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Crummer E, Cohen JT, Rosmarin D, Lin PJ. Impact on quality of life, health care access, and health care utilization of individuals with vitiligo: an analysis of the All of Us research program. Arch Dermatol Res 2024; 316:554. [PMID: 39172282 PMCID: PMC11346581 DOI: 10.1007/s00403-024-03275-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2024] [Revised: 07/18/2024] [Accepted: 08/05/2024] [Indexed: 08/23/2024]
Abstract
Vitiligo is an autoimmune skin depigmenting disorder that can negatively impact quality of life. A new FDA approved treatment for vitiligo offers considerable promise, and to maximize benefits strategies to implementation should consider disease burden, healthcare access, and healthcare utilization of individuals with vitiligo. Using the All of Us Research Program's large data set, including survey responses, we investigated these outcomes among participants with and without vitiligo. Our analysis used quality of life, delayed care due to an obstacle, and seeing a doctor in the past year as dichotomized proxies for disease burden, healthcare access, and healthcare utilization. The results show that people with vitiligo are more likely to report worse quality of life but ostensibly greater healthcare access and utilization compared to people without vitiligo. However, these relationships are not significant when adjusted for demographics, socioeconomic characteristics, and comorbidities of vitiligo. Prior research has shown non-Caucasian individuals have worse health outcomes in general, and worse quality of life within the vitiligo population. Our data demonstrated consistent findings; moreover, we found that non-Caucasian individuals with vitiligo had inferior healthcare access and lower health care utilization than Caucasian individuals. Implementation of new treatments for vitiligo should prioritize disadvantaged individuals to improve health equity.
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Affiliation(s)
- Elliott Crummer
- Center for the Evaluation of Value and Risk in Health, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA
| | - Joshua T Cohen
- Center for the Evaluation of Value and Risk in Health, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA
| | - David Rosmarin
- Department of Dermatology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Pei-Jung Lin
- Center for the Evaluation of Value and Risk in Health, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA.
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Taylor N, Maduesesi O, Vasiliou VS, Thompson AR. The experience of living with vitiligo in Nigeria: A participatory Interpretative Phenomenological Analysis. J Health Psychol 2024:13591053241261684. [PMID: 39077838 DOI: 10.1177/13591053241261684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/31/2024] Open
Abstract
Vitiligo is a visible depigmenting skin condition, particularly noticeable on Black skin. There is widespread misunderstanding of the condition. Using a participatory form of Interpretative Phenomenological Analysis (IPA), we conducted eight semi-structured interviews with Nigerians living with vitiligo. Participants described their initial attempts to understand the condition, which typically drew on both traditional illness beliefs, religious influences, and the biomedical disease model. All participants reported experiencing marked stigmatization and discrimination. Participants experienced distress associated with thoughts about the personal meaning of the disease including its impact on their appearance and from concerns about anticipated and direct discrimination. Despite the wide-ranging impact, the participants' narratives also contained references to the development of strategies that maintained wellbeing. This study provides valuable insights into the role of faith and traditional beliefs in both the experience and management of vitiligo in Nigeria. These insights can be used to develop individual and community interventions.
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Affiliation(s)
| | | | | | - Andrew R Thompson
- Cardiff University, Wales, UK
- Cardiff and Vale University Health Board, Wales, UK
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D’Onghia M, Ciaffi J, Calabrese L, Tognetti L, Cinotti E, Rubegni P, Frediani B, Ursini F. Fibromyalgia and Skin Disorders: A Systematic Review. J Clin Med 2024; 13:4404. [PMID: 39124671 PMCID: PMC11312914 DOI: 10.3390/jcm13154404] [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: 06/25/2024] [Revised: 07/22/2024] [Accepted: 07/25/2024] [Indexed: 08/12/2024] Open
Abstract
Background: Fibromyalgia is a complex multifaceted syndrome primarily characterised by chronic musculoskeletal pain, fatigue, and functional symptoms. Although FM is known to be associated with several comorbidities, the aim of this systematic review was to comprehensively examine the available evidence regarding the relationship between FM and dermatological manifestations. Methods: We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and MedLine and Web of Science (WOS) databases were searched up to June 2023. After removing duplicate records, 21 articles were deemed eligible for inclusion in the qualitative synthesis. Results: Overall, the included studies revealed an increased frequency of FM among patients with cutaneous diseases, including psoriasis, chronic urticaria, contact allergy, acneiform disorders, hidradenitis suppurativa, and vitiligo. Additionally, the presence of comorbid FM may intensify skin conditions, which has a negative impact on quality of life and vice versa. Conclusions: Although the causal mechanisms of FM are still far from being understood, this systematic review suggests a relationship between FM and skin disorders. However, further research is encouraged in this area.
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Affiliation(s)
- Martina D’Onghia
- Department of Medical, Surgical and Neurological Sciences, Dermatology Section, University of Siena, 53100 Siena, Italy; (M.D.); (L.C.); (E.C.); (P.R.)
| | - Jacopo Ciaffi
- Medicine and Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy;
- Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, 40123 Bologna, Italy
| | - Laura Calabrese
- Department of Medical, Surgical and Neurological Sciences, Dermatology Section, University of Siena, 53100 Siena, Italy; (M.D.); (L.C.); (E.C.); (P.R.)
| | - Linda Tognetti
- Department of Medical, Surgical and Neurological Sciences, Dermatology Section, University of Siena, 53100 Siena, Italy; (M.D.); (L.C.); (E.C.); (P.R.)
| | - Elisa Cinotti
- Department of Medical, Surgical and Neurological Sciences, Dermatology Section, University of Siena, 53100 Siena, Italy; (M.D.); (L.C.); (E.C.); (P.R.)
| | - Pietro Rubegni
- Department of Medical, Surgical and Neurological Sciences, Dermatology Section, University of Siena, 53100 Siena, Italy; (M.D.); (L.C.); (E.C.); (P.R.)
| | - Bruno Frediani
- Rheumatology Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy;
| | - Francesco Ursini
- Medicine and Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy;
- Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, 40123 Bologna, Italy
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Chan CS, Smith T, He Z, Garter C. The Sequelae and Moderators of Influence of Dandruff on Mental Health Among Mainland Chinese Adults. Clin Cosmet Investig Dermatol 2024; 17:1333-1346. [PMID: 38881702 PMCID: PMC11179641 DOI: 10.2147/ccid.s459498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Accepted: 05/26/2024] [Indexed: 06/18/2024]
Abstract
Introduction The psychological impact of dandruff has been largely understudied. Methods In this cross-sectional study (N = 2116), we examined the consequences of self-perception of dandruff severity on mental health, quality of life, and sleep quality among Chinese adults. Additionally, we examined the moderating factors that influence these associations. Results Bivariate analyses revealed that greater self-perceived dandruff severity was associated with poorer mental health, lower quality of life, and reduced sleep quality. Furthermore, dandruff severity was positively correlated with appearance anxiety, feelings of helplessness, and perceived stigma. Individuals with more severe dandruff experienced increased teasing and ostracism and, subsequently, heightened psychological distress. Moderation analyses demonstrated that females were more adversely affected by dandruff than males, and those with comorbid skin conditions or a history of being teased and ostracized during adolescence due to dandruff experienced exacerbated negative outcomes. Discussion This study highlights the need for further research on the psychological consequences of self-perceived severity of dandruff and potential interventions to mitigate its impact.
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Affiliation(s)
- Christian S Chan
- Department of Psychology, The University of Hong Kong, Hong Kong SAR, People's Republic of China
- Department of Psychology and Linguistics, International Christian University, Tokyo, Japan
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Ghalamkarpour F, Araghi F, Tabari M, Moslemi Haghighi S, Pourgholi E. Comparing quality of life, anxiety, depression, sleep disturbance, and associated factors in vitiligo and alopecia areata patients. J Cosmet Dermatol 2024; 23:1808-1815. [PMID: 38169098 DOI: 10.1111/jocd.16158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 11/24/2023] [Accepted: 12/15/2023] [Indexed: 01/05/2024]
Abstract
INTRODUCTION AND OBJECTIVES Vitiligo and alopecia areata (AA) are two autoimmune skin diseases that affect patients' quality of life (QoL) and give rise to psychosocial complications, such as depression, negative self-image, less joyful social engagements, and low self-esteem. These two disorders have common and uncommon characteristics. Therefore, in this study, we tried to evaluate the similarities and differences in the psychological parameters including quality of life, sleep disturbance, anxiety, and depression levels between, vitiligo and AA patients. MATERIALS AND METHODS Patients with either vitiligo or AA visiting the outpatient dermatology clinic from November 2017 to December 2020 have been included in this study. Persian versions of three questionnaires including the dermatology life quality index (DLQI), hospital anxiety and depression scale (HADS), and Pittsburgh sleep quality index (PSQI), have been used to assess the QoL, sleep disturbance, anxiety, and depression levels in patients. RESULTS In total, 188 patients, including 94 (50%) cases of AA and 94 (50%) patients with vitiligo, met the criteria. In AA patients, a significantly higher DLQI score was found (p-value = 0.002) compared to the vitiligo cases, which means a better QoL in vitiligo patients. Additionally, AA patients had higher scores of anxiety (P-value<0.001) and depression (p-Value<0.001). However, sleep disturbance (64.9% of AA patients vs. 59.3% of vitiligo patients; p-Value = 0.4888) was not significantly different between the two groups. CONCLUSIONS Our data showed lower QoL and higher levels of anxiety and depression in AA patients compared to vitiligo cases, but no difference was seen in sleep disturbance in the PSQI-P score.
