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Liu J, Liu S, Guo M, Yong M, Hu Z. Clinical validation and study of stem cell transplantation in treatment of vitiligo. Arch Dermatol Res 2023; 315:2983-2984. [PMID: 37676313 PMCID: PMC10615963 DOI: 10.1007/s00403-023-02692-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 06/20/2023] [Accepted: 07/27/2023] [Indexed: 09/08/2023]
Affiliation(s)
- Jingwei Liu
- Nanhai Renshu International Skin Hospital (Hainan) Co., Ltd., Haidian Sandong Road, Haikou, 570208, China.
| | - Shiyu Liu
- Nanhai Renshu International Skin Hospital (Hainan) Co., Ltd., Haidian Sandong Road, Haikou, 570208, China
| | - Min Guo
- Nanhai Renshu International Skin Hospital (Hainan) Co., Ltd., Haidian Sandong Road, Haikou, 570208, China
| | - Miao Yong
- Affiliated Hospital of Southern Medical University, Guangdong, 050100, China
| | - Zhiqi Hu
- Affiliated Hospital of Southern Medical University, Guangdong, 050100, China
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2
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Management of Stable Vitiligo-A Review of the Surgical Approach. J Clin Med 2023; 12:jcm12051984. [PMID: 36902772 PMCID: PMC10004352 DOI: 10.3390/jcm12051984] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 02/13/2023] [Accepted: 02/14/2023] [Indexed: 03/06/2023] Open
Abstract
At present, vitiligo is the most common depigmenting skin disorder, characterized by clearly demarcated discolored patches of various shapes and sizes. Depigmentation results from the initial dysfunction and subsequent destruction of melanin-producing cells, called melanocytes, which are located in the basal layer of the epidermis and in hair follicles. This review concludes that the extent of repigmentation, regardless of the treatment method, is greatest in stable localized vitiligo patients. The aim of this review is to provide an overview of the clinical evidence for which the vitiligo treatment method (cellular or tissue) is more effective. The treatment relies on multiple factors, ranging from patient skin predisposition for repigmentation to the experience of the facility performing the procedure. Vitiligo is a significant problem in modern society. Although it is a typically asymptomatic and not life-threatening disease, it may have significant psychological and emotional impacts. Standard treatment relies on pharmacotherapy and phototherapy; however, the treatment of patients with stable vitiligo varies. The stability of vitiligo more than often implies the exhaustion of the potential for skin self-repigmentation. Thus, the surgical methods that distribute normal melanocytes into the skin are crucial elements of these patients' therapy. The most commonly used methods are described in the literature, with an indication of their recent progress and changes. In addition, information on the efficiency of the individual methods at specific locations is compiled in this study, and the prognostic factors indicating repigmentation are presented. Cellular methods are the best therapeutic option for large-sized lesions; although they are more exorbitant than tissue methods, they benefit from more rapid healing times and presenting fewer side effects. Dermoscopy is a valuable tool used to assess the further course of repigmentation, where it is of great value to evaluate the patient prior to and following an operation.
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3
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Oberoi B, Baveja S, Pathania V, Neema S. Comparative study of the efficacy and safety of two grafting procedures (an automated epidermal harvesting system and non-cultured epidermal cell suspension) in the treatment of stable vitiligo. Indian J Dermatol Venereol Leprol 2022:1-7. [DOI: 10.25259/ijdvl_1010_2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 05/01/2022] [Indexed: 11/04/2022]
Abstract
Background
The non-cultured epidermal cell suspension method is a well-established but tedious grafting modality in the management of stable vitiligo. Recently a more user-friendly automated epidermal harvesting system has been introduced.
Aim
This was a pilot study to compare the efficacy and safety outcomes of the above two grafting procedures.
Study design
The study was a single-blinded split-body randomised controlled trial. After scientific and ethical clearance, the trial was registered with CTRI (CTRI/2018/05/014225). Thirty consenting patients of stable vitiligo with 60 near-symmetrical patches were recruited. Block randomisation was done using computer-generated randomisation software and each patch was allocated either of the two grafting modalities. Efficacy was assessed by the Physician Global Assessment Scale on serial images and pain by the Numerical Rating Pain Scale.
Results and conclusion
The non-cultured epidermal cell suspension was found to be an overall statistically superior technique to the automated epidermal harvesting system in terms of efficacy (re-pigmentation). Both donor and recipient site complications were significantly less with the automated epidermal harvesting system grafting and this method had the distinct advantage of being a painless and easy technique with minimal recovery time. A novel observation was that a good colour match and near-complete re-pigmentation occurred in patients with a darker skin colour with both techniques.
Limitations
The main limitation of our study was the small sample size. Also, the size of the treated patches was limited such that they could be covered by the 5 × 5 cm size of the automated epidermal harvesting system blade. However, a larger area can be covered with multiple sessions.
