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Vitiligo treatment

James P Strassner, John E Harris
Vitiligo is an autoimmune disease of the skin that leads to life-altering depigmentation and remains difficult to treat. However, clinical observations and translational studies over 30-40 years have led to the development of an insightful working model of disease pathogenesis: Genetic risk spanning both immune and melanocyte functions is pushed over a threshold by known and suspected environmental factors to initiate autoimmune T cell-mediated killing of melanocytes. While under cellular stress, melanocytes appear to signal innate immunity to activate T cells...
October 17, 2016: Current Opinion in Immunology
L Lazzeri, R Colucci, A Cammi, F Dragoni, S Moretti
Background. There are limited epidemiological studies evaluating the effect of age at onset on disease features in vitiligo. Objectives. To identify factors associated with adult onset vitiligo in comparison with childhood onset vitiligo. Patients and Methods. We retrospectively collected medical records of 191 patients. Such records included clinical examination, personal and familial medical history, laboratory evaluations, concomitant vitiligo treatment and drug assumption. Results. 123 patients with a disease onset after the age of 40 (adult onset vitiligo) were compared with 68 patients who developed vitiligo before the age of 12 (childhood onset vitiligo)...
2016: BioMed Research International
Carmen Cheng, Lois La Grenade, Ida-Lina Diak, Allen Brinker, Robert L Levin
OBJECTIVE: To identify and characterize cases of chemical leukoderma, an underrecognized adverse event, associated with the methylphenidate transdermal system (MTS) reported to the US Food and Drug Administration Adverse Event Reporting System (FAERS). STUDY DESIGN: We searched the Food and Drug Administration Adverse Event Reporting System for reports of chemical leukoderma associated with MTS, received by the Food and Drug Administration from April 6, 2006 to December 23, 2014...
October 10, 2016: Journal of Pediatrics
Julie Bonigen, Christine Raynaud-Donzel, José Hureaux, Nora Kramkimel, Astrid Blom, Géraldine Jeudy, Anne-Laure Breton, Thomas Hubiche, Christophe Bedane, Delphine Legoupil, Anne Pham-Ledard, Julie Charles, Maurice Pérol, Emilie Gérard, Patrick Combemale, Daphné Bonnet, Michèle-Léa Sigal, Emmanuel Mahé
Nivolumab (Opdivo(®) ), pembrolizumab (Keytruda(®) ), atezolizumab, and pidilizumabab are anti-PD1 monoclonal antibodies. Nivolumab is licensed in advanced melanoma and second-line therapy of advanced or metastatic non-small cell lung cancer. When activated, the programmed cell death (PD)-1 is implicated in the inhibition of the immune system. Anti-PD1 removes this inhibition and allows the immune system to control tumour cell progression.(1-4) Immune-mediated toxicity of this treatment have been reported, either organ-specific toxicities - i...
October 14, 2016: Journal of the European Academy of Dermatology and Venereology: JEADV
Deepak Dimri, Venkatashiva Reddy B, Amit Kumar Singh
Background. The pattern of skin morbidity in an area depends on climate, geography, socioeconomic status, nutrition, genetics, and habits of the community. Objective. The objective of the present study was to describe the morbidity profile of patients attending dermatology outpatient department in a tertiary care centre of Garhwal hills, North India. Methodology. This is a record based study carried out using the morbidity registers. Patient details, diagnosis, and treatment provided by physicians were documented in the morbidity register...
2016: Dermatology Research and Practice
Ying Jin, Genevieve Andersen, Daniel Yorgov, Tracey M Ferrara, Songtao Ben, Kelly M Brownson, Paulene J Holland, Stanca A Birlea, Janet Siebert, Anke Hartmann, Anne Lienert, Nanja van Geel, Jo Lambert, Rosalie M Luiten, Albert Wolkerstorfer, J P Wietze van der Veen, Dorothy C Bennett, Alain Taïeb, Khaled Ezzedine, E Helen Kemp, David J Gawkrodger, Anthony P Weetman, Sulev Kõks, Ele Prans, Külli Kingo, Maire Karelson, Margaret R Wallace, Wayne T McCormack, Andreas Overbeck, Silvia Moretti, Roberta Colucci, Mauro Picardo, Nanette B Silverberg, Mats Olsson, Yan Valle, Igor Korobko, Markus Böhm, Henry W Lim, Iltefat Hamzavi, Li Zhou, Qing-Sheng Mi, Pamela R Fain, Stephanie A Santorico, Richard A Spritz
Vitiligo is an autoimmune disease in which depigmented skin results from the destruction of melanocytes, with epidemiological association with other autoimmune diseases. In previous linkage and genome-wide association studies (GWAS1 and GWAS2), we identified 27 vitiligo susceptibility loci in patients of European ancestry. We carried out a third GWAS (GWAS3) in European-ancestry subjects, with augmented GWAS1 and GWAS2 controls, genome-wide imputation, and meta-analysis of all three GWAS, followed by an independent replication...