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Affiliation(s)
- Fariba Ghalamkarpour
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farnaz Araghi
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | | | - Elnaz Pourgholi
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Kang S, Liu ZY, Yuan HH, Wang SM, Pan GG, Wei W, Jiang Y, Hou Y. The impact of different states of type 2 diabetes when stratified by baseline HbA1c on the periodontal outcomes of non-surgical periodontal treatment: A systematic review and network meta-analysis. Int J Dent Hyg 2024; 22:401-413. [PMID: 38394099 DOI: 10.1111/idh.12789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 09/16/2023] [Accepted: 02/11/2024] [Indexed: 02/25/2024]
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) has been considered by many studies to have a bidirectional relationship with periodontitis. This systematic review and network meta-analysis aimed to investigate the impact of different states of T2DM when stratified by baseline HbA1c on the clinical outcomes of non-surgical periodontal treatment (NSPT). METHODS This study followed the Preferred Reporting Items for Meta-Analyses (PRISMA) guidelines and involved an electronic literature search (from inception to the 2nd of January 2023). The study included at least two groups of patients: chronic periodontitis only (No-DM) or periodontitis and well-controlled/poorly controlled type 2 diabetes mellitus (WC/PC-T2DM). Clinical outcomes included probing depth (PD) reduction, bleeding on probing reduction, and clinical attachment level (CAL) gain. Direct and indirect comparisons between groups were assessed by network meta-analysis, thus allowing us to establish a treatment ranking. RESULTS Ten prospective cohort studies (11 data sets) were included for qualitative analysis and network meta-analysis. The data included in this study had high consistency; in addition, a funnel plot and Egger's test showed that the articles had low publication bias. Network meta-analysis showed that the effect of NSPT in the No-DM group was significantly better than the WC-T2DM group [weighted mean difference (WMD) = 0.09, 95% confidence interval (CI) (0.01, 0.18)] and the PC-T2DM group [WMD = 0.09, 95% CI (0.01, 0.18)] in terms of CAL gain and better than the PC-T2DM group [WMD = 0.15, 95% CI (0.02, 0.28)] in terms of PD reduction. According to the surface under the cumulative ranking value, the No-DM group had the highest probability of achieving the best outcome following NSPT. CONCLUSIONS Collectively, our analyses show that T2DM exerts significant effects on the outcomes of NSPT.
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Affiliation(s)
- Shuai Kang
- Institute of Stomatology, Chinese People's Liberation Army No.989 hospital, Luoyang, China
| | - Zheng-Ya Liu
- Institute of Stomatology, Chinese People's Liberation Army No.989 hospital, Luoyang, China
| | - Huan-Huan Yuan
- Institute of Stomatology, Chinese People's Liberation Army No.989 hospital, Luoyang, China
| | - Shu-Min Wang
- Institute of Stomatology, Chinese People's Liberation Army No.989 hospital, Luoyang, China
| | - Ge-Ge Pan
- Institute of Stomatology, Chinese People's Liberation Army No.989 hospital, Luoyang, China
| | - Wei Wei
- Institute of Stomatology, Chinese People's Liberation Army No.989 hospital, Luoyang, China
| | - Yi Jiang
- Institute of Stomatology, First Medical Center, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Yu Hou
- Institute of Stomatology, Chinese People's Liberation Army No.989 hospital, Luoyang, China
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Liu H, Wang Y, Le Q, Tong J, Wang H. The IFN-γ-CXCL9/CXCL10-CXCR3 axis in vitiligo: Pathological mechanism and treatment. Eur J Immunol 2024; 54:e2250281. [PMID: 37937817 DOI: 10.1002/eji.202250281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 10/24/2023] [Accepted: 11/07/2023] [Indexed: 11/09/2023]
Abstract
Vitiligo is a disease featuring distinct white patches that result from melanocyte destruction. The overall pathogenesis of vitiligo remains to be elucidated. Nevertheless, considerable research indicates that adaptive immune activation plays a key role in this process. Specifically, the interferon-gamma (IFN-γ), C-X-C motif chemokine ligands (CXCL9/10), and C-X-C motif chemokine receptor (CXCR3) signaling axis, collectively referred to as IFN-γ-CXCL9/10-CXCR3 or ICC axis, has emerged as a key mediator responsible for the recruitment of autoimmune CXCR3+ CD8+ T cells. These cells serve as executioners of melanocytes by promoting their detachment and apoptosis. Moreover, IFN-γ is generated by activated T cells to create a positive feedback loop, exacerbating the autoimmune response. This review not only delves into the mechanistic insights of the ICC axis but also explores the significant immunological effects of associated cytokines and their receptors. Additionally, the review provides a thorough comparison of existing and emerging treatment options that target the ICC axis for managing vitiligo. This review aims to foster further advancements in basic research within related fields and facilitate a deeper understanding of alternative treatment strategies targeting different elements of the axis.
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Affiliation(s)
- Hanqing Liu
- Precision Research Center for Refractory Diseases, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, P. R. China
- College of Health Science and Technology, Shanghai Jiao Tong University School of Medicine, Shanghai, P. R. China
| | - Yihui Wang
- College of Health Science and Technology, Shanghai Jiao Tong University School of Medicine, Shanghai, P. R. China
| | - Qianqian Le
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, P. R. China
| | - Jiajia Tong
- Shanghai Institute of Immunology, Precision Research Center for Refractory Diseases, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, P. R. China
| | - Honglin Wang
- Precision Research Center for Refractory Diseases, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, P. R. China
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Kumar S, Kesari PK, Dixit V, Kumar R, Chaudhury S. Gender differences in quality of life of vitiligo patients attending a tertiary care center. Ind Psychiatry J 2024; 33:147-153. [PMID: 38853817 PMCID: PMC11155653 DOI: 10.4103/ipj.ipj_74_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 04/06/2023] [Accepted: 04/11/2023] [Indexed: 06/11/2024] Open
Abstract
Background Vitiligo is a common depigmenting dermatosis characterized by milky-white macules or patches. Any pathological discoloration of the skin has been linked to an impact on the body image of an individual, and vitiligo has been linked to decreased self-esteem and poor socialization of the affected people. In Indian society, vitiligo is labeled as Shweta-Kushta (i.e., white-colored leprosy) and is compared to leprosy-a more stigmatizing skin condition. Aim This study aims to study gender-related differences in the quality of life of Indian vitiligo patients. Methodology In this hospital-based cross-sectional study, a total of 55 vitiligo patients (females 25 and males 30) were enrolled using the purposive sampling technique. The sample was assessed on Dermatology Life Quality Index (DLQI) questionnaire, Rosenberg Self-Esteem Scale (RSS), and General Health Questionnaire-12 (GHQ-12) to assess their quality of life, self-esteem, and psychological well-being, respectively. The gender differences in sociodemographic and clinical details as well as their relationship with the quality of life of the patients were sought with the help of appropriate statistical measures. Results The patients of both genders were comparable in terms of all sociodemographic and clinical variables except the females being less educated and employed than the males. There was a statistically significant trend of higher mean DLQI total score in females than males (6.6 ± 3.55 vs 4.8 ± 2.71, Mann-Whitney U = 263.5, P =0.058). Significantly, the average DLQI score in female vitiligo patients was negatively related to family income (r s = -.659, P <.001) and it was significantly higher for the patients from a rural background than those from an urban background (8.55 ± 3.30 vs 5.07 ± 3.03, Mann-Whitney U = 33.5, P <.05). The average DLQI score was negatively correlated to RSS score but positively correlated to GHQ-12 score in patients of both genders. Conclusion The quality of life of female patients with vitiligo is poorer than the same in male patients. The poor financial condition of families and rural living are two factors related to the poorer quality of life of female patients. A poorer quality of life in vitiligo patients of both genders is linked with decreased self-esteem and decreased psychological well-being. Gender-related issues in the quality of life and the overall well-being of such patients are important in their management and policy-making.
