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Lee YH, Song GG. Association between vitamin D receptor polymorphisms and vitiligo susceptibility: An updated meta-analysis. J Cosmet Dermatol 2023; 22:969-979. [PMID: 36254395 DOI: 10.1111/jocd.15474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 08/21/2022] [Accepted: 10/03/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Vitamin D receptor (VDR) polymorphisms may play an important role in the vitiligo susceptibility. There have been many studies looking at the associations between VDR polymorphisms and vitiligo risk, but the conclusions are still up for debate. AIM This study aimed to determine whether polymorphisms in the VDR are associated to the susceptibility to vitiligo. METHODS Vitamin D receptor polymorphisms in vitiligo patients and controls were identified using PubMed/Medline and Embase databases. The relationships between the VDR ApaI, TaqI, BsmI, and TaqI polymorphisms and vitiligo were investigated using meta-analyses of all participants and Asian, Arab, European, and Latin American groups. RESULTS This meta-analysis included 13 papers with 2034 patients and 2771 controls. In all individuals, there was no link between vitiligo and the VDR ApaI A allele (OR = 0.889, 95% CI = 0.713-1.109, p = 0.298). However, in Asians (OR = 0.721, 95% CI = 0.553-0.940, p = 0.016) but not in Europeans or Arabs, there was a link between the VDR ApaI A allele and vitiligo. Utilizing recessive, dominant, and homozygote contrast models, a link between vitiligo and the VDR ApaI polymorphism was discovered in Asians. Meta-analysis of the VDR BsmI polymorphism showed a significant association between vitiligo and the B allele (OR = 0.812, 95% CI = 0.686-0.961, p = 0.015). In contrast, no connection between vitiligo and VDR polymorphisms was identified for TaqI and FokI polymorphisms. CONCLUSION In the Asian population, ApaI and BsmI polymorphisms in VDR have been correlated to vitiligo susceptibility. However, TaqI and FokI polymorphisms in VDR are not associated with vitiligo susceptibility in European, Asian, Arab, and Latin American populations.
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Affiliation(s)
- Young Ho Lee
- Department of Rheumatology, Korea University College of Medicine, Korea University Medicine, Seoul, South Korea
| | - Gwan Gyu Song
- Department of Rheumatology, Korea University College of Medicine, Korea University Medicine, Seoul, South Korea
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Nedelcu R, Dobre A, Brinzea A, Hulea I, Andrei R, Zurac S, Balaban M, Antohe M, Manea L, Calinescu A, Coman A, Pantelimon F, Dobritoiu A, Popescu C, Popescu R, Balasescu E, Ion D, Turcu G. Current Challenges in Deciphering Sutton Nevi-Literature Review and Personal Experience. J Pers Med 2021; 11:jpm11090904. [PMID: 34575681 PMCID: PMC8470687 DOI: 10.3390/jpm11090904] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 09/01/2021] [Accepted: 09/06/2021] [Indexed: 01/01/2023] Open
Abstract
Halo nevi, known as leukoderma acquisitum centrifugum, Sutton nevus, leukopigmentary nevus, perinevoid vitiligo, or perinevoid leukoderma, together with vitiligo and melanoma-associated hypopigmentation, belong to the group of dermatoses designated as immunological leukodermas. The etiology and pathogenesis of halo nevi has not been fully elucidated. There are several mechanisms through which a lymphocytic infiltrate can induce tumoral regression. In this review, we aimed to update the knowledge about Sutton nevi starting with the clinical appearance and dermoscopic features, continuing with information regarding conventional microscopy, immunohistochemistry, and the immunological mechanisms responsible for the occurrence of halo nevi. We also included in the article original unpublished results when discussing dermoscopic, pathologic and immunohistochemical results in halo nevi. Sutton nevi are valuable models for studying antitumor reactions that the human body can generate. The slow and effective mechanism against a melanocytic skin tumor can teach us important lessons about both autoimmune diseases and anticancer defenses.
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Affiliation(s)
- Roxana Nedelcu
- General Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (R.N.); (A.B.); (I.H.); (S.Z.); (M.A.); (L.M.); (A.C.); (A.C.); (C.P.); (R.P.); (E.B.); (D.I.); (G.T.)