October 10, 2016: Nature Genetics
Jian Li, Lu-Yan Tang, Wen-Wen Fu, Jin Yuan, You-Yu Sheng, Qin-Ping Yang
Hydrogen peroxide (H2O2) may have a biphasic effect on melanin synthesis and melanosome transfer. High H2O2 concentrations are involved in impaired melanosome transfer in vitiligo. However, low H2O2 concentration promotes the beneficial proliferation and migration of melanocytes. The aim of this study was to explore low H2O2 and its mechanism in melanosome transfer, protease-activated receptor-2 (PAR-2) expression and calcium balance. Melanosomes were fluorescein-labeled for clear visualization of their transfer...
October 8, 2016: Archives of Dermatological Research
Hiroshi Uchi, Mao Yasumatsu, Saori Morino-Koga, Chikage Mitoma, Masutaka Furue
BACKGROUND: Dioxins and other environmental pollutants are toxic and remain in biological tissues for a long time leading to various levels of oxidative stress. Although the toxicity of these agents has been linked to activation of the aryl hydrocarbon receptor (AHR), no effective treatment has been developed. OBJECTIVE: To explore novel phytochemicals that inhibit AHR activation in keratinocytes. METHODS: Keratinocytes were used in this study because the skin is one of the organs most affected by dioxin and other environmental pollutants...
October 4, 2016: Journal of Dermatological Science
Chao Niu, Guang Xian Pang, Gen Li, Jun Dou, Li Fei Nie, Helimay Himit, Madina Kabas, Haji Akber Aisa
Furocoumarins, isolated from Psoralen corylifolia L., were found to be the most effective drug in the treatment of vitiligo nowadays. Twenty-five furocoumarin derivatives were thus designed and synthesized in order to improve the melanogenesis in B16 cells for the first time. Among them, twenty-three compounds were more potent than the positive control (8-MOP), the commonly used drug for vitiligo in clinic. Noticeably, compounds 6m (350.5%) and 6p (313.1%) based on the scaffold of 6k (2H-benzofuro[2,3-h]chromen-2-one) were nearly 3-fold stronger than 8-MOP (114...
September 23, 2016: Bioorganic & Medicinal Chemistry
Surabhi Dayal, Priyadarshini Sahu, Nidhi Gupta
BACKGROUND/OBJECTIVES: A combination of narrowband ultraviolet B (NBUVB) phototherapy plus topical tacrolimus has been used in adult vitiligo but has not yet been explored in children. We therefore sought to highlight the efficacy of this synergistic combination in childhood vitiligo. The objective was to study the clinical efficacy and safety of a combination of NBUVB with topical tacrolimus ointment 0.03% in childhood vitiligo. METHOD: In this open-label study, 20 children, 4 to 14 years of age, with symmetrical vitiligo lesions were enrolled for 24 weeks...
October 4, 2016: Pediatric Dermatology
Ronghua Li, Meng Qiao, Xiaoyan Wang, Xintong Zhao, Qing Sun
BACKGROUND: The treatment of vitiligo is still one of the most difficult dermatological challenges, although there are many therapeutic options. Narrow band ultraviolet B (NB-UVB) phototherapy is considered to be a very important modality for generalized vitiligo. OBJECTIVE: The aim of this study was to explore whether a combination of NB-UVB and topical agents would be superior to NB-UVB alone for treating vitiligo. METHODS: We searched the electronic databases such as PUBMED, EMBASE, Cochrane Library and Web of Science...
October 1, 2016: Photodermatology, Photoimmunology & Photomedicine
Oratai Neamsuvan, Pattaraporn Bunmee
ETHNOPHARMACOLOGICAL RELEVANCE: Skin diseases are common health problems which affecting to all ages. In Thailand, the number of patients diagnosed with skin diseases is increasing every year. Nowadays, The Ministry of Public Health is supporting and promoting herbs for treating various disorders, including disorders of the skin to reduce the problem of antibiotic resistance and adverse drug reactions. This study aimed to: (1) enumerate the herbal weeds for treating skin disorders; (2) study local knowledge of weed utilization for treating skin disorders according to the folk healers in Songkhla and Krabi province; and (3) study quantitative data by Informant consensus factor (ICF), Use value (UV) and Fidelity level (FL) value...
September 27, 2016: Journal of Ethnopharmacology
Jillian M Richmond, Dinesh S Bangari, Kingsley I Essien, Sharif D Currimbhoy, Joanna R Groom, Amit G Pandya, Michele E Youd, Andrew D Luster, John E Harris
Vitiligo is an autoimmune disease of the skin that results in the destruction of melanocytes and the clinical appearance of white spots. Disease pathogenesis depends on IFN-γ and IFN-γ-induced chemokines to promote T cell recruitment to the epidermis where melanocytes reside. The skin is a complex organ, with a variety of resident cell types. We sought to better define the microenvironment and distinct cellular contributions during autoimmunity in vitiligo, and found that the epidermis is a chemokine-high niche in both a mouse model and human vitiligo...