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Affiliation(s)
- Santosh Kumar
- Department of Psychiatry, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India
| | - Pravin Kumar Kesari
- Department of Psychiatry, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India
| | - Vidhata Dixit
- Department of Psychology, J D Womens College, Patna, India
| | - Rajesh Kumar
- Department of Psychiatry, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India
| | - Suprakash Chaudhury
- Department of Psychiatry, Dr. D. Y. Patil Medical College, Hospital and Research Center, Dr. D. Y. Patil Vidyapeeth, Pune, Maharashtra, India
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Guttman-Yassky E, Del Duca E, Da Rosa JC, Bar J, Ezzedine K, Ye Z, He W, Hyde C, Hassan-Zahraee M, Yamaguchi Y, Peeva E. Improvements in immune/melanocyte biomarkers with JAK3/TEC family kinase inhibitor ritlecitinib in vitiligo. J Allergy Clin Immunol 2024; 153:161-172.e8. [PMID: 37777018 DOI: 10.1016/j.jaci.2023.09.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 08/29/2023] [Accepted: 09/22/2023] [Indexed: 10/02/2023]
Abstract
BACKGROUND Vitiligo is an autoimmune depigmenting disorder with no effective and safe treatments. Its pathogenesis is not fully elucidated. OBJECTIVE This substudy of a randomized, double-blind, placebo-controlled phase 2b trial (NCT03715829) evaluated effects of ritlecitinib, an oral JAK3/TEC family kinase inhibitor, on skin and blood biomarkers in participants with nonsegmental vitiligo (NSV). METHODS Sixty-five adults with NSV participated in the substudy and received daily treatment for 24 weeks with placebo (n = 14) or ritlecitinib with or without a 4-week loading dose: 200 (loading dose)/50 mg (n = 13), 100/50 mg (n = 12), 50 mg (n = 11), 30 mg (n = 8), or 10 mg (n = 6). Skin (lesional and nonlesional) biopsy samples were obtained at baseline and at 4 and 24 weeks. Changes from baseline to weeks 4 and 24 in skin and blood molecular and cellular biomarkers were evaluated by RNA sequencing, quantitative real-time PCR, proteomic analysis, and flow cytometry. RESULTS Ritlecitinib-treated groups showed downregulation of immune biomarkers and upregulation of melanocyte-related markers at weeks 4 and 24 compared to baseline and/or placebo. Significant reductions were seen in CD3+/CD8+ T-cell infiltrates, with significant increases in melanocyte markers (tyrosinase; Melan-A) in NSV lesions in the 50 mg ritlecitinib groups (both P < .05). There was significant, dose-dependent downregulation in T-cell activation, NK, cytotoxic, and regulatory markers in lesional skin (IL-2, IL2-RA, IL-15, CCR7, CD5, CRTAM, NCR1, XCL1, KIR3DL1, FASLG, KLRD; P < .05). TH1 and TH2 markers were also downregulated in lesional skin and blood in a dose-dependent manner (P < .05). Changes in immune biomarkers correlated with clinical response. CONCLUSIONS Ritlecitinib significantly downregulated proinflammatory biomarkers and increased melanocyte products in skin and blood of participants with NSV, suggesting its potential in treatment. Ritlecitinib-mediated changes positively correlated with clinical response.
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Affiliation(s)
- Emma Guttman-Yassky
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, Mount Sinai, New York, NY.
| | - Ester Del Duca
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, Mount Sinai, New York, NY
| | - Joel Correa Da Rosa
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, Mount Sinai, New York, NY
| | - Jonathan Bar
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, Mount Sinai, New York, NY; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Khaled Ezzedine
- Hôpital Henri Mondor and Université Paris-Est Créteil, EpiDermE-Epidemiology in Dermatology and Evaluation of Therapeutics, Creteil, France
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Liu Y, Wang J, Huo J, Zhang S, Han L, Lei Y, Wang Y. Application Effect of Comprehensive Noise Reduction Technology in Outpatients with Vitiligo: A Retrospective Study. Noise Health 2024; 26:37-43. [PMID: 38570309 PMCID: PMC11141697 DOI: 10.4103/nah.nah_60_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 12/19/2023] [Accepted: 01/02/2024] [Indexed: 04/05/2024] Open
Abstract
OBJECTIVE Noise is a kind of perceived public nuisance that is closely related to people's subjective feelings and lives. This study explores the clinical application effect of comprehensive noise reduction technology in outpatients with vitiligo. METHODS A total of 76 patients with vitiligo were selected in the Department of Dermatology at Baoding No. 2 Central Hospital from January 2020 to January 2021, as the control group (CG), receiving 5S management mode, and 80 patients with vitiligo from February 2021 to October 2022 were selected as the study group (SG), receiving comprehensive noise reduction technology combined with the 5S management mode for this retrospective study. The effects of different management modes on these patients were observed. RESULTS SG had higher nursing quality scores in service attitude, service initiative, communication skills, environmental management and item management and overtly a lower noise level than CG (all P < 0.001). The Hamilton Anxiety Scale (HAMA) scores of the two groups at the end of treatment were significantly lower than those on admission (P < 0.05), with SG showing a lower score than CG (P < 0.001). Correlation analysis showed that noise levels and HAMA scores had a positive correlation (r = 0.423, P < 0.001). Patients with negative feelings about medical treatment caused by various noise sources in SG were obviously less than those in CG (P < 0.05). Both the groups had a statistical difference in overall satisfaction (P < 0.05). CONCLUSION The investigation and data analysis demonstrated that comprehensive noise reduction in outpatients with vitiligo had a considerable effect. This technology can standardise the behaviour of medical staff, enhance nursing quality, reduce noise levels and alleviate patients' anxiety and improve their satisfaction. It has great benefits for the outpatient environment and patients.
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Affiliation(s)
- Yong Liu
- Dermatology Venereal Disease Department, Baoding NO. 2 Central Hospital, Zhuozhou, Hebei, China
| | - Jingjing Wang
- Dermatology Venereal Disease Department, Baoding NO. 2 Central Hospital, Zhuozhou, Hebei, China
| | - Jianli Huo
- Dermatology Venereal Disease Department, Baoding NO. 2 Central Hospital, Zhuozhou, Hebei, China
| | - Shaoguang Zhang
- Dermatology Venereal Disease Department, Baoding NO. 2 Central Hospital, Zhuozhou, Hebei, China
| | - Li Han
- Dermatology Venereal Disease Department, Baoding NO. 2 Central Hospital, Zhuozhou, Hebei, China
| | - Yong Lei
- Dermatology Venereal Disease Department, Baoding NO. 2 Central Hospital, Zhuozhou, Hebei, China
| | - Ya’nan Wang
- Department of Neurology, Baoding NO. 2 Central Hospital, Zhuozhou, Hebei, China
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11
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Samela T, Malorni W, Matarrese P, Mattia G, Alfani S, Abeni D. Gender differences in vitiligo: psychological symptoms and quality of life assessment description. Front Psychol 2023; 14:1234734. [PMID: 38187434 PMCID: PMC10769495 DOI: 10.3389/fpsyg.2023.1234734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 12/04/2023] [Indexed: 01/09/2024] Open
Abstract
Objective Assuming that the difference exist in the manifestation of psychological suffering among genders, the purpose of this review is to summarize the current knowledge on gender differences in vitiligo quality of life and psychological assessment. Methods We searched in PubMed, Scopus, and Web of Science databases for original articles in English language. Results were screened according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA checklist). Results The study yielded 107 results; 12 articles have been evaluated as eligible. Each eligible study has been screened and analyzed. The study's qualitative evaluation revealed that 8 papers were classifiable as satisfactory, 4 were classifiable as unsatisfactory. The agreement between the coders was high (% agreement = 84.6%; Cohen's kappa = 0.79). All considered researches (100%) were cross-sectional studies, based on self-report questionnaires. From our analysis, women with vitiligo had a higher risk to experience lower quality of life, and worse mental health in a wide range of psychopathology symptoms than men. A wide heterogeneity of tools is used to investigate the quality of life and psychological symptoms among these patients. Conclusion Unfortunately, there are few explanatory models proposed in the literature to rationalize these findings. It will be important to investigate in further researches the specific influence of known risk factors for psychopathology in this population to better explore these phenomena.
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Affiliation(s)
- Tonia Samela
- Clinical Psychology Unit, Istituto Dermopatico Dell’Immacolata, (IDI) IRCCS, Rome, Italy
- Clinical Epidemiology Unit, Istituto Dermopatico Dell’Immacolata, (IDI) IRCCS, Rome, Italy
| | - Walter Malorni
- Center for Global Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Paola Matarrese
- Center for Gender-Specific Medicine, Istituto Superiore di Sanità (ISS), Rome, Italy
| | - Gianfranco Mattia
- Center for Gender-Specific Medicine, Istituto Superiore di Sanità (ISS), Rome, Italy
| | - Stefania Alfani
- Clinical Epidemiology Unit, Istituto Dermopatico Dell’Immacolata, (IDI) IRCCS, Rome, Italy
| | - Damiano Abeni
- Clinical Epidemiology Unit, Istituto Dermopatico Dell’Immacolata, (IDI) IRCCS, Rome, Italy
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12
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Naldi L, Pagani A, Alduini C. Vitiligo: Epidemiology and Economic Impact. Dermatol Pract Concept 2023; 13:dpc.1304S2a315S. [PMID: 38241395 PMCID: PMC10824327 DOI: 10.5826/dpc.1304s2a315s] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/11/2023] [Indexed: 01/21/2024] Open
Abstract
INTRODUCTION Vitiligo is an acquired disorder of pigmentation, characterized by the development of white patches on the skin, often with a typical symmetrical distribution and progressive extension . Although vitiligo does not cause direct physical impairment, it can produce a relevant psychosocial burden. Despite this burden, effective treatments are lacking, emphasizing the need for new therapeutic options. OBJECTIVES The aim of this study was to systematically scan the scientific literature for studies dealing with vitiligo epidemiology. Additionally, the study aimed to assess the social costs of vitiligo, ultimately raising awareness about the societal impact of the condition. The focus was on Italian data. METHODS Our research employed a comprehensive methodology. For the epidemiology, we systematically searched PubMed database up to October 2023 and complemented the analysis with Real World Evidence. For social costs, we conducted an in-depth literature review, administered a web-survey to 20 Italian dermatologists and conducted an equivalent number of interviews during the same period in March 2022. RESULTS The data suggest that in Italy the prevalence of vitiligo increases with age, and it varies from 0.19% (age 18-21) to 0.6% (age >45) . We estimated 152,000 patients diagnosed with Non-Segmental Vitiligo (NSV) in Italy; based on Body Surface Area (BSA), 33% are Not Severe, 31% Mild, 27% Moderate/Severe, 9% Very Severe. The yearly social costs of vitiligo amount to €0.5Bln. CONCLUSIONS There is a remarkable association of vitiligo with anxiety and depression , and Mental Health is associated with 30% of social costs. Moreover, vitiligo social costs distribution highlights inequity, with patients bearing 55% of them.