- Derma 360 Clinic, 11273 Bucharest, Romania; (M.B.); (F.P.); (A.D.)
| | - Alexandra Dobre
- General Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (R.N.); (A.B.); (I.H.); (S.Z.); (M.A.); (L.M.); (A.C.); (A.C.); (C.P.); (R.P.); (E.B.); (D.I.); (G.T.)
- Correspondence: ; Tel.: +40-740-853-353
| | - Alice Brinzea
- General Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (R.N.); (A.B.); (I.H.); (S.Z.); (M.A.); (L.M.); (A.C.); (A.C.); (C.P.); (R.P.); (E.B.); (D.I.); (G.T.)
- Derma 360 Clinic, 11273 Bucharest, Romania; (M.B.); (F.P.); (A.D.)
- National Institute for Infectious Diseases, Outpatient Clinic, 021105 Bucharest, Romania
| | - Ionela Hulea
- General Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (R.N.); (A.B.); (I.H.); (S.Z.); (M.A.); (L.M.); (A.C.); (A.C.); (C.P.); (R.P.); (E.B.); (D.I.); (G.T.)
| | - Razvan Andrei
- Department of Pathology and Dermatovenerology, Colentina Clinical Hospital, 020125 Bucharest, Romania;
- Synevo Medical Laboratory, 014192 Bucharest, Romania
| | - Sabina Zurac
- General Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (R.N.); (A.B.); (I.H.); (S.Z.); (M.A.); (L.M.); (A.C.); (A.C.); (C.P.); (R.P.); (E.B.); (D.I.); (G.T.)
- Department of Pathology and Dermatovenerology, Colentina Clinical Hospital, 020125 Bucharest, Romania;
| | - Mihaela Balaban
- Derma 360 Clinic, 11273 Bucharest, Romania; (M.B.); (F.P.); (A.D.)
| | - Mihaela Antohe
- General Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (R.N.); (A.B.); (I.H.); (S.Z.); (M.A.); (L.M.); (A.C.); (A.C.); (C.P.); (R.P.); (E.B.); (D.I.); (G.T.)
- Derma 360 Clinic, 11273 Bucharest, Romania; (M.B.); (F.P.); (A.D.)
| | - Lorena Manea
- General Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (R.N.); (A.B.); (I.H.); (S.Z.); (M.A.); (L.M.); (A.C.); (A.C.); (C.P.); (R.P.); (E.B.); (D.I.); (G.T.)
- Department of Pathology and Dermatovenerology, Colentina Clinical Hospital, 020125 Bucharest, Romania;
- Department of Dermatovenerology, Centre Hospitalier Régional D’orléans, 45100 Orléans, France
| | - Andreea Calinescu
- General Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (R.N.); (A.B.); (I.H.); (S.Z.); (M.A.); (L.M.); (A.C.); (A.C.); (C.P.); (R.P.); (E.B.); (D.I.); (G.T.)
- Derma 360 Clinic, 11273 Bucharest, Romania; (M.B.); (F.P.); (A.D.)
| | - Anastasia Coman
- General Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (R.N.); (A.B.); (I.H.); (S.Z.); (M.A.); (L.M.); (A.C.); (A.C.); (C.P.); (R.P.); (E.B.); (D.I.); (G.T.)
- Derma 360 Clinic, 11273 Bucharest, Romania; (M.B.); (F.P.); (A.D.)
| | | | - Adina Dobritoiu
- Derma 360 Clinic, 11273 Bucharest, Romania; (M.B.); (F.P.); (A.D.)
| | - Catalin Popescu
- General Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (R.N.); (A.B.); (I.H.); (S.Z.); (M.A.); (L.M.); (A.C.); (A.C.); (C.P.); (R.P.); (E.B.); (D.I.); (G.T.)
- Department of Pathology and Dermatovenerology, Colentina Clinical Hospital, 020125 Bucharest, Romania;
| | - Raluca Popescu
- General Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (R.N.); (A.B.); (I.H.); (S.Z.); (M.A.); (L.M.); (A.C.); (A.C.); (C.P.); (R.P.); (E.B.); (D.I.); (G.T.)