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Affiliation(s)
| | - Sukriti Baveja
- Department of Dermatology, Armed Forces Medical College, Pune, Maharashtra, India
| | - Vikas Pathania
- Department of Dermatology, Armed Forces Medical College, Pune, Maharashtra, India
| | - Shekhar Neema
- Department of Dermatology, Armed Forces Medical College, Pune, Maharashtra, India
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4
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Utilization of Our Toolkit: A Systematic Review and Meta-analysis of Surgical Therapies in Vitiligo Treatment. Dermatol Surg 2022; 48:815-821. [DOI: 10.1097/dss.0000000000003503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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5
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Zhang J, Liang N, Cao Y, Li M. Differentially Expressed Circular RNAs and Their Therapeutic Mechanism in Non-segmental Vitiligo Patients Treated With Methylprednisolone. Front Med (Lausanne) 2022; 9:839066. [PMID: 35652072 PMCID: PMC9149005 DOI: 10.3389/fmed.2022.839066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 03/30/2022] [Indexed: 01/31/2023] Open
Abstract
Vitiligo is characterized by chronic skin depigmentation arising from the autoimmune destruction of epidermal melanocytes. Systemic corticosteroid therapy is an effective immunosuppressive treatment for progressive generalized vitiligo. Circular RNAs (circRNAs) play various roles in diseases. In systemic corticosteroid therapy, however, how circRNAs function to counter vitiligo is still unclear. In this article, we identified the differentially expressed circRNAs (DEcircRNAs) in vitiligo patients before and after the administration of methylprednisolone. Total RNA was extracted from the peripheral blood of patients with vitiligo, and samples were hybridized into a circRNA array. A total of 375 (51 upregulated and 324 downregulated) circRNAs were differentially expressed. Box, scatter, volcano, and heatmap plots were generated to classify the samples. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were performed on DEcircRNAs. These DEcircRNAs were enriched in vitiligo-related biological processes, such as ferroptosis, organic substance transport, protein metabolic process, and cellular component organization or biogenesis. Two different databases, TargetScan and miRanda, were used to predict circRNA/miRNA interactions. Several circRNA/miRNA interactions were involved in ferroptosis. These circRNAs might serve as therapeutic targets in the treatment of vitiligo.
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Affiliation(s)
- Jiaqi Zhang
- Department of Dermatology, The Affiliated Changzhou No. 2 People’s Hospital of Nanjing Medical University, Changzhou, China
| | - Ning Liang
- Department of Dermatology, The Affiliated Changzhou No. 2 People’s Hospital of Nanjing Medical University, Changzhou, China
| | - Yan Cao
- Department of Dermatology, The Affiliated Changzhou No. 2 People’s Hospital of Nanjing Medical University, Changzhou, China
- *Correspondence: Yan Cao,
| | - Min Li
- Department of Dermatology, Children’s Hospital of Nanjing Medical University, Nanjing, China
- Min Li,
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6
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Microneedling in Combination with Topical Pimecrolimus 1% versus Topical Pimecrolimus 1% for the Treatment of Refractory Stable Vitiligo: A Randomized Clinical Trial. Dermatol Res Pract 2021; 2021:5652140. [PMID: 34887918 PMCID: PMC8651420 DOI: 10.1155/2021/5652140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 11/02/2021] [Accepted: 11/12/2021] [Indexed: 11/17/2022] Open
Abstract
Objective Vitiligo is a common, autoimmune disease that results in the destruction of the melanocytes and manifests as depigmented macules on various areas of the skin. Numerous treatment options have been proposed for vitiligo. The purpose of this study was to compare the efficacy of microneedling plus topical pimecrolimus 1% versus the sole use of topical pimecrolimus 1% for the treatment of vitiligo. Methods This clinical trial was conducted on 30 skin lesions on 15 Al-Zahra hospital patients. Each patient had two similar lesions in the limb area, and each lesion was considered a separate treatment group. The left or right side of the patient's lesion was randomly assigned to receive microneedling plus topical pimecrolimus for three months, while the other side received only topical pimecrolimus 1%. As part of the follow-up, digital photography was taken at the baseline and biweekly for three months after treatment and six months' follow-up. The following methods were used to evaluate the results: DLQI questionnaires, patient satisfaction questionnaires, and two independent dermatologists comparing the improvement rate for each group. Results Topical pimecrolimus 1% treatment led to unsatisfactory results, whereas the combination of microneedling and topical pimecrolimus1% treatment produced a more favorable overall outcome (P < 0.001). Conclusion This study established that combination therapy results in more significant patient improvement. Additionally, one patient experienced mild skin irritation as a side effect of topical pimecrolimus.
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El-Domyati M, El-Din WH, Rezk AF, Chervoneva I, Lee JB, Farber M, Uitto J, Igoucheva O, Alexeev V. Systemic CXCL10 is a predictive biomarker of vitiligo lesional skin infiltration, PUVA, NB-UVB and corticosteroid treatment response and outcome. Arch Dermatol Res 2021; 314:275-284. [PMID: 33866437 DOI: 10.1007/s00403-021-02228-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 02/24/2021] [Accepted: 04/03/2021] [Indexed: 10/21/2022]
Abstract
Vitiligo is an acquired pigmentary skin disorder that currently lacks standardized treatment and validated biomarkers to objectively evaluate disease state or therapeutic response. Although prior studies have linked vitiligo autoimmunity with CXCL10/CXCL9-mediated recruitment of leukocytes to the skin, only limited clinical data are available regarding CXCL10 as vitiligo biomarker. To evaluate the utility of systemic CXCL10 as a predictor of disease progression and treatment response on a large cohort of vitiligo patients. CXCL10 levels in lesional, perilesional, and unaffected skin of vitiligo patient (n = 30) and in the serum (n = 51) were measured by quantitative ELISA. CXCL10 expression, recruitment of leukocytes, and inflammatory infiltrates were evaluated by histochemical (n = 32) and immunofluorescence (n = 10) staining. Rigorous cross-sectional and longitudinal biostatistical analysis were employed to correlate CXCL10 levels with disease variables, treatment response, and outcome. We demonstrated that elevated CXCL10 level (2 pg/mm2 and higher) in lesional skin correlates with increased leukocytic infiltrate, disease duration (< 2 year), and its higher level in the serum (50 pg/ml and higher). Changes in CXCL10 serum levels in patients treated with psoralen plus UVA (PUVA) phototherapy, narrowband UVB (NB-UVB) phototherapy, and systemic steroids (SS) correlated with changes in the intralesional CXCL10 levels in repigmented skin. NB-UVB and SS regimens provided most consistent CXCL10 mean change, suggesting that these regimens are most effective in harnessing CXCR3-mediated inflammatory response. Serum CXCL10 is a useful vitiligo biomarker, which predicts lesional skin leukocytic infiltration, and vitiligo treatment response and outcome.