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Affiliation(s)
- Luigi Naldi
- UOC Dermatologia, Ospedale San Bortolo, Vicenza, Centro Studi GISED, Bergamo
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13
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Kapur S, Goyal E, Kumar A, Puria A, Raj R. Psychiatric morbidity among patients suffering from Vitiligo. Ind Psychiatry J 2023; 32:S131-S135. [PMID: 38370957 PMCID: PMC10871402 DOI: 10.4103/ipj.ipj_220_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 03/11/2023] [Accepted: 05/18/2023] [Indexed: 02/20/2024] Open
Abstract
Background Vitiligo is a chronic acquired, stigmatizing disease characterized by discoloration of skin and mucous membranes. Patients suffering from this condition suffer from a lack of confidence and psychological stress. Aim To assess depression, anxiety, and social anxiety among patients suffering from vitiligo. Material and Method This hospital-based cross-sectional, observational, descriptive study was carried out in a tertiary care center on 100 patients suffering from vitiligo, who were consecutively enrolled after informed consent from the outpatient department (OPD) of the dermatology department. Permission was obtained from the institutional ethics committee Diagnosis of vitiligo was made by two consultants from the department of dermatology. Sociodemographic variables were recorded in the sociodemographic form. The General Health Questionnaire-12 (GHQ-12) was applied to all 100 patients. Patients who scored >3 on GHQ-12 were further subjected to the Hamilton Depression Rating Scale (HAM-D), Hamilton Anxiety Rating Scale (HAM-A), and Social Interaction Anxiety Scale. Results were statistically analyzed on SPSS-22.0 (IBM, Armonk, USA). Results Of all the patients, 55% (n = 55) had a GHQ score >3 (i.e., Psychiatric morbidity was present in 55% of patients.). Out of 50 patients in the age group of 18-25 years, 41 patients in the age groups of 26-35 years, and 9 patients in the age groups of 36-45 years, 22 (44%), 17 (42.1%), and 6 patients had psychiatric morbidity, respectively. Of the total number of patients, 46% had depression according to the HAM-D scale. Of all the patients, 18% had mild, 22% had moderate, and 6% had severe depression. Age-wise analysis showed that out of 50 patients in the age group of 18-25 years, 41 patients in the age group of 26-35 years, and 9 patients in the age group of 36-45 years, 22 (44%), 20 (48.7%), and 4 patients had depression, respectively. Of the patients who had depression, 39% were male and 58% were female. On HAM-A, 47% of the patients had anxiety; 33% had mild, 12% had moderate, and 2% had severe anxiety. Age-wise analysis showed that out of 50 patients in the age group of 18-25, 41 patients in the age group of 26-35 years, and 9 patients in the age group of 36-45 years, 20 (40%), 23 (56.1%), and 3 patients had anxiety, respectively. On SIAS, 36% of the patients had social anxiety. Out of 50 patients in the age group of 18-25 years, 41 patients in the age group of 26-35 years, and 9 patients in the age group of 36-45 years, 23 (46%), 9 (7.8%) and 4 patients had social anxiety, respectively. According to gender-wise distribution, 17% of male and 63% of female patients had social anxiety. Conclusion A high prevalence of anxiety, depression, and social anxiety has been observed in this present study. Therefore, importance should be given to psychiatric evaluation of such patients and, if required, necessary interventions should be undertaken to improve their quality of life.
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Affiliation(s)
- Sandeep Kapur
- Department of Psychiatry, Dr. B. R. Ambedkar State Institute of Medical Sciences, Mohali, Punjab, India
| | - Ekram Goyal
- Department of Psychiatry, Dr. B. R. Ambedkar State Institute of Medical Sciences, Mohali, Punjab, India
| | - Ajay Kumar
- Department of Psychiatry, Government Medical College, Patiala, Punjab, India
| | - Alka Puria
- Department of Biochemistry, Government Medical College, Patiala, Punjab, India
| | - Richa Raj
- Department of Biochemistry, DMCH Lahersarai, Darbhanga, Bihar, India
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14
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Hamzavi IH, Bibeau K, Grimes P, Harris JE, van Geel N, Parsad D, Tulpule M, Gardner J, Valle Y, Tlhong Matewa G, LaFiura C, Ren H, Ezzedine K. Exploring the natural and treatment history of vitiligo: perceptions of patients and healthcare professionals from the global VALIANT study. Br J Dermatol 2023; 189:569-577. [PMID: 37493275 DOI: 10.1093/bjd/ljad245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 07/11/2023] [Accepted: 07/14/2023] [Indexed: 07/27/2023]
Abstract
BACKGROUND Vitiligo is a chronic autoimmune disease affecting melanocytes, resulting in skin depigmentation. Patients with vitiligo often have reduced quality of life and comorbid autoimmune conditions and have reported a lack of available treatments for their vitiligo. OBJECTIVES The Vitiligo and Life Impact Among International Communities (VALIANT) study is the first global survey to explore the natural history and management of vitiligo from the perspectives of patients and healthcare professionals (HCPs). METHODS The survey recruited adults (≥ 18 years) diagnosed with vitiligo and HCPs treating patients with vitiligo via an online panel in 17 countries. Patients were queried regarding clinical characteristics and vitiligo treatment. HCPs were queried regarding diagnosis and management of patients with vitiligo. RESULTS Included in the analysis were 3541 patients and 1203 HCPs. Nearly half (45.2%) of the patients had > 5% affected body surface area; 57.1% reported family history. Patients obtained formal diagnosis after a mean (SD) of 2.4 (4.1) years; 44.9% reported previous misdiagnosis. Many patients (56.7%) reported being told that vitiligo could not be treated; 53.9% of HCPs believed patients who never treated their vitiligo had been told that vitiligo could not be treated. One-quarter of HCPs (26.3%) did not believe that an effective therapy for vitiligo exists; 44.6% of patients reported giving up on finding an effective therapy. Top treatment goals for patients and HCPs, respectively, were reduction or cessation of spread (24.7% and 18.5%) and repigmentation (22.5% and 37.2%). Patient perception of effective care was similar for treatment by dermatologists (66.9%) and primary care HCPs (67.0%). CONCLUSIONS Patients with vitiligo and HCPs reported similar treatment goals and expressed frustration with the lack of effective therapies. Patients reported high rates of initial misdiagnosis; many ceased seeking healthcare because they perceived that vitiligo could not be treated. The findings highlight the need for earlier diagnosis and improved disease management for vitiligo.
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Affiliation(s)
| | | | - Pearl Grimes
- Vitiligo & Pigmentation Institute of Southern California, Los Angeles, CA, USA
| | - John E Harris
- University of Massachusetts Medical School, Worcester, MA, USA
| | | | - Davinder Parsad
- Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | | | | | - Yan Valle
- Vitiligo Research Foundation, New York, NY, USA
| | | | | | - Haobo Ren
- Incyte Corporation, Wilmington, DE, USA
| | - Khaled Ezzedine
- Henri Mondor University Hospital and Université Paris-Est Créteil Val de Marne, Paris, France
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15
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Ezzedine K, Soliman AM, Li C, Camp HS, Pandya AG. Comorbidity Burden Among Patients with Vitiligo in the United States: A Large-Scale Retrospective Claims Database Analysis. Dermatol Ther (Heidelb) 2023; 13:2265-2277. [PMID: 37668899 PMCID: PMC10539259 DOI: 10.1007/s13555-023-01001-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 08/02/2023] [Indexed: 09/06/2023] Open
Abstract
INTRODUCTION Vitiligo is often associated with comorbid conditions that may increase economic burden and affect patients' health-related quality of life. No large-scale study has been published to date using claims databases to evaluate the burden of comorbidities among patients with vitiligo. Herein, we evaluate the comorbidity burden among patients diagnosed with vitiligo from the US. METHODS This retrospective cohort analysis used the Merative MarketScan Commercial Database. Eligible patients were diagnosed with vitiligo between January 2008 and December 2020 and matched 1:4 (vitiligo:control) with control subjects with no diagnosis of vitiligo between January 2007 and December 2021. Study outcomes were the incidence of comorbidities after matching, adjusted hazard ratios of comorbidity incidence among patients with vitiligo relative to matched control subjects, and time to comorbidity diagnosis or incidence. RESULTS Baseline demographics were well balanced between matched vitiligo (n = 13,687) and control cohorts (n = 54,748). Incidence rates of comorbidities were higher among patients compared with control subjects (psychiatric, 28.4% vs 22.8%; autoimmune, 13.4% vs 5.1%; and non-autoimmune, 10.0% vs 7.0%). The most common psychiatric and autoimmune comorbidities in patients with vitiligo compared with control subjects included anxiety (14.3% vs 11.0%, respectively), sleep disturbance (9.1% vs 7.1%), depression (8.0% vs 6.3%), atopic dermatitis (3.1% vs 1.1%), psoriasis (2.7% vs 0.6%), and linear morphea (1.5% vs 0.1%). The risk of developing any psychiatric (hazard ratio 1.31; P < 0.01), autoimmune (hazard ratio 2.77; P < 0.01), or non-autoimmune (hazard ratio 1.45; P < 0.01) comorbidity was significantly higher among patients with vitiligo. Time to diagnosis of most vitiligo comorbidities was 1-3 years, although linear morphea was diagnosed at < 1 year. CONCLUSION Results of this retrospective analysis demonstrated that patients were much more likely to be diagnosed with autoimmune or psychiatric comorbidities following a vitiligo diagnosis, which likely contributed to increased economic burden and lower quality of life.
