malondialdehyde (MDA) and nitric oxide (NO) levels were investigated in 24 patients with generalized vitiligo and 20 healthy controls. Our results indicated that significantly increased levels of erythrocyte SOD, serum MDA, and NO were associated with a marked reduction of erythrocyte GSH-Px and GSH activities in patients with generalized vitiligo (p<0.05). Our observations suggest that the presence of an imbalance in the oxidant-antioxidant system might play a role in the pathogenesis of vitiligo. Our results further support the concept that free radical-mediated damage may be the initial pathogenic event in melanocyte degeneration in generalized vitiligo.

F.A.Q.

Does Vitiligo spread from parents to children

Although most cases of vitiligo are sporadic, familial clustering is not uncommon, with up to 20% of patients reporting this connection. But be optimistic! If you have vitiligo, most probably your children will not have vitiligo.

Is it possible to stop the progression of vitiligo?

Vitiligo is progressive in 73% of cases and regressive in 1.3%. It is usually explain to the patients that progression depends on the modality of the disease spreading.

How can I treat vitiligo?

Choosing a treatment for vitiligo can be difficult, sometimes overwhelming. In general, first-line therapy should be SAFE, effective, minimally invasive, and cost effective, the most important being SAFETY. As it stands now in Kenya and other countries, the safest and most effective treatment is NB-UVB

What causes vitiligo?

It remains unclear what causes damage to melanocytes and their subsequent total inactivation and/or disappearance in vitiligo skin. There are several theories