September 26, 2016: Journal of Investigative Dermatology
Shahrzad Bakhtiar, Frank Ruemmele, Fabienne Charbit-Henrion, Eva Lévy, Frédéric Rieux-Laucat, Nadine Cerf-Bensussan, Peter Bader, Ulrich Paetow
Monogenic primary immunodeficiency syndromes can affect one or more endocrine organs by autoimmunity during childhood. Clinical manifestations include type 1 diabetes mellitus, hypothyroidism, adrenal insufficiency, and vitiligo. Lipopolysaccharide (LPS)-responsive beige-like anchor protein (LRBA) deficiency was described in 2012 as a novel primary immunodeficiency, predominantly causing immune dysregulation and early onset enteropathy. We describe the heterogeneous clinical course of LRBA deficiency in two siblings, mimicking an autoimmune polyendocrine disorder in one of them in presence of the same underlying genetic mutation...
2016: Frontiers in Pediatrics
Li Lei, Jinhua Huang, Qinghai Zeng, Caiyun Xi, Aiyuan Guo, Jing Chen
OBJECTIVE: To evaluate the efficacy and influential factors for 308 nm excimer laser in the treatment of stable vitiligo patients.
 METHODS: A total of 207 stable vitiligo patients with 1 763 patches were treated with 308 nm excimer laser. Open-label study was carried out to investigate the efficacy and safety regarding the treatment with 308 nm excimer laser, and to compare the response under different conditions including gender, age, duration, lesion location, and hair color...
September 28, 2016: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
Poupak Fallahi, Silvia Martina Ferrari, Ilaria Ruffilli, Giusy Elia, Marco Biricotti, Roberto Vita, Salvatore Benvenga, Alessandro Antonelli
We have evaluated prospectively the prevalence of other autoimmune disorders in outpatient clinic in 3069 consecutive patients with diagnosed chronic autoimmune thyroiditis (AT), with respect to two age- and sex-matched control groups: a) a control group of 1023 subjects, extracted from a random sample of the general population without thyroid disorders; b) 1023 patients with non-toxic multinodular goiter extracted from the same random sample of the general population, with similar iodine intake. The results of our study demonstrate a significant increase of the prevalence of autoimmune disorders in AT patients (with respect to both controls), for the following diseases: chronic autoimmune gastritis (CAG), vitiligo (Vit), rheumatoid arthritis, polymialgia rheumatica (Polym), celiac disease, diabetes, sjogren disease, multiple sclerosis, systemic lupus erythematosus, sarcoidosis, alopecia, psoriathic arthritis, systemic sclerosis, and HCV-related cryoglobulinemia...
September 15, 2016: Autoimmunity Reviews
Cary S Crall, Jillian F Rork, Sophia Delano, Jennifer T Huang
Phototherapy can be a safe and effective treatment for various skin diseases in children. Special considerations governing the use of this treatment modality in pediatric populations include patient, family, and facility-based factors that are oriented around heightened concerns with regard to safety and tolerability of treatment. Although phototherapy has been found to be effective in a wide range of dermatologic conditions affecting pediatric populations, including psoriasis, atopic dermatitis, pityriasis lichenoides, cutaneous T-cell lymphoma, and vitiligo, there is need for additional research on other conditions in which phototherapy has shown promise...
September 2016: Clinics in Dermatology
Viktoria Eleftheriadou, Khaled Ezzedine
Vitiligo is the most common depigmentation disorder, affecting around 1% of population worldwide. There is no cure, and no firm clinical recommendations can be made for the treatment of vitiligo. A European guideline suggests early treatment of small lesions of recent onset and childhood vitiligo with combination of phototherapy and topical agents. Suitable facilities and equipment, such as hand-held portable phototherapy devices, are needed, if this new guideline is to be implemented. Hand-held units are suitable for small lesions, making phototherapy available for patients with limited and/or early vitiligo...
September 2016: Clinics in Dermatology
Samia Esmat, Wedad Mostafa, Rehab A Hegazy, Suzan Shalaby, Vaneeta Sheth, Randa Youssef, Medhat El-Mofty
Phototherapy has been the mainstay of vitiligo therapy for several decades. A variety of wavelengths and modalities are available, but narrowband ultraviolet B remains the safest and most commonly used treatment. Acting on multiple steps in vitiligo pathogenesis, narrowband ultraviolet B is one of the few therapies that can effectively induce stabilization and stimulate repigmentation. Achievement of optimal results involves using a combination of appropriate treatment protocols, careful patient selection, and patient education to set expectations...
September 2016: Clinics in Dermatology
Asta Juzeniene, Mantas Grigalavicius, Marina Juraleviciute, William B Grant
The skin is the site for the photosynthesis of vitamin D and is a target tissue for the active metabolite of vitamin D. An increasing body of evidence indicates that vitamin D produced during phototherapy may be responsible for the positive effects observed during treatment of some skin diseases. Topical or oral application of vitamin D derivatives are used alone or with phototherapy. This paper reviews what is known about the use of phototherapy to enhance vitamin D levels, the use of vitamin D analogues with phototherapy, the efficacy of combination therapies, and controversies regarding some of the outcomes...
September 2016: Clinics in Dermatology
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