- Department of Pathology and Dermatovenerology, Colentina Clinical Hospital, 020125 Bucharest, Romania;
| | - Elena Balasescu
- General Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (R.N.); (A.B.); (I.H.); (S.Z.); (M.A.); (L.M.); (A.C.); (A.C.); (C.P.); (R.P.); (E.B.); (D.I.); (G.T.)
| | - Daniela Ion
- General Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (R.N.); (A.B.); (I.H.); (S.Z.); (M.A.); (L.M.); (A.C.); (A.C.); (C.P.); (R.P.); (E.B.); (D.I.); (G.T.)
| | - Gabriela Turcu
- General Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (R.N.); (A.B.); (I.H.); (S.Z.); (M.A.); (L.M.); (A.C.); (A.C.); (C.P.); (R.P.); (E.B.); (D.I.); (G.T.)
- Derma 360 Clinic, 11273 Bucharest, Romania; (M.B.); (F.P.); (A.D.)
- Department of Pathology and Dermatovenerology, Colentina Clinical Hospital, 020125 Bucharest, Romania;
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Müller-Dott K, Thiermann H, Steinritz D, Popp T. Effect of sulfur mustard on melanogenesis in vitro. Toxicol Lett 2020; 319:197-203. [PMID: 31785464 DOI: 10.1016/j.toxlet.2019.11.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 10/22/2019] [Accepted: 11/15/2019] [Indexed: 10/25/2022]
Abstract
The chemical warfare agent sulfur mustard (SM) affects all cells in the epidermis including melanocytes which are responsible for melanin synthesis. After exposure to SM, pigment abnormalities like hypo- and hyperpigmentation can occur. The underlying molecular pathomechanisms of SM exposure on human melanogenesis have not been elucidated so far. In our study, we investigated the effect of SM on human melanocytes and melanogenesis. Normal human epidermal melanocytes (NHEM) were used as in vitro model and they were exposed to different concentrations of SM (4.5 μM-100 μM). Melanin production was analyzed by absorption measurements at 405 nm. In addition, quantitative real-time PCR (qPCR) and Western blot experiments were performed to determine the expression of essential melanogenesis-related proteins including tyrosinase (TYR), tyrosinase-related protein (TRP) 1 and 2 and microphthalmia transcription factor (MITF). Our findings demonstrated that exposure to low SM concentrations increased melanin synthesis accompanied with an increase in protein expression. In contrast, high SM concentrations led to decreased melanin content and a downregulation in expression of all investigated melanogenesis-associated proteins. We concluded that low SM concentrations may cause hyperpigmentation while high SM concentrations decreased melanin content which may explain hypopigmented skin areas in SM exposed patients.
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Affiliation(s)
- Katharina Müller-Dott
- Bundeswehr Institute of Pharmacology and Toxicology, 80937, Munich, Germany; Walther-Straub-Institute of Pharmacology and Toxicology, LMU Munich, 80336, Munich, Germany.
| | - Horst Thiermann
- Bundeswehr Institute of Pharmacology and Toxicology, 80937, Munich, Germany
| | - Dirk Steinritz
- Bundeswehr Institute of Pharmacology and Toxicology, 80937, Munich, Germany; Walther-Straub-Institute of Pharmacology and Toxicology, LMU Munich, 80336, Munich, Germany
| | - Tanja Popp
- Walther-Straub-Institute of Pharmacology and Toxicology, LMU Munich, 80336, Munich, Germany; Bundeswehr Institute of Radiobiology Affiliated to the University of Ulm, 80937, Munich, Germany
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Saleem MD, Oussedik E, Picardo M, Schoch JJ. Acquired disorders with hypopigmentation: A clinical approach to diagnosis and treatment. J Am Acad Dermatol 2018; 80:1233-1250.e10. [PMID: 30236514 DOI: 10.1016/j.jaad.2018.07.070] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2017] [Revised: 07/09/2018] [Accepted: 07/13/2018] [Indexed: 02/07/2023]
Abstract
Acquired hypopigmented skin changes are commonly encountered by dermatologists. Although hypopigmentation is often asymptomatic and benign, occasional serious and disabling conditions present with cutaneous hypopigmentation. A thorough history and physical examination, centered on disease distribution and morphologic findings, can aid in delineating the causes of acquired hypopigmented disorders. The second article in this 2-part continuing medical education series focuses on conditions with a hypopigmented phenotype. Early diagnosis and appropriate management of these disorders can improve a patient's quality of life, halt disease progression, and prevent irreversible disability.