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Affiliation(s)
- Khaled Ezzedine
- Department of Dermatology, AP-HP, Henri Mondor University Hospital, UPEC, 51 Avenue de Lattre de Tassignv, 94000, Créteil, France.
- EA 7379 EpiDermE, Université Paris-Est Créteil (UPEC), Créteil, France.
| | | | - Chao Li
- AbbVie Inc., North Chicago, IL, USA
| | | | - Amit G Pandya
- Palo Alto Foundation Medical Group, Sunnyvale, CA, USA
- University of Texas Southwestern Medical Center, Dallas, TX, USA
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16
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Liang H, Zheng J, Sun Y. Prevalence and predictive risk factors of self-stigmatization in patients with rare diseases: Based on health ecology model. Int J Soc Psychiatry 2023; 69:1541-1545. [PMID: 37092767 DOI: 10.1177/00207640231168023] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
Abstract
BACKGROUND AND AIMS Given the cause of self-stigmatization of patients with rare diseases is complicated, and the self-stigmatization can be prevented by managing the related risk factors. This study aimed to report the prevalence as well as influencing factors associated with self-stigmatization in patients with rare diseases. METHODS From January to April 2022, the respondent-driven sampling (RDS) method was used to select patients with rare diseases through the Chinese Organization for Rare Disorders as the subjects. Based on the theoretical model of health ecology, logistic regression analysis was used to explore the association between self-stigmatization level and sample characteristics of patients with rare diseases. RESULTS A total of 530 patients were included, 50.2% of whom were male, and most of them are under 45 years old (86.5%). The prevalence of self-stigmatization in patients with rare diseases was 85.7%. Logistic regression analysis indicated that age (OR: 0.624, 95% CI: [0.399, 0.976]), mental health status (OR: 0.184, 95% CI: [0.076, 0.445]), family relations (OR: 0.180, 95% CI: [0.074, 0.434]), full time work (OR: 2.835, 95% CI: [1.024, 7.849]) and medical insurance (OR: 0.296, 95% CI: [0.105, 0.835]) were risk factors for self-stigmatization of patients with rare diseases. CONCLUSIONS Chinese patients with rare diseases have a high level of self-stigmatization, and the potential risk factors are multi-level and multi-dimensional.
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Affiliation(s)
- Haixu Liang
- School of Public Health, Xiamen University, China
| | - Jiaqi Zheng
- School of Public Health, Shenyang Medical College, China
| | - Yongkang Sun
- Traditional Chinese Medicine Department, Baodi Clinical College of Medical University of Tianjin, China
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17
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Salama AH, Alnemr L, Khan AR, Alfakeer H, Aleem Z, Ali-Alkhateeb M. Unveiling the Unseen Struggles: A Comprehensive Review of Vitiligo's Psychological, Social, and Quality of Life Impacts. Cureus 2023; 15:e45030. [PMID: 37829995 PMCID: PMC10566310 DOI: 10.7759/cureus.45030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/11/2023] [Indexed: 10/14/2023] Open
Abstract
This review explores the psychosocial impact of vitiligo on patients, its consequences for their quality of life, and the need for holistic support. Vitiligo's psychosocial burden, driven by the need to conceal lesions and societal beauty ideals, leads to stress, sadness, and low self-esteem. Social stigma affects self-esteem, especially in cultural contexts, exacerbating the need for culturally sensitive support. Anxiety and depression are common due to visible differences and societal pressures. Vitiligo significantly reduces the quality of life, especially in younger patients, impacting daily activities, careers, and relationships. Disease severity worsens these effects, particularly in visible areas and among individuals with darker skin tones. Long-term disease activity may improve acceptance and quality of life. Psychological support and counseling are crucial, as many patients don't seek medical help. Education plays a key role, improving understanding and reducing anxiety. Raising awareness about the impact of vitiligo can challenge perceptions and contribute to enhancing patients' well-being. In conclusion, this review highlights the interplay between psychosocial factors, quality of life, and the importance of addressing social stigma, providing psychological support, and advancing education and awareness for those with vitiligo.
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Affiliation(s)
- Abdelaziz H Salama
- Medical School, Hamidiye International School of Medicine, University of Health Sciences, Istanbul, TUR
| | - Lujain Alnemr
- Medical School, Hamidiye International School of Medicine, University of Health Sciences, Istanbul, TUR
| | - Ahmad R Khan
- Internal Medicine, University Hospital Limerick, Limerick , IRL
| | - Hussein Alfakeer
- Medical School, Hamidiye International School of Medicine, University of Health Sciences, Istanbul, TUR
| | - Zoha Aleem
- Internal Medicine, Batterjee Medical College, Jeddah, SAU
| | - Mohamed Ali-Alkhateeb
- Medical School, Hamidiye International School of Medicine, University of Health Sciences, Istanbul, TUR
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18
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Murshidi R, Shewaikani N, Al Refaei A, Alfreijat B, Al-Sabri B, Abdallat M, Murshidi M, Khamis T, Al-Dawoud Y, Alattar Z. Public Knowledge and Attitude towards Vitiligo: A Cross-Sectional Survey in Jordan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6183. [PMID: 37372769 DOI: 10.3390/ijerph20126183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 06/15/2023] [Accepted: 06/18/2023] [Indexed: 06/29/2023]
Abstract
BACKGROUND Vitiligo is an autoimmune disease affecting approximately 2% of the world's population. Besides vitiligo cosmetic issues, patients suffer from psychological comorbidities. This results from the stigmatization they encounter from surrounding individuals. Accordingly, the current study was the first to assess Jordanians' knowledge and attitude toward vitiligo. METHODS Data collection was completed by an online questionnaire consisting of four sections to capture participants' sociodemographic characteristics, previous exposure, and knowledge and attitude toward vitiligo. The analysis took place through R and RStudio. RESULTS Of our 994 surveyed participants, only 8.45% and 12.47% had a low level of vitiligo knowledge and negative total attitude score, respectively. Moreover, independent predictors of positive attitudes included younger age (18-30), high school education or lower, hearing about or living with a vitiligo patient, and higher knowledge scores. The highest prevalence of positive attitudes was observed when physicians were the source of knowledge. CONCLUSION Some critical misconceptions were identified despite the Jordanian public having sufficient overall knowledge. Furthermore, higher knowledge reflected a higher prevalence of positive attitudes toward the patients. We recommend that future efforts target the public understanding of the nature of the disease and its being non-communicable. Moreover, we emphasize that medical knowledge should be communicated through qualified healthcare providers.
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Affiliation(s)
- Rand Murshidi
- Department of Dermatology, School of Medicine, The University of Jordan, Amman 11942, Jordan
| | - Nour Shewaikani
- School of Medicine, The University of Jordan, Amman 11942, Jordan
| | - Assem Al Refaei
- School of Medicine, The University of Jordan, Amman 11942, Jordan
| | - Balqis Alfreijat
- School of Medicine, The University of Jordan, Amman 11942, Jordan
| | | | - Mahmoud Abdallat
- Department of Neurosurgery, Jordan University Hospital, Amman 11942, Jordan
| | - Muayyad Murshidi
- Department of Dermatology, The Jordanian Royal Medical Services, Amman 11942, Jordan
| | - Tala Khamis
- School of Medicine, The University of Jordan, Amman 11942, Jordan
| | - Yasmin Al-Dawoud
- School of Medicine, The University of Jordan, Amman 11942, Jordan
| | - Zahraa Alattar
- School of Medicine, The University of Jordan, Amman 11942, Jordan
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Dong J, Lai Y, Zhang X, Yue Y, Zhong H, Shang J. Optimization of Monobenzone-Induced Vitiligo Mouse Model by the Addition of Chronic Stress. Int J Mol Sci 2023; 24:ijms24086990. [PMID: 37108153 PMCID: PMC10138324 DOI: 10.3390/ijms24086990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 03/31/2023] [Accepted: 04/03/2023] [Indexed: 04/29/2023] Open
Abstract
Vitiligo is a common primary, limited or generalized skin depigmentation disorder. Its pathogenesis is complex, multifactorial and unclear. For this reason, few animal models can simulate the onset of vitiligo, and studies of drug interventions are limited. Studies have found that there may be a pathophysiological connection between mental factors and the development of vitiligo. At present, the construction methods of the vitiligo model mainly include chemical induction and autoimmune induction against melanocytes. Mental factors are not taken into account in existing models. Therefore, in this study, mental inducement was added to the monobenzone (MBEH)-induced vitiligo model. We determined that chronic unpredictable mild stress (CUMS) inhibited the melanogenesis of skin. MBEH inhibited melanin production without affecting the behavioral state of mice, but mice in the MBEH combined with CUMS (MC) group were depressed and demonstrated increased depigmentation of the skin. Further analysis of metabolic differences showed that all three models altered the metabolic profile of the skin. In summary, we successfully constructed a vitiligo mouse model induced by MBEH combined with CUMS, which may be better used in the evaluation and study of vitiligo drugs.