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Affiliation(s)
- M El-Domyati
- Department of Dermatology, STDs and Andrology At Minia University, Minia, Egypt.
| | - W H El-Din
- Department of Dermatology, STDs and Andrology At Minia University, Minia, Egypt
| | - A F Rezk
- Department of Dermatology, STDs and Andrology At Minia University, Minia, Egypt.,Department of Dermatology and Cutaneous Biology, Sidney Kimmel Medical College, Thomas Jefferson University, 233 S. 10th Street, BLSB, Suite 430, Philadelphia, PA, 19107, USA
| | - I Chervoneva
- Department of Pharmacology and Experimental Therapeutics, Division of Biostatistics, Thomas Jefferson University, 1015 Chestnut Street, Philadelphia, PA, 19107, USA
| | - J B Lee
- Department of Dermatology and Cutaneous Biology, Sidney Kimmel Medical College, Thomas Jefferson University, 233 S. 10th Street, BLSB, Suite 430, Philadelphia, PA, 19107, USA
| | - M Farber
- Department of Dermatology and Cutaneous Biology, Sidney Kimmel Medical College, Thomas Jefferson University, 233 S. 10th Street, BLSB, Suite 430, Philadelphia, PA, 19107, USA
| | - J Uitto
- Department of Dermatology and Cutaneous Biology, Sidney Kimmel Medical College, Thomas Jefferson University, 233 S. 10th Street, BLSB, Suite 430, Philadelphia, PA, 19107, USA
| | - O Igoucheva
- Department of Dermatology and Cutaneous Biology, Sidney Kimmel Medical College, Thomas Jefferson University, 233 S. 10th Street, BLSB, Suite 430, Philadelphia, PA, 19107, USA
| | - Vitali Alexeev
- Department of Dermatology and Cutaneous Biology, Sidney Kimmel Medical College, Thomas Jefferson University, 233 S. 10th Street, BLSB, Suite 430, Philadelphia, PA, 19107, USA.
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8
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Bakr RM, Abdel-Gaber RM, Tawfik YM. A comparative study on the use of fractional CO 2 laser with tacrolimus or calcipotriol or narrow band ultraviolet-B in treatment of stable nonsegmental vitiligo. Dermatol Ther 2020; 34:e14604. [PMID: 33249712 DOI: 10.1111/dth.14604] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Revised: 11/10/2020] [Accepted: 11/23/2020] [Indexed: 11/28/2022]
Abstract
Conventional methods of treatment for vitiligo are often unsatisfactory to the patients and time consuming, new treatment modalities are needed. This study was conducted to evaluate the efficacy and safety of fractional carbon dioxide (CO2 ) laser therapy followed by narrow band ultraviolet-B (NB-UVB) phototherapy, topical tacrolimus or topical calcipotriol on stable nonsegmental vitiligo. Thirty patients with stable nonsegmental vitiligo were evaluated. All patients were subjected to three sessions of fractional CO2 laser 1 month apart. Patients were divided into three groups (each group 10 patients). Group (A) treated with tacrolimus ointment twice daily for 3 months, group (B) treated with calcipotriol ointment twice daily for 3 months, and group (C) treated with NB-UVB twice weekly for 3 months. Outcomes were evaluated by calculating vitiligo area scoring index (VASI) score change, percentage of repigmentation, patient satisfaction, and adverse effects. There was a statistical significant decrease in VASI score after treatment in the three groups. The VASI change and % of regimentation was higher in group (C) treated by laser and NB-UVB and this was significantly higher than group (B) treated with laser and calcipotriol. Otherwise, there was no statistical significant difference between other treatment groups. In concluion, NB-UVB phototherapy, topical tacrolimus, or topical calcipotriol in combination with fractional CO2 laser could be used effectively and safely as an alternative modality for treatment of vitiligo. The combination of fractional CO2 laser and NB-UVB was found to be more effective.
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Affiliation(s)
- Radwa M Bakr
- Department of Dermatology, Venereology and Andrology, Assiut University, Assiut, Egypt
| | - Reham M Abdel-Gaber
- Department of Dermatology, Venereology and Andrology, Assiut University, Assiut, Egypt
| | - Yasmin M Tawfik
- Department of Dermatology, Venereology and Andrology, Assiut University, Assiut, Egypt
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9
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Shaaban M, Nasr M, Tawfik AA, Fadel M, Sammour O. Bergamot oil as an integral component of nanostructured lipid carriers and a photosensitizer for photodynamic treatment of vitiligo: Characterization and clinical experimentation. Expert Opin Drug Deliv 2020; 18:139-150. [PMID: 33119413 DOI: 10.1080/17425247.2021.1844180] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Background: Bergamot oil (BO) is a photosensitizer that can be used for photodynamic therapy (PDT) of dermatological diseases such as vitiligo. Being an oil, it can be integrated within the lipidic matrix of nanostructured lipid carriers (NLCs) as the liquid lipid constituent, hence exhibiting a dual role. Research design and methods: NLCs were prepared with different emulsifiers and coemulsifiers, and the effect of the preparation method and formulation variables on the NLCs' size was elucidated. The prepared NLCs were further characterized for their in vitro release, viscosity, thermal behavior, and in vitro photostability. Furthermore, a preclinical photodynamic study on animal skin was conducted, followed by clinical experimentation on patients with vitiligo. Results: Results showed that BO was successfully incorporated within the NLCs. The selected NLCs formulation was in the nanometer range with a gel consistency, and it provided sustained release of BO for 24 h. NLCs improved the photostability and photodynamic properties of BO, and displayed promising preclinical and clinical results for the topical PDT of vitiligo. Expert Opinion: BO containing NLCs was proven to be promising means for PDT of vitiligo, and can be further explored in other dermatological diseases.