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Affiliation(s)
- Mohammed D Saleem
- Department of Internal Medicine, University of Florida College of Medicine and University of Florida Health, Gainesville, Florida.
| | | | - Mauro Picardo
- Department of Dermatology and Pediatric Dermatology, Cutaneous Physiopathology and Integrated Center of Metabolomics Research, San Gallicano Dermatologic Institute, IRCCS, Rome, Italy
| | - Jennifer J Schoch
- Department of Dermatology, University of Florida, Gainesville, Florida; Department of Pediatrics, University of Florida, Gainesville, Florida
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Saleem MD, Oussedik E, Schoch JJ, Berger AC, Picardo M. Acquired disorders with depigmentation: A systematic approach to vitiliginoid conditions. J Am Acad Dermatol 2018; 80:1215-1231.e6. [PMID: 30236516 DOI: 10.1016/j.jaad.2018.03.063] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2018] [Revised: 03/01/2018] [Accepted: 03/21/2018] [Indexed: 01/14/2023]
Abstract
Acquired disorders with depigmentation are commonly encountered by dermatologists and present with a wide differential diagnosis. Vitiligo, the most common disorder of acquired depigmentation, is characterized by well-defined depigmented macules and patches. Other conditions, such as chemical leukoderma, can present with similar findings, and are often easily mistaken for vitiligo. Key clinical features can help differentiate between acquired disorders of depigmentation. The first article in this continuing medical education series focuses on conditions with a vitiligo-like phenotype. Early recognition and adequate treatment of these conditions is critical in providing appropriate prognostication and treatment.
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Affiliation(s)
- Mohammed D Saleem
- Department of Internal Medicine, University of Florida College of Medicine and University of Florida Health, Gainesville, Florida.
| | | | - Jennifer J Schoch
- Department of Dermatology and Pediatrics, University of Florida, Gainesville, Florida
| | - Adam C Berger
- Department of Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Mauro Picardo
- Department of Dermatology and Pediatric Dermatology, Cutaneous Physiopathology and Integrated Center of Metabolomics Research, San Gallicano Dermatologic Institute, IRCCS, Rome, Italy
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The angiotensin-converting enzyme insertion/deletion polymorphism of vitiligo in a population in upper Egypt. JOURNAL OF THE EGYPTIAN WOMENʼS DERMATOLOGIC SOCIETY 2016. [DOI: 10.1097/01.ewx.0000481054.37701.f5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Maroñas-Jiménez L, Celano N, Barrio V. Case 2: Zosteriform hypopigmented rash in a 13-year-old girl. Paediatr Child Health 2016; 21:9-10. [DOI: 10.1093/pch/21.1.9a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | - Nicholas Celano
- University of California, San Diego, School of Medicine, La Jolla, California Rady Children’s Hospital, San Diego, California, USA
| | - Victoria Barrio
- University of California, San Diego, School of Medicine, La Jolla, California Rady Children’s Hospital, San Diego, California, USA
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Song GG, Bae SC, Kim JH, Lee YH. The angiotensin-converting enzyme insertion/deletion polymorphism and susceptibility to rheumatoid arthritis, vitiligo and psoriasis: A meta-analysis. J Renin Angiotensin Aldosterone Syst 2013; 16:195-202. [DOI: 10.1177/1470320313478285] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2012] [Accepted: 08/09/2014] [Indexed: 12/29/2022] Open
Affiliation(s)
- Gwan Gyu Song
- Division of Rheumatology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Sang-Cheol Bae
- Division of Rheumatology, Department of Internal Medicine, The Hospital for Rheumatic Diseases, Hanyang University Medical Center, Seoul, Korea
| | - Jae-Hoon Kim
- Division of Rheumatology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Young Ho Lee
- Division of Rheumatology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
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Song GG, Kim JH, Lee YH. The CTLA-4 +49 A/G, CT60 A/G and PTPN22 1858 C/T polymorphisms and susceptibility to vitiligo: a meta-analysis. Mol Biol Rep 2012; 40:2985-93. [DOI: 10.1007/s11033-012-2370-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2012] [Accepted: 12/17/2012] [Indexed: 02/07/2023]
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de Morais Cavalcanti SM, de França ER, Magalhães M, Lins AK, Brandão LC, Magalhães V. A quantitative analysis of Propionibacterium acnes in lesional and non-lesional skin of patients with progressive macular hypomelanosis by real-time polymerase chain reaction. Braz J Microbiol 2011; 42:423-9. [PMID: 24031649 PMCID: PMC3769848 DOI: 10.1590/s1517-83822011000200002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2010] [Revised: 08/02/2010] [Accepted: 11/04/2010] [Indexed: 11/22/2022] Open