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Affiliation(s)
- Jing Dong
- School of Traditional Chinese Pharmacy, China Pharmaceutical University, Nanjing 211198, China
| | - Yifan Lai
- School of Traditional Chinese Pharmacy, China Pharmaceutical University, Nanjing 211198, China
| | - Xiaofeng Zhang
- School of Traditional Chinese Pharmacy, China Pharmaceutical University, Nanjing 211198, China
| | - Yunyun Yue
- School of Traditional Chinese Pharmacy, China Pharmaceutical University, Nanjing 211198, China
| | - Hui Zhong
- School of Traditional Chinese Pharmacy, China Pharmaceutical University, Nanjing 211198, China
| | - Jing Shang
- School of Traditional Chinese Pharmacy, China Pharmaceutical University, Nanjing 211198, China
- State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing 210009, China
- Jiangsu Key Laboratory of TCM Evaluation and Translational Research, China Pharmaceutical University, Nanjing 211198, China
- NMPA Key Laboratory for Research and Evaluation of Cosmetics, National Institutes for Food and Drug Control, Beijing 100050, China
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Castillo E, González-Rosende ME, Martínez-Solís I. The Use of Herbal Medicine in the Treatment of Vitiligo: An Updated Review. PLANTA MEDICA 2023; 89:468-483. [PMID: 36379447 DOI: 10.1055/a-1855-1839] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Vitiligo is a chronic disease of unknown etiology that causes progressive cutaneous depigmentation. Current pharmacological treatments have limited success and present significant risks. Many efforts have been made in recent years to explore new anti-vitiligo therapeutic strategies, including herbal-based therapies. The objective of the present review is to provide an updated overview on the most frequently used medicinal plants in the treatment of vitiligo. A bibliographical search was carried out in scientific databases Pubmed, Scifinder, Scopus, Google Scholar, and Medline up to October 2021 using the descriptors vitiligo, herbal, medicinal plants, and alternative therapies. In our search, the highest number of published studies comprise plants commonly used in traditional herbal medicine, highlighting the usefulness of ethnopharmacology in the discovery of new therapeutic agents. The review outlines current understanding and provides an insight into the role of psoralens and khellin (photosensitizing agents obtained from plants such as Cullen corylifolium or Ammi visnaga). The paper also describes other traditional herbs such as Ginkgo biloba, Phlebodium aureum, Piper nigrum, Picrorhiza kurroa, and Baccharoides anthelmintica that can likewise act as potential therapeutical agents. Based on our findings, photosensitizing agents in combination with phototherapy, the association of oral Phebodium aureum with phototherapies as well as oral G. biloba in monotherapy showed greater scientific evidence as therapeutic options. The research results emphasize that further investigation in this area is merited. More long-term follow up clinical trials and higher quality randomized trials are needed.
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Affiliation(s)
- Encarna Castillo
- Department of Pharmacy, Faculty of Health Sciences, University CEU-Cardenal Herrera, CEU Universities, Alfara del Patriarca, Valencia (Spain)
| | - María Eugenia González-Rosende
- Department of Pharmacy, Faculty of Health Sciences, University CEU-Cardenal Herrera, CEU Universities, Alfara del Patriarca, Valencia (Spain)
| | - Isabel Martínez-Solís
- Department of Pharmacy, Faculty of Health Sciences, University CEU-Cardenal Herrera, CEU Universities, Alfara del Patriarca, Valencia (Spain)
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Sun C, Ren Y, Zhang W. Association between skin disease and anxiety: a logistic analysis and prediction. ANNALS OF TRANSLATIONAL MEDICINE 2023; 11:115. [PMID: 36819527 PMCID: PMC9929807 DOI: 10.21037/atm-22-6511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 01/10/2023] [Indexed: 01/18/2023]
Abstract
Background Dermatosis has symptoms of flushing, itching, pain, and burning, which causes psychological distress in patients. Methods We collected the data of 214 patients from the Wuhan Institute of Dermatology and Venereology from January 2020 to January 2022, including age, gender, diagnosis, Hamilton Anxiety Rating Scale (HAMA), and anxiety. First, descriptive analysis and difference analysis of the included data were carried out. Second, a correlation matrix was used to exclude the confounding factors with strong collinearity. Finally, logistic regression was used to analyze and predict the risk factors of anxiety. Results In the anxiety group and nonanxiety group, eczema and generalized eczema accounted for the largest proportion, and there was no difference in the composition of the diagnosis between the 2 groups. Several related analyses proved the accuracy of the logistic model. The results showed that age had a protective effect on the anxiety of patients with skin diseases [odds ratio (OR) =0.8606 with 95% confidence interval (CI): 0.7812, 0.8987]. Neurodermatitis (OR =1.0853 with 95% CI: 1.0115, 1.2512), eczema (OR =1.1358 with 95% CI: 1.0215, 1.2129), generalized eczema (OR =1.3346 with 95% CI: 1.1212, 1.5521), and psoriasis (OR =1.3685 with 95% CI: 1.1728, 1.6215) were associated with the anxiety of patients. Prediction analysis showed that with increase of patients' age, the likelihood of anxiety decreased. Conclusions This study demonstrated a strong correlation between skin diseases and anxiety and that the likelihood of anxiety decreases as age increases. Therefore, psychological intervention for patients with skin diseases, especially young patients, is essential.
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Affiliation(s)
- Chao Sun
- Hospital Office, Wuhan Institute of Dermatology and Venereology, Wuhan, China
| | - Yali Ren
- Department of Outpatient, Wuhan Institute of Dermatology and Venereology, Wuhan, China
| | - Wanhong Zhang
- Hospital Office, Wuhan Institute of Dermatology and Venereology, Wuhan, China
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22
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Hu Z, Wang T. Beyond skin white spots: Vitiligo and associated comorbidities. Front Med (Lausanne) 2023; 10:1072837. [PMID: 36910477 PMCID: PMC9995999 DOI: 10.3389/fmed.2023.1072837] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 02/07/2023] [Indexed: 02/25/2023] Open
Abstract
Vitiligo is a common depigmentation disorder of an unknown origin characterized by the selective loss of melanocytes, resulting in typical white macules and patches. However, vitiligo is now recognized as more than just a skin disease, what a dermatologist observes as a white spot of skin is just the "tip of the iceberg" of the condition. We attempt to clarify the classification of comorbidities associated with vitiligo from various reviews and reports, and describe their possible pathogenesis. In conclusion, the literature provides evidence of an association between vitiligo and ocular and auditory abnormalities, autoimmune disorders, other dermatological diseases, metabolic syndrome and related disorders, and psychological diseases. These associations highlight the importance of a multidisciplinary approach in managing vitiligo patients.
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Affiliation(s)
- Zhonghui Hu
- Department of Dermatology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases, Beijing, China
| | - Tao Wang
- Department of Dermatology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases, Beijing, China
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Ning J, Tang X, Shi H, Yao D, Zhao Z, Li J. Social support and posttraumatic growth: A meta-analysis. J Affect Disord 2023; 320:117-132. [PMID: 36181914 DOI: 10.1016/j.jad.2022.09.114] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 09/14/2022] [Accepted: 09/21/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND The beneficial role of social support on posttraumatic growth (PTG) has been assumed by theoretical models and established in some studies. However, there are inconsistent findings and little knowledge on moderators. The present study aims to investigate the overall effect size of the relationship and identify factors affecting the association. METHODS Six electronic databases were searched. Newcastle-Ottawa Quality Assessment Scale (NOS) were used to evaluate the quality of studies. Study quality, study design, trauma type, PTG measure, social support measure, continent, publishing language, sample size, gender, religion, and age were analyzed as moderators. Meta-regression was conducted with the significant differential predictors in moderator analysis. RESULTS The meta-analysis included 217 samples and a total of 47,940 participants from both longitudinal and cross-sectional studies. There was a medium positive effect size between social support and PTG in random effect model, r = 0.418, p < .001. The meta-regression analysis indicated that the association between social support and PTG was stronger among caregivers (vs. other traumatized samples), Chinese, older individuals and studies with smaller sample size. LIMITATIONS Only survey results were included in the analysis. The retrospective self-report may limit a more objective assessment of the relations. In addition, 87 % of the studies were cross-sectional, which may influence the estimation of a valid effect size. CONCLUSIONS Regarding the medium positive association between social support and PTG, it is important to enhance social support for trauma survivors. It will be especially effective for caregivers, Chinese, and older people.
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Affiliation(s)
- Jing Ning
- Department of Psychology, Renmin University of China, Beijing, China
| | - Xinfeng Tang
- Department of Psychology, Renmin University of China, Beijing, China
| | - Hanlu Shi
- Department of Psychology, Renmin University of China, Beijing, China
| | - Dongpeng Yao
- Department of Psychology, Renmin University of China, Beijing, China
| | - Ziqing Zhao
- Department of Psychology, Renmin University of China, Beijing, China
| | - Jie Li
- Department of Psychology, Renmin University of China, Beijing, China.