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Affiliation(s)
- Mai Shaaban
- Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Ain Shams University , Cairo, Egypt
| | - Maha Nasr
- Dermatology and Laser Dermatology Unit, Department of Medical Applications of Laser, National Institute of Laser Enhanced Sciences, Cairo University , Cairo, Egypt
| | - Abeer A Tawfik
- Dermatology and Laser Dermatology Unit, Department of Medical Applications of Laser, National Institute of Laser Enhanced Sciences, Cairo University , Cairo, Egypt
| | - Maha Fadel
- Pharmaceutical Technology Unit, Department of Medical Applications of Laser, National Institute of Laser Enhanced Sciences, Cairo University , Cairo, Egypt
| | - Omaima Sammour
- Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Ain Shams University , Cairo, Egypt
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10
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Liu R, Niu T, Cheng Y, Zhou D, Zhang C, Qu J, Sun L, Guo G, Gao R, Zhao G, Wang J. Effect of serum from healthy individuals on the growth of melanocytes in vitro following moxibustion at the "Jiudianfeng" point. J Int Med Res 2020; 48:300060520910667. [PMID: 32228312 PMCID: PMC7132557 DOI: 10.1177/0300060520910667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 01/20/2020] [Indexed: 12/01/2022] Open
Abstract
Objective To investigate the effects of serum from healthy individuals obtained following moxibustion at the “Jiudianfeng” point on melanocytes in vitro . Methods Ten healthy adults (five male and five female) were treated by moxibustion at the “Jiudianfeng” point for 30 minutes once daily for 3 months. The effects of treatment with serum obtained following moxibustion on melanocyte proliferation, melanin content, tyrosinase activity, cell cycle progression, and c-kit mRNA and protein expression were assessed in vitro before and after moxibustion for 1, 2, and 3 months. Results Exposure to sera from healthy adults following moxibustion therapy promoted melanocyte proliferation, melanin synthesis, tyrosinase activity, and c-kit mRNA and protein expression in vitro . Melanin synthesis and tyrosinase activity increased in the first 2 months following moxibustion and a synchronous decline was observed during the third month. Serum also promoted melanocyte entry into the G1 phase of the cell cycle. Conclusions Serum treatment following moxibustion at the “Jiudianfeng” point promoted melanocyte proliferation and melanin synthesis. Further exploration of this intriguing phenomenon is essential.
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Affiliation(s)
- Rupeng Liu
- Department of Dermatology, Beijing Hospital of Traditional
Chinese Medicine, Capital Medical University, Beijing, China
| | - Tianhui Niu
- Health Sciences Research Center, Air Force Medical Center, PLA,
Beijing, China
| | - Yu Cheng
- Department of Dermatology, Beijing Hospital of Traditional
Chinese Medicine, Capital Medical University, Beijing, China
| | - Dongmei Zhou
- Department of Dermatology, Beijing Hospital of Traditional
Chinese Medicine, Capital Medical University, Beijing, China
| | - Cang Zhang
- Department of Dermatology, Beijing Hospital of Traditional
Chinese Medicine, Capital Medical University, Beijing, China
| | - Jianhua Qu
- Department of Dermatology, Beijing Hospital of Traditional
Chinese Medicine, Capital Medical University, Beijing, China
| | - Liyun Sun
- Department of Dermatology, Beijing Hospital of Traditional
Chinese Medicine, Capital Medical University, Beijing, China
| | - Guangjin Guo
- Health Sciences Research Center, Air Force Medical Center, PLA,
Beijing, China
| | - Ran Gao
- Department of Dermatology, Beijing Hospital of Integrated
Traditional Chinese and Western Medicine, Beijing, China
| | - Guang Zhao
- Department of Dermatology, Air Force Medical Center, PLA,
Beijing, China
| | - Jusheng Wang
- Department of Dermatology, Beijing Hospital of Traditional
Chinese Medicine, Capital Medical University, Beijing, China
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11
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Ebrahim HM, Albalate W. Efficacy of microneedling combined with tacrolimus versus either one alone for vitiligo treatment. J Cosmet Dermatol 2020; 19:855-862. [DOI: 10.1111/jocd.13304] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Accepted: 12/19/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Howyda M. Ebrahim
- Dermatology, Venereology and Andrology Department Faculty of Medicine Zagazig University Zagazig Egypt
| | - Waleed Albalate
- Dermatology, Venereology and Andrology Department Faculty of Medicine Zagazig University Zagazig Egypt
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12
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Abd‐Elazim NE, Yassa HA, Mahran AM. Microdermabrasion and topical tacrolimus: A novel combination therapy of vitiligo. J Cosmet Dermatol 2019; 19:1447-1455. [DOI: 10.1111/jocd.13193] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2018] [Revised: 09/06/2019] [Accepted: 09/23/2019] [Indexed: 12/31/2022]
Affiliation(s)
- Nagwa E. Abd‐Elazim
- Department of Dermatology, Venereology and Andrology Faculty of Medicine Assuit University Assiut Egypt
| | - Haidy A. Yassa
- Department of Dermatology, Venereology and Andrology Faculty of Medicine Assuit University Assiut Egypt
| | - Ayman M. Mahran
- Department of Dermatology, Venereology and Andrology Faculty of Medicine Assuit University Assiut Egypt
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13
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Ly K, Smith MP, Thibodeaux QG, Beck KM, Liao W, Bhutani T. Beyond the Booth: Excimer Laser for Cutaneous Conditions. Dermatol Clin 2019; 38:157-163. [PMID: 31753188 DOI: 10.1016/j.det.2019.08.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
The excimer laser has emerged as an efficacious treatment modality for many dermatologic diseases. The excimer laser is an alternative to standard narrowband ultraviolet B (NBUVB) phototherapy treatment in patients with limited disease. In comparison to standard NBUVB, the excimer laser requires fewer treatment sessions, has reduced treatment duration, requires a lower cumulative UVB dose, and limits UVB exposure to lesional skin. This review addresses the mechanism, safety, application, and efficacy of the excimer laser for the treatment of these conditions.