Abstract
Little is known about the etiology of progressive macular hypomelanosis, although it has been suggested that Propionibacterium acnes plays an important role. While microbiological culture is commonly employed to identify Propionibacterium acnes, new identification methods have been under investigation, amongst them polymerase chain reaction. To determine the cut-off point for the number of genome copies of Propionibacterium acnes in the lesional skin of patients with progressive macular hypomelanosis as a positive marker, employing quantitative real-time polymerase chain reaction and anaerobic culture, considered gold standard. An observational study with a comparison group, included 35 patients with dermatosis, attended at the Oswaldo Cruz University Hospital, Pernambuco, Brazil, between March and May 2008. Lesional skin was compared to non-lesional skin through positive testing with real-time polymerase chain reaction and culture. The Statistical Package for Social Sciences, version 12.0, was employed for the association analysis with the McNemar test, and the cut-off point with the ROC curve for maximum values. Propionibacterium acnes was most frequently encountered in lesional areas (p<0,025). The cut-off point of Propionibacterium acnes in lesional skin was 1,333 genome copies, with a sensitivity of 87,9% and a specificity of 100,0%. Since Propionibacterium acnes is a saprophyte, identifying the cut-off point may assist in determining its positivity in lesional skin in patients suffering with this dermatosis.
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Deeba F, Syed R, Quareen J, Waheed MA, Jamil K, Rao H. CTLA-4 A49G gene polymorphism is not associated with vitiligo in South Indian population. Indian J Dermatol 2010; 55:29-32. [PMID: 20418973 PMCID: PMC2856369 DOI: 10.4103/0019-5154.60347] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Background: Vitiligo or leukoderma is a chronic skin condition that causes loss of pigment due to destruction of melanocytes, resulting in irregular pale patches of skin. Vitiligo is a polygenic disease and is associated with autoimmunity with an unknown etiology. Aims: One of the candidate genes which has a strong association with several autoimmune diseases is CTLA-4 gene located in chromosome 2q33 region. We investigated the possible association between CTLA-4 gene polymorphism in exon 1 (A49G) and vitiligo in patients from South India and compared the distribution of this polymorphism to matched control groups. Patients and Methods: The polymorphism was detected by Polymerase Chain Reaction-Restriction Fragment Length Polymorphism (PCR-RFLP) method in 175 patients and 180 normal, age/ethnicity matched individuals. Consistency of genotype frequencies with the Hardy-Weinberg equilibrium was tested using a χ2 test. Results: There was no significant difference between the genotype (P = 0.93) and allele (P = 0.615) frequencies of CTLA-4 A49G polymorphism in patients and normal healthy individuals. However there was significant association of the CTLA-4 genotype (P = 0.02) and allelic frequency (P = 0.008) between the segmental and non-segmental sub groups within vitiligo. Conclusion: Our results indicate that there is no association between CTLA-4 A49G gene polymorphism and vitiligo in southern Indian population.
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Affiliation(s)
- Farha Deeba
- Department of Genetics, Osmania University, India
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Abstract
LEARNING OBJECTIVES After reading this article, the participant should be able to: 1. Clinically describe various cutaneous neoplasms. 2. Identify the corresponding histopathologic findings. 3. Discuss the optimal treatment approach for each entity. SUMMARY Cutaneous neoplasms are broadly viewed as benign, premalignant, or malignant. In dermatology, lesions are classified based on the primary cell of origin or the component of the skin predominantly affected by the pathologic change (epidermis, dermis, or subcutaneous fat). The diagnosis and treatment of skin lesions rely on understanding the clinical presentation and corresponding histopathology. Surgical treatment is not always indicated and is dependent on multiple variables. This review discusses several benign and premalignant neoplasms frequently encountered by the plastic surgeon. The emphasis is on clinical presentation, histopathologic correlation, and management approach.