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Chivu AM, Bălășescu E, Pandia LD, Nedelcu RI, Brînzea A, Turcu G, Antohe M, Ion DA. Vitiligo-Thyroid Disease Association: When, in Whom, and Why Should It Be Suspected? A Systematic Review. J Pers Med 2022; 12:jpm12122048. [PMID: 36556267 PMCID: PMC9785784 DOI: 10.3390/jpm12122048] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 12/07/2022] [Accepted: 12/07/2022] [Indexed: 12/14/2022] Open
Abstract
In most dermatological pathologies, the phenomena observed on the skin are a reflection of internal disorders. In patients with associated acral involvement on the dorsal sides of the hands, this "vitiligo phenotype" may lead to the investigation of certain associated pathologies that sometimes have no obvious clinical impact. To assess the link between skin depigmentation and autoimmune pathologies, we conducted a systematic review involving article selection from the PubMed database. Patients with coexisting thyroid pathologies were found to have a predisposition for developing acral vitiligo and depigmentation of the wrists, and autoimmune thyroid pathologies appeared to be the only coexisting autoimmune or inflammatory diseases in vitiligo patients to show a pattern of distribution. The association of concomitant thyroid dysfunction with depigmentation of the hands was found to be so strong that the absence of depigmented macules on the hands may exclude the coexistence of an autoimmune thyroid pathology. Although the frequency of acral involvement in patients with vitiligo and autoimmune pathologies is higher, the mechanism by which thyroid dysfunction influences this distribution pattern remains incompletely elucidated and requires future studies.
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Affiliation(s)
- Ana Maria Chivu
- 2nd Pathophysiology Department, Laboratory of Experimental Medicine and Fundamental Research, Carol Davila University of Medicine and Pharmacy, 37 Dionisie Lupu Street, District 2, 020021 Bucharest, Romania
| | - Elena Bălășescu
- 2nd Pathophysiology Department, Laboratory of Experimental Medicine and Fundamental Research, Carol Davila University of Medicine and Pharmacy, 37 Dionisie Lupu Street, District 2, 020021 Bucharest, Romania
- SanacareVital Clinic, 010161 Bucharest, Romania
- Correspondence:
| | - Larisa Diana Pandia
- Astera Diamed Diabetes & Nutrition and Endocrinology Clinic, 010161 Bucharest, Romania
| | - Roxana Ioana Nedelcu
- 2nd Pathophysiology Department, Laboratory of Experimental Medicine and Fundamental Research, Carol Davila University of Medicine and Pharmacy, 37 Dionisie Lupu Street, District 2, 020021 Bucharest, Romania
- Derma 360 Clinic, 11273 Bucharest, Romania
| | - Alice Brînzea
- 2nd Pathophysiology Department, Laboratory of Experimental Medicine and Fundamental Research, Carol Davila University of Medicine and Pharmacy, 37 Dionisie Lupu Street, District 2, 020021 Bucharest, Romania
- Institutul Național de Boli Infecțioase (INBI) Matei Bals, 021105 Bucharest, Romania
| | - Gabriela Turcu
- 2nd Pathophysiology Department, Laboratory of Experimental Medicine and Fundamental Research, Carol Davila University of Medicine and Pharmacy, 37 Dionisie Lupu Street, District 2, 020021 Bucharest, Romania
- Department of Dermatovenerology, Colentina Clinical Hospital, 020125 Bucharest, Romania
| | - Mihaela Antohe
- 2nd Pathophysiology Department, Laboratory of Experimental Medicine and Fundamental Research, Carol Davila University of Medicine and Pharmacy, 37 Dionisie Lupu Street, District 2, 020021 Bucharest, Romania
- Derma 360 Clinic, 11273 Bucharest, Romania
| | - Daniela Adriana Ion
- 2nd Pathophysiology Department, Laboratory of Experimental Medicine and Fundamental Research, Carol Davila University of Medicine and Pharmacy, 37 Dionisie Lupu Street, District 2, 020021 Bucharest, Romania
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Thompson AR, Eleftheriadou V, Nesnas J. The mental health associations of vitiligo: UK population-based cohort study. BJPsych Open 2022; 8:e190. [PMID: 36268886 PMCID: PMC9634603 DOI: 10.1192/bjo.2022.591] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Vitiligo is an acquired, autoimmune depigmenting skin disorder that may affect psychological well-being. AIMS To determine the risk and impact of psychological comorbidity in people with new-onset vitiligo. METHOD We conducted a retrospective observational study, using UK general practice data (2004-2020). Adults diagnosed with vitiligo (n = 7224) were matched 1:4 with controls (n = 28 880). Associations within 2 years of diagnosis were assessed for psychological conditions: recurrent depressive disorder (RDD), depressive episodes, non-phobia-related anxiety disorder, social phobia, adjustment disorder, substance misuse, self-harm and suicide attempts. Healthcare utilisation, time off work and unemployment within 1 year were compared in those with and without a mental health condition at vitiligo diagnosis. RESULTS At diagnosis, people with vitiligo had a similar prevalence of mental health conditions as controls, except for anxiety disorder (cases 7.9%, controls 7.0%; P = 0.014). Incident RDD and anxiety disorder were more common in people with vitiligo (RDD: adjusted hazard ratio (aHR) 1.25, 95% CI 1.01-1.55; anxiety disorder: aHR 1.23, 95% CI 1.00-1.51). Risk was highest in Black and minority ethnic individuals (RDD: aHR 1.72, 95% CI 1.06-2.79; depressive episodes: aHR 1.56, 95% CI 1.03-2.37). No association was found with other mental health conditions. People with vitiligo and psychological comorbidity had more primary care encounters, more time off workand higher unemployment. CONCLUSIONS People with vitiligo have a higher incidence of RDD and anxiety disorder than controls, and this risk increase may be greatest in Black and minority ethnic populations.
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Affiliation(s)
- Andrew R Thompson
- South Wales Clinical Psychology Training Programme, Department of Psychology, Cardiff University, Wales, UK
| | | | - John Nesnas
- Inflammation and Immunology, Medical Dermatology, Pfizer Ltd, UK
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Padmakar S, Murti K, Pandey K, Kumari S, Kumar R, Siddiqui NA, Pal B. Suicidal ideation associated with vitiligo - A systematic review of prevalence and assessment. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2022. [DOI: 10.1016/j.cegh.2022.101140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
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Sangha AM. Dermatological Conditions in SKIN OF COLOR-: Debunking Vitiligo Myths. THE JOURNAL OF CLINICAL AND AESTHETIC DERMATOLOGY 2022; 15:S10-S11. [PMID: 36118789 PMCID: PMC9476987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Affiliation(s)
- Archana M Sangha
- Ms. Sangha is a medical science liaison for Incyte in Wilmington, Delaware. Prior to that, she spent over a decade as a dermatology PA specializing in general, surgical, and cosmetic dermatology. She is a fellow of the American Academy of Physician Assistants in Alexandria, Virginia. She is also Immediate Past President of the Society of Dermatology Physician Assistants
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Tong N, Zhang Y, Yang A, Dai X, Hao S. The potency of common proinflammatory cytokines measurement for revealing the risk and severity of anxiety and depression in psoriasis patients. J Clin Lab Anal 2022; 36:e24643. [PMID: 35944185 PMCID: PMC9459285 DOI: 10.1002/jcla.24643] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 07/21/2022] [Accepted: 07/25/2022] [Indexed: 11/17/2022] Open
Abstract
Objective Proinflammatory cytokines mediate anxiety and depression in various ways, such as immunity, inflammation, and the hypothalamic–pituitary–adrenal axis. This study intended to further explore the linkage of common proinflammatory cytokine levels with anxiety and depression in psoriasis patients. Methods Totally, 150 psoriasis patients and 50 healthy controls (HCs) were included; the serum samples were collected, then common proinflammatory cytokines were measured by ELISA. Hospital Anxiety and Depression Scale (HADS) was assessed. Results HADS‐anxiety (HADS‐A) score, HADS‐depression (HADS‐D) score, TNF‐α, IL‐1β, IL‐6, IL‐12, IL‐17A, and IL‐23 were all increased in psoriasis patients compared to HCs (all p < 0.05). In psoriasis patients, TNF‐α (p = 0.001), IL‐12 (p = 0.035), and IL‐17A (p < 0.001), but not IL‐1β (p = 0.255), IL‐6 (p = 0.248), and IL‐23 (p = 0.216), were positively linked to HADS‐A score. Meanwhile, TNF‐α (p = 0.007) and IL‐17A (p = 0.007) were enhanced in psoriasis patients with anxiety in contrast to those without anxiety; whereas IL‐1β (p = 0.178), IL‐6 (p = 0.360), IL‐12 (p = 0.239), and IL‐23 (p = 0.450) were not different. TNF‐α (p < 0.001), IL‐1β (p = 0.013), Il‐17A (p < 0.001), and IL‐23 (p = 0.023), but not IL‐6 (p = 0.143) and IL‐12 (p = 0.158), were positively linked to HADS‐D score. Concurrently, TNF‐α (p = 0.015), IL‐17A (p < 0.001), and IL‐23 (p = 0.017) were climbed in psoriasis patients with depression by comparison to those without depression; whereas IL‐1β (p = 0.113), IL‐6 (p = 0.237), IL‐12 (p = 0.660) did not differ. Conclusion TNF‐α, IL‐17A, and IL‐23 increments reflect anabatic anxiety and depression in psoriasis patients, uncovering the potency of proinflammatory cytokines measurement for monitoring or even preventing psoriasis patients' anxiety and depression.