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Affiliation(s)
- Karen Ly
- Department of Dermatology, University of California San Francisco, 515 Spruce Street, San Francisco, CA 94118, USA
| | - Mary P Smith
- Department of Dermatology, University of California San Francisco, 515 Spruce Street, San Francisco, CA 94118, USA
| | - Quinn G Thibodeaux
- Department of Dermatology, University of California San Francisco, 515 Spruce Street, San Francisco, CA 94118, USA
| | - Kristen M Beck
- Department of Dermatology, University of California San Francisco, 515 Spruce Street, San Francisco, CA 94118, USA
| | - Wilson Liao
- Department of Dermatology, University of California San Francisco, 515 Spruce Street, San Francisco, CA 94118, USA
| | - Tina Bhutani
- Department of Dermatology, University of California San Francisco, 515 Spruce Street, San Francisco, CA 94118, USA.
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14
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Xu W, Wang X. Detection of melanocyte lineage-specific genes in vitiligo lesions. Exp Ther Med 2019; 17:4485-4491. [PMID: 31086580 PMCID: PMC6489045 DOI: 10.3892/etm.2019.7496] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 10/19/2018] [Indexed: 12/15/2022] Open
Abstract
Vitiligo is an acquired pigmentary disorder characterized by the loss of skin color and functional melanocytes. The pathogenesis of vitiligo remains unclear, which means that effective clinical treatment is difficult. However, if melanocyte linkage-specific genes are identified in vitiligo lesions, the appropriate treament for melanocytes may be implemented. The current study aimed to detect the expression of melanocyte lineage-specific genes in vitiligo lesion needle biopsies and to predict the occurrence of perifollicular repigmentation in depigmented macules. A total of 6 patients with stable vitiligo and 4 healthy volunteers were recruited from the Department of Dermatology, Wuhan Third Hospital. Total RNA was extracted from skin tissue needle biopsies from the periphery and center of depigmented macules, and adjacent normal skin. The expression of dopachrome tautomerase (Dct), tyrosinase (Tyr) and β-actin (ACTB) genes were detected using a reverse transcription (RT)-semi quantitative polymerase chain reaction (PCR) assay. RNA extracted from 7 mg of skin samples was sufficient to amplify all three genes. The expression profile of each patient was then observed in the center of vitiligous lesions and were deemed to be Dct+Tyr-ACTB+, Dct-Tyr-ACTB+ or Dct+Tyr+ACTB+. At 5 months, patient follow-up indicated that perifollicular repigmentation was efficaciously induced by 308 nm eximer light radiation in a patient who had a Dct+Tyr-ACTB+ gene expression. The results demonstrated that needle skin biopsy and RT-semi quantitative PCR may be used as a less traumatic and reliable method to detect the expression profiles of melanocyte lineage-specific genes in needle biopsies, which may have the potential to predict the occurrence of perifollicular repigmentation in vitiligo.
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Affiliation(s)
- Wanwen Xu
- Division of Dermatology, Wuhan Third Hospital and Tongren Hospital of Wuhan University, Wuhan, Hubei 430060, P.R. China
| | - Xiong Wang
- Division of Nephrology, Renmin Hospital, Wuhan University, Wuhan, Hubei 430060, P.R. China
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15
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Mirnezami M, Rahimi H. Serum Zinc Level in Vitiligo: A Case-control Study. Indian J Dermatol 2018; 63:227-230. [PMID: 29937559 PMCID: PMC5996627 DOI: 10.4103/ijd.ijd_457_16] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background: Vitiligo is characterized by the idiopathic destruction of melanocytes, probably of autoimmune etiology, that results in depigmented patches of skin and mucosal surfaces. Oxidative stress may contribute to the pathogenesis of vitiligo. Zinc, a trace element with antiapoptotic properties, plays a major role in the process of melanogenesis and elimination of free radicals. The present study was conducted with the aim of comparing serum zinc levels in patients with vitiligo and in normal controls. Materials and Methods: In this case–control study, we studied 103 patients with vitiligo and 103 healthy sex-and age-matched controls. Serum zinc levels were measured in these two groups using atomic absorption spectrophotometry and compared with each other. Results: The mean serum zinc level was 92.1 mcg/dl in the focal vitiligo, 81.3 mcg/dl in the generalized vitiligo, and 91.8 mcg/dl in the control group. A significant difference in serum zinc levels was observed between the patients with generalized vitiligo and the controls. Lower serum zinc levels were also correlated with longer duration of the disease. Furthermore, a negative relationship was found between serum zinc level and age of patients with vitiligo. Conclusion: Serum zinc level is low in patients with generalized vitiligo. In these patients, serum zinc level is in negative correlation with patient's age and disease duration.