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Affiliation(s)
- H L Tey
- National Skin Centre, Singapore City, Singapore.
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Ubriani R, Clarke LE, Ming ME. Non-Neoplastic Disorders of Pigmentation. Dermatopathology (Basel) 2010. [DOI: 10.1016/b978-0-443-06654-2.00007-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Abstract
A large number of pigmentary disorders exist and although not all dermatologic entities are covered in this article, some of the pigmentary disorders that an internist or general practitioner is likely to encounter are reviewed. The clinician must be able to recognize pigmentary changes that suggest a serious underlying disease. In a situation where a malignancy or other serious illness may exist, an extensive evaluation to detect the disorder is required. This approach can allow for early treatment and referral to an appropriate specialist if necessary. The clinician must also recognize that pigmentary disorders that are essentially cosmetic still cause concern for the patient and can be emotionally distressing. These patients need emotional support and in some cases referral to a mental health specialist.
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Affiliation(s)
- Paul T Rose
- Academic Alliance in Dermatology, 4238 West Kennedy Boulevard, Tampa, FL 33609, USA.
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Abstract
Skin color is highly individual and the variations are controlled by numerous genes. The different skin colors result from the size and number of melanosomes and do not mirror the amount of melanocytes. Disorders of pigmentation can result from migration abnormalities of melanocytes from the neural crest to the skin during embryogenesis. In addition, impairment of melanosome transfer to the surrounding keratinocytes, an alteration in melanin synthesis and a defective degradation or removal of melanin may lead to abnormal skin pigmentation. Immunologic or toxic mediated destructions of melanocytes can end in pigmentation disorders. Disorders of pigmentation are classified in hypo- or hyperpigmentation which can occur as a genetic or acquired disease. They can manifest locally or diffuse. Congenital hypopigmentation can be restricted to the skin as in piebaldism or they represent a systemic disease as in Menkes disease or phenylketonuria. Localized hypo- or hyperpigmentation in children may serve as markers for systemic diseases. Ash-leaf hypopigmentation are characteristic for tuberous sclerosis and more than 5 café-au-lait spots suggest neurofibromatosis 1 (von Recklinghausen disease). The most common autoimmune-induced depigmentation is vitiligo. Generalized hyperpigmentation only rarely reflects a primary genetic disorder but is most often from acquired diseases as in Addison disease, secondary hemochromatosis or primary biliary cirrhosis. Treatment of pigmentation disorders are based on a diagnosis which sometimes allow a specific intervention. Cosmetically acceptable results are difficult to obtain.
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Dessinioti C, Stratigos AJ, Rigopoulos D, Katsambas AD. A review of genetic disorders of hypopigmentation: lessons learned from the biology of melanocytes. Exp Dermatol 2009; 18:741-9. [PMID: 19555431 DOI: 10.1111/j.1600-0625.2009.00896.x] [Citation(s) in RCA: 105] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Inherited diseases of pigmentation were among the first traits studied in humans because of their easy recognition. The discovery of genes that regulate melanocytic development and function and the identification of disease-causative mutations have greatly improved our understanding of the molecular basis of pigmentary genodermatoses and their underlying pathogenetic mechanisms. Pigmentation mutants can account for hypo-/amelanosis, with or without altered melanocyte number, resulting in different phenotypes, such as Waardenburg syndrome, piebaldism, Hermansky-Pudlak syndrome, Chediak-Higashi syndrome, oculocutaneous albinism and Griscelli syndrome. In this review, we summarize the basic concepts of melanocyte biology and discuss how molecular defects in melanocyte development and function can result in the development of hypopigmentary hereditary skin diseases.
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Affiliation(s)
- Clio Dessinioti
- Department of Dermatology, A. Sygros Hospital, University of Athens, Athens, Greece
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Prignano F, Pescitelli L, Becatti M, Di Gennaro P, Fiorillo C, Taddei N, Lotti T. Ultrastructural and functional alterations of mitochondria in perilesional vitiligo skin. J Dermatol Sci 2009; 54:157-67. [DOI: 10.1016/j.jdermsci.2009.02.004] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2008] [Revised: 01/09/2009] [Accepted: 02/05/2009] [Indexed: 10/21/2022]
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