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Affiliation(s)
- Mina Mirnezami
- Department of Dermatology, Faculty of Medicine, Arak University of Medical Sciences, Arak, Iran
| | - Hoda Rahimi
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Commentary on Effect of Procedural-Related Variables on Melanocyte-Keratinocyte Suspension Transplantation in Nonsegmental Stable Vitiligo. Dermatol Surg 2017; 43:236-237. [PMID: 28165348 DOI: 10.1097/dss.0000000000000892] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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17
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BinSheikhan S, Al Abadie M. Improvement in moderate to severe vitiligo using a novel combination of 308 nm excimer laser and a surgical needling technique. Clin Exp Dermatol 2017; 42:363-366. [PMID: 28300320 DOI: 10.1111/ced.13056] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/06/2016] [Indexed: 11/28/2022]
Affiliation(s)
- S. BinSheikhan
- Department of Dermatology; Zayed Military Hospital; Abu Dhabi United Arab Emirates
| | - M. Al Abadie
- Department of Dermatology; Royal Wolverhampton NHS Trust; Wolverhampton, and Medical School Birmingham West Midlands UK
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18
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Vachiramon V, Chaiyabutr C, Rattanaumpawan P, Kanokrungsee S. Effects of a preceding fractional carbon dioxide laser on the outcome of combined local narrowband ultraviolet B and topical steroids in patients with vitiligo in difficult-to-treat areas. Lasers Surg Med 2015; 48:197-202. [PMID: 26175036 DOI: 10.1002/lsm.22389] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/15/2015] [Indexed: 11/06/2022]
Abstract
BACKGROUND AND OBJECTIVE Conventional treatment of vitiligo on hands and feet often produces an unsatisfactory result. Various ablative treatment methods were tried with favorable results in facial, neck, and truncal areas. The aim of this study is to evaluate the efficacy and safety of combined fractional CO2 laser, narrowband UVB (NB-UVB) phototherapy, and topical clobetasol propionate in managing stable vitiligo in difficult-to-treat areas. STUDY DESIGN A prospective randomized-intraindividual study was conducted on 27 patients with 27 pair-lesions of non-segmental vitiligo on both hands. The lesions were randomized to receive treatment with fractional CO2 laser, NB-UVB phototherapy, and 0.05% clobetasol propionate cream (Group A) or NB-UVB phototherapy and 0.05% clobetasol propionate cream (Group B). Fractional CO2 laser was performed at 1-week interval for 10 sessions. NB-UVB phototherapy was administered twice weekly for 20 sessions. Patients were evaluated 12 weeks after the last treatment. Outcome was evaluated objectively based on standard digital photographs, patient satisfaction, and adverse events. RESULTS Twenty-six patients completed the study. Six vitiligious lesions (23.1%) in group A achieved good to excellent repigmentation compared with one lesion (3.9%) in group B (P = 0.065). The overall mean improvement score was 1.35 (± 1.38) in group A and 0.50 (± 0.95) in group B (P = 0.0004). Patients' satisfaction score was significantly higher for the lesions in group A than group B. Lesions on the dorsum of the hand showed a higher response rate than those on the fingers. No serious side-effects were noted. CONCLUSION This study demonstrates that adding fractional CO2 laser treatment to NB-UVB phototherapy and topical steroids improves the repigmentation rate of vitiliginous lesions on hands in some patients. This technique may be offered to vitiligo patients who are unresponsive to other treatments.
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Affiliation(s)
- Vasanop Vachiramon
- Division of Dermatology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Chayada Chaiyabutr
- Division of Dermatology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Pinyo Rattanaumpawan
- Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Silada Kanokrungsee
- Division of Dermatology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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19
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Al-Hadidi N, Griffith JL, Al-Jamal MS, Hamzavi I. Role of Recipient-site Preparation Techniques and Post-operative Wound Dressing in the Surgical Management of Vitiligo. J Cutan Aesthet Surg 2015; 8:79-87. [PMID: 26157306 PMCID: PMC4477467 DOI: 10.4103/0974-2077.158439] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Vitiligo is an acquired skin disorder characterized by the destruction of melanocytes resulting in achromic macules and patches involving the affected skin. Multiple methods of treatments have emerged to manage vitiligo, including medical and surgical techniques. Among the surgical techniques described in the management of vitiligo are minipunch grafting, split-thickness skin grafting, hair follicle transplantation, suction blister grafting, and cultured and non-cultured autologous melanocyte transplantation. However, prior to grafting optimal recipient-site preparation is needed for graft survival and successful repigmentation outcomes. Similarly, post-operative care of the recipient site is vital to yielding a viable graft irrespective of the transplantation technique employed. This article reviews the multiple methods employed to prepare the recipient site in vitiligo surgeries and the post-surgical conditions which optimize graft viability. A pubmed search was conducted utilizing the key words listed below.
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Affiliation(s)
- Nour Al-Hadidi
- University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - James L Griffith
- Department of Dermatology, Multicultural Dermatology Center, Henry Ford Hospital, Detroit, Michigan, USA
| | - Mohammed S Al-Jamal
- Department of Dermatology, Multicultural Dermatology Center, Henry Ford Hospital, Detroit, Michigan, USA
| | - Iltefat Hamzavi
- Department of Dermatology, Multicultural Dermatology Center, Henry Ford Hospital, Detroit, Michigan, USA
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20
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Faria AR, Tarlé RG, Dellatorre G, Mira MT, Castro CCSD. Vitiligo--Part 2--classification, histopathology and treatment. An Bras Dermatol 2015; 89:784-90. [PMID: 25184918 PMCID: PMC4155957 DOI: 10.1590/abd1806-4841.20142717] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2013] [Accepted: 06/11/2013] [Indexed: 11/22/2022] Open
Abstract
In an unprecedented effort in the field of vitiligo, a global consensus resulted on a suggested new classification protocol for the disease. The main histopathological finding in vitiligo is the total absence of functioning melanocytes in the lesions, while the inflammatory cells most commonly found on the edges of the lesions are CD4+ and CD8+ T lymphocytes. Physical and pharmacological treatment strategies aim to control the autoimmune damage and stimulate melanocyte migration from the unaffected edges of lesions and the outer hair follicle root sheath to the affected skin; moreover, surgical treatments can be combined with topical and physical treatments.
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21
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Mei X, Sun Y, Wu Z, Pan W, Zhu J, Shi W. In vitro-induced differentiation of bone marrow mesenchymal stem cells into melanocytes. Cell Biol Int 2015; 39:824-33. [PMID: 25712780 DOI: 10.1002/cbin.10455] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Accepted: 02/18/2015] [Indexed: 12/12/2022]
Affiliation(s)
- Xingyu Mei
- Shanghai First People's Hospital; Shanghai Jiaotong University; Shanghai China
| | - Yue Sun
- Shanghai First People's Hospital; Shanghai Jiaotong University; Shanghai China
| | - Zhouwei Wu
- Shanghai First People's Hospital; Shanghai Jiaotong University; Shanghai China
| | - Weihua Pan
- Shanghai First People's Hospital; Shanghai Jiaotong University; Shanghai China
| | - Jianyu Zhu
- Shanghai First People's Hospital; Shanghai Jiaotong University; Shanghai China
| | - Weimin Shi
- Shanghai First People's Hospital; Shanghai Jiaotong University; Shanghai China
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22
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Purschke M, Asrani F, Sabir S, Farinelli W, Anderson R. Novel methods for generating fractional epidermal micrografts. Br J Dermatol 2015; 172:1021-8. [DOI: 10.1111/bjd.13468] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/05/2014] [Indexed: 11/26/2022]
Affiliation(s)
- M. Purschke
- Wellman Center for Photomedicine; Massachusetts General Hospital/Harvard Medical School; Boston MA U.S.A
| | - F.A. Asrani
- Wellman Center for Photomedicine; Massachusetts General Hospital/Harvard Medical School; Boston MA U.S.A
| | - S.A. Sabir
- Center for Integration of Medicine and Innovative Technology (CIMIT); Massachusetts General Hospital; Boston MA U.S.A
| | - W.A. Farinelli
- Wellman Center for Photomedicine; Massachusetts General Hospital/Harvard Medical School; Boston MA U.S.A
| | - R.R. Anderson
- Wellman Center for Photomedicine; Massachusetts General Hospital/Harvard Medical School; Boston MA U.S.A
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23
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Kovacs D, Abdel-Raouf H, Al-Khayyat M, Abdel-Azeem E, Hanna MR, Cota C, Picardo M, Anbar TS. Vitiligo: characterization of melanocytes in repigmented skin after punch grafting. J Eur Acad Dermatol Venereol 2014; 29:581-90. [PMID: 25089006 DOI: 10.1111/jdv.12647] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2013] [Accepted: 06/23/2014] [Indexed: 01/30/2023]
Abstract
BACKGROUND Punch grafting is a surgical technique mainly applied in therapy-resistant, stable and circumscribed vitiligo. OBJECTIVE (i) To characterize in detail the features of the repigmented skin among punch grafts; and (ii) to correlate the ex vivo results with clinical data and punch grafting outcome. METHODS We evaluated by immunohistochemistry and image analysis the expression of a panel of specific melanocyte markers including HMB45, MITF, c-kit, MART-1 and TRP1, the proliferation marker Ki67 and the cell-cell adhesion molecule E-cadherin in tissue samples collected from nine patients after punch grafting. RESULTS Cells positive for MITF, c-kit, MART-1 and TRP1 were detected in the repigmented skin of all biopsies, whereas no reactivity was observed for HMB45. Melanocytes were identified along the entire length of the sections, and their mature state was assessed by the immuno-reactivity for the differentiation marker MART-1, the absence of cells positively stained for Ki67 and by the co-expression of c-kit and TRP1, a marker of a differentiated and pigmented state. Clinically, smaller punch grafts aimed at repigmenting lesional areas on the face gave the faster clinical results with no side-effects. Patients subjected to bigger punch grafts on the knee exhibited a longer repigmentation time and presented cobble stoning. CONCLUSION Our results suggest that the repigmentation observed in the areas between the grafts is due to the activation of the melanocytes located in the donor sites. These cells start to horizontally migrate towards the lesional skin thanks to successively the enlargement of intercellular spaces in relation to a decrease of E-cadherin reactivity and the up-modulation of pro-melanogenic mediators. Production and transfer of melanin in the surrounding keratinocytes and their persistence were assessed by the reactivity for MITF, c-kit, MART-1 and TRP1 but not for the pre-melanosome marker (HMB45).
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Affiliation(s)
- D Kovacs
- Laboratory of Cutaneous Physiopathology and Integrated Center of Metabolomics Research, San Gallicano Dermatologic Institute (IRCCS), Rome, Italy
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Naini FF, Shooshtari AV, Ebrahimi B, Molaei R. The effect of pseudocatalase/superoxide dismutase in the treatment of vitiligo: A pilot study. J Res Pharm Pract 2014; 1:77-80. [PMID: 24991594 PMCID: PMC4076862 DOI: 10.4103/2279-042x.108375] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Objective: Pseudocatalase/superoxide dismutase (PSD) is a topical gel considered having therapeutic effects in vitiligo. This study was designed to evaluate the efficacy of this combination in vitiligo. Methods: This was a pilot randomized, double-blind, placebo-controlled trial on 46 symmetrical vitiligo lesions of limbs in 23 patients referring to dermatology clinics, Isfahan, Iran in 2010. Patients were received this formula or placebo gels for the right and left lesions. Lesion area and degree of pigmentation were assessed at baseline, 2, 4, and 6 months. Findings: There were no significant changes in lesion area and perifollicular pigmentation in each group (P > 0.05). Conclusion: The results indicated no significant therapeutic effect for PSD in vitiligo.
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Affiliation(s)
- Farahnaz Fatemi Naini
- Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran ; Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran ; Department of Dermatology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Alireza Vaez Shooshtari
- Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran ; Department of Dermatology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Bahareh Ebrahimi
- Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Razieh Molaei
- Cell and Molecular Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
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25
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Hélou J, Maatouk I, Obeid G, Moutran R, Stéphan F, Tomb R. Fractional laser for vitiligo treated by 10,600 nm ablative fractional carbon dioxide laser followed by sun exposure. Lasers Surg Med 2014; 46:443-8. [PMID: 24889492 DOI: 10.1002/lsm.22260] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2014] [Indexed: 11/08/2022]
Abstract
BACKGROUND Vitiligo is an acquired disorder of the skin and mucous membranes. Many patients with vitiligo remain in the refractory state despite the availability of numerous potential treatments. To the best of our knowledge, only one trial considers ablative fractional CO2 laser in the treatment of vitiligo. OBJECTIVE To investigate the effects of fractional CO2 laser followed by systemic sun exposure on non-segmental vitiligo (NSV). METHODS Ten patients presenting refractory NSV were enrolled in this study. The patients underwent three sessions, one month apart, of fractional CO2 laser therapy on the affected areas of the skin (L-group). Five days after each laser treatment, patients were asked to expose themselves to the sun for 2 hours on a daily basis. Objective and subjective clinical assessments were performed at the beginning and at the end of the treatment. The L-group was then compared to a control group (C-group) that consisted of vitiligo lesions in the same patients but with sun exposure as the exclusive therapy. RESULTS Compared to the C-group, the L-group showed better improvement in both objective and subjective assessments. There were no noticeable adverse events in terms of scarring and Koebner phenomenon among others. CONCLUSIONS All patients treated with both, laser sessions and sun exposure, improved their chronic NSV lesions. Improvement was less significant in patients who exhibited vitiligo lesions over articular surfaces such as elbows and underarms. The best results were observed in vitiligo plaques located on the face, neck and legs. Consequently, fractional CO2 laser followed by sun exposure could be considered as an alternative modality for the treatment of refractory vitiligo, especially in sunny regions.
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Affiliation(s)
- J Hélou
- Department of Dermatology, Hôtel-Dieu de France, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
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26
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Furocoumarins and coumarins photoinactivate Colletotrichum acutatum and Aspergillus nidulans fungi under solar radiation. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2014; 131:74-83. [PMID: 24509069 DOI: 10.1016/j.jphotobiol.2014.01.008] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Revised: 01/08/2014] [Accepted: 01/12/2014] [Indexed: 11/22/2022]
Abstract
The increasing tolerance to currently-used fungicides is a major problem both in clinical and agricultural areas leading to an urgent need for the development of novel antifungal strategies. This study investigated the in vitro antimicrobial photo treatment (APT) of conidia of the plant-pathogenic fungus Colletotrichum acutatum and the ascomycete Aspergillus nidulans with the furocoumarins 8-methoxypsoralen (8-MOP) and isopimpinellin, and a mixture of two coumarins (7-methoxy coumarin and citropten). Subcellular localization of the photosensitizer 8-MOP was also determined in C. acutatum conidia. Additionally, the effects of APT on the leaves of the plant host Citrus sinensis were determined. APT with 8-MOP (50μM) led to a reduction of approximately 4 logs in the survival of the conidia of both species, and the mixture of the two coumarins (12.5mgL(-1)) resulted in a reduction of approximately 4 logs for A. nidulans and 3 logs for C. acutatum. Isopimpinellin (50μM) displayed a reduction of 4 logs for A. nidulans but less than 2 logs for C. acutatum. Washing the conidia to remove unbound photosensitizers before light exposure reduced the photodynamic inactivation of C. acutatum both with 8-MOP and the mixture of the two coumarins. The reduction was smaller for A. nidulans. 8-MOP spread throughout the cytoplasm and accumulated in structures such as lipid bodies of C. acutatum conidia. No damage to orange tree leaves was observed after APT with any of the photosensitizers.
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Abstract
There is a limited number of options in vitiligo treatment, with the disease frequently refractory to all existing treatment modalities. This warrants development of novel and improving existing vitiligo treatments as well as finding predicting factors to improve treatment outcome through appropriate selection and the most efficient application of a treatment. These issues are addressed in clinical studies aiming to evaluate safety and efficiency of novel treatments, improvements and modifications introduced to existing treatments, and to define predictors of treatment efficiency and their limitations. Here, results of recent (since year 2009) clinical studies in vitiligo field are overviewed, with the emphasis on their contribution to improved vitiligo management.
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28
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Lee BW, Schwartz RA, Hercogová J, Valle Y, Lotti TM. Vitiligo road map. Dermatol Ther 2013; 25 Suppl 1:S44-56. [PMID: 23237038 DOI: 10.1111/dth.12006] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Vitiligo is a depigmenting disorder stemming from melanocyte loss or dysfunction. It has a complex, multifaceted etiology. We constructed a "vitiligo road map," consisting of basic science, clinical, and treatment components, in order to better portray our current understanding of vitiligo pathogenesis and reflect upon novel biomarkers and therapeutic targets for future research. The melanocyte map elaborates on the molecular processes and intracellular signaling pathways initiated by various external autocrine/paracrine factors in representing normal melanocyte homeostatic functions modulating its viability, proliferation, differentiation, dendricity, migration, and melanogenic processes. This vitiligo map identifies known inducers/triggers of vitiligo onset and progression that cultivate a microenvironment for melanocyte disappearance, real or functional. This map describes the molecular mechanisms of currently utilized clinical and experimental treatments of vitiligo that facilitate repigmentation.
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Affiliation(s)
- Brian W Lee
- Dermatology and Pathology, New Jersey Medical School, Newark, New Jersey 07103-2714, USA
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29
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Rogers NE. Commentary on repigmentation of poliosis after epithelial grafting for vitiligo. Dermatol Surg 2013; 39:412-3. [PMID: 23458251 DOI: 10.1111/dsu.12090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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