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Affiliation(s)
- Nannan Tong
- Department of Dermatology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Yu Zhang
- Department of Dermatology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Anping Yang
- Department of Dermatology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Xiaoli Dai
- Department of Dermatology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Siyu Hao
- Department of Dermatology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China.,Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
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Kussainova A, Kassym L, Bekenova N, Akhmetova A, Glushkova N, Kussainov A, Urazalina Z, Yurkovskaya O, Smail Y, Pak L, Semenova Y. Gene polymorphisms and serum levels of BDNF and CRH in vitiligo patients. PLoS One 2022; 17:e0271719. [PMID: 35905107 PMCID: PMC9337645 DOI: 10.1371/journal.pone.0271719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Accepted: 06/28/2022] [Indexed: 11/19/2022] Open
Abstract
Background Vitiligo is one of the most common hypomelanoses, in which the destruction of functioning melanocytes causes depigmentation of the skin, hair and mucous membranes. The genes encrypting brain-derived neurotrophic factor (BDNF) and corticotropin releasing hormone (CRH) might be the conceivable contributors to the development of vitiligo. This study was aimed at investigation of the serum levels of BDNF and CRH as well as their selected single nucleotide polymorphisms (SNPs) in vitiligo patients in comparison with the healthy controls. Methods The cross-sectional study was carried out between October 2020 and June 2021 in 93 vitiligo patients (age range from 23 to 48 years) and 132 healthy controls (age range from 24 to 52 years). The psychological status of study participants was evaluated using the Generalized Anxiety Disorder-7 (GAD-7) scale. Serum levels of BDNF and CRH were measured with the help of a commercially available sandwich enzyme-linked immunosorbent assay (ELISA) kit. Genotyping for the rs11030094 polymorphism of the BDNF gene and for the rs242924 polymorphism of the corticotropin releasing hormone receptor 1 (CRH-R1) gene was performed by a real-time polymerase chain reaction (PCR). Results There was a significant relationship between the CRH-R1 rs242924 and BDNF rs11030094 polymorphisms and vitiligo. Moreover, serum levels of neurotransmitters differed significantly between vitiligo and control groups and were associated with the CRH-R1 rs242924 and BDNF rs11030094 SNPs. Conclusions Our findings demonstrated the association between CRH-R1 rs242924 and BDNF rs11030094 polymorphisms and vitiligo. Further studies need to be carried out in vitiligo patients to confirm the results observed.
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Affiliation(s)
- Assiya Kussainova
- Department of Dermatovenerology and Cosmetology, NJSC "Semey Medical University", Semey, Republic of Kazakhstan
| | - Laura Kassym
- School of Medicine, Nazarbayev University, Nur-Sultan, Republic of Kazakhstan
- * E-mail:
| | - Nazira Bekenova
- Department of Dermatovenerology and Cosmetology, NJSC "Semey Medical University", Semey, Republic of Kazakhstan
| | - Almira Akhmetova
- Department of Dermatovenerology and Cosmetology, NJSC "Semey Medical University", Semey, Republic of Kazakhstan
| | - Natalya Glushkova
- Department of Epidemiology, Biostatistics & Evidence Based Medicine, Al-Farabi Kazakh National University, Almaty, Republic of Kazakhstan
| | - Almas Kussainov
- Department of Psychiatry and Narcology, NJSC "Astana Medical University", Nur-Sultan, Republic of Kazakhstan
| | - Zhanar Urazalina
- Department of Emergency Medicine, NJSC "Semey Medical University", Semey, Republic of Kazakhstan
| | - Oxana Yurkovskaya
- Department of Personalized Medicine, NJSC "Semey Medical University", Semey, Republic of Kazakhstan
| | - Yerbol Smail
- Department of Infectious Diseases and Immunology, NJSC "Semey Medical University", Semey, Republic of Kazakhstan
| | - Laura Pak
- Department of Clinical Oncology and Nuclear Medicine, NJSC "Semey Medical University", Semey, Republic of Kazakhstan
| | - Yuliya Semenova
- Department of Neurology, Ophthalmology, Otorhinolaryngology, NJSC "Semey Medical University", Semey, Republic of Kazakhstan
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Do Bú EA, Santos VMD, Lima KS, Pereira CR, Alexandre MESD, Bezerra VADS. Neuroticism, stress, and rumination in anxiety and depression of people with Vitiligo: An explanatory model. Acta Psychol (Amst) 2022; 227:103613. [PMID: 35569205 DOI: 10.1016/j.actpsy.2022.103613] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 05/05/2022] [Accepted: 05/06/2022] [Indexed: 11/16/2022] Open
Abstract
Psychological impacts of Vitiligo have been demonstrated, and associations of the skin disease with anxiety and depression disorders have already been shown. However, it is still unclear the role of individuals' personality factors, such as neuroticism, stress, and rumination, as well as sociodemographic characteristics of people with Vitiligo in such disorders. We conducted a study in a community sample of individuals with Vitiligo (N = 324) aiming to test the hypothesis that neuroticism, stress, and rumination are subjacent to these individuals' anxiety and depression symptomatology. We also explored whether individuals' gender might favor the onset or worsening of the psychological consequences of such disorders. Results showed that the relationship between neuroticism, anxiety and depression was mediated by stress and rumination (brooding), being this effect moderated by the participants' gender. Specifically, women's reflection and stress seemed to be important mechanisms to predict their anxiety and depression symptoms, whereas brooding predicts such disorders' symptomatology in men with Vitiligo. These findings may guide future research and clinical interventions for this population, for which it is necessary to consider the psychological consequences of the disease and not just its physiological aspects.
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Affiliation(s)
- Emerson Araújo Do Bú
- Institute of Social Sciences, University of Lisbon, Lisbon, Portugal; Faculty of Psychology, University of Lisbon, Lisbon, Portugal.
| | | | | | - Cicero Roberto Pereira
- Institute of Social Sciences, University of Lisbon, Lisbon, Portugal; Federal University of Paraíba, João Pessoa, Paraíba, Brazil
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Associations between serum levels of brain-derived neurotrophic factor, corticotropin releasing hormone and mental distress in vitiligo patients. Sci Rep 2022; 12:7260. [PMID: 35508633 PMCID: PMC9068776 DOI: 10.1038/s41598-022-11028-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 04/18/2022] [Indexed: 01/03/2023] Open
Abstract
Vitiligo is clinically characterized by the appearance of non-symptomatic depigmented macules, but the disorder is highly correlated with a wide range of psychiatric disorders and psychological problems. The aim of our study was to investigate serum brain-derived neurotrophic factor (BDNF) and corticotropin releasing hormone (CRH) levels in vitiligo patients and healthy controls in relation to the observed symptoms of depression and anxiety disorders. This study comprised 96 vitiligo patients and 96 healthy controls who filled out the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) scales. Serum levels of BDNF and CRH were measured using enzyme-linked immunosorbent assay (ELISA) technique. There was a significant increase of depression and anxiety scores in vitiligo patients as compared with healthy controls (P < 0.05). The serum levels of BDNF were significantly lower in vitiligo patients than in healthy individuals (Z = 4.002; P < 0.001), while the serum levels of CRH were markedly higher in cases than those in controls (Z = 3.764; P < 0.001). The significant positive correlations between serum CRH levels and GAD-7, PHQ-9 scores were observed. However, the aforementioned psychometric scales did not correlate significantly with serum BDNF level. Vitiligo is associated with the depression and is closely linked with lower BDNF levels.
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Qi F, Liu F, Gao L. Janus Kinase Inhibitors in the Treatment of Vitiligo: A Review. Front Immunol 2021; 12:790125. [PMID: 34868078 PMCID: PMC8636851 DOI: 10.3389/fimmu.2021.790125] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 11/02/2021] [Indexed: 11/17/2022] Open
Abstract
Vitiligo is a multifactorial reversible skin disorder characterized by distinct white patches that result from melanocyte destruction. Activated CXCR3+ CD8+ T cells promote melanocyte detachment and apoptosis through interferon-gamma (IFN-γ secretion and chemokines secreted by keratinocytes through the Janus kinase (JAK)/signal transducer and activator of transcription (STAT)-1 signaling pathway results in further recruitment of CXCR3+ CD8+ T cells and the formation of a positive-feedback loop. JAK inhibitors target the JAK/STAT pathway and are now approved to treat many immune-related diseases. In the treatment of vitiligo, JAK inhibitors, including ruxolitinib, baricitinib, and tofacitinib, are effective, supporting the implication of the IFN-γ-chemokine signaling axis in the pathogenesis of vitiligo. However, more studies are required to determine the ideal dosage of JAK inhibitors for the treatment of vitiligo, and to identify other inflammatory pathways that may be implicated in the pathogenesis of this condition.
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Affiliation(s)
- Fei Qi
- Department of Dermatology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Fang Liu
- Department of Dermatology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Ling Gao
- China CDC Key Laboratory of Radiological Protection and Nuclear Emergency, National Institute for Radiological Protection, China Centers for Disease Control, Beijing, China
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Tan C, Jiang J, Deng X, Xiang W, Hu T. Effect of cognitive behavioral therapy on anxiety and depression in patients with psoriasis: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2021; 100:e27720. [PMID: 34797297 PMCID: PMC8601342 DOI: 10.1097/md.0000000000027720] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 10/21/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Psoriasis can lead to higher social and psychological burden, and its occurrence is related to psychological disturbance. At present, there are many clinical trials on cognitive behavior therapy for depression and anxiety in patients with psoriasis. However, the results of studies vary greatly due to the different time and content of the intervention, and the curative effect is still controversial. Therefore, the purpose of this study was to explore the effect of cognitive behavior therapy on anxiety and depression in patients with psoriasis through meta-analysis. METHODS We searched Chinese and English databases to collect all randomized controlled trials of cognitive behavior therapy on anxiety and depression in patients with psoriasis until October 2021. Two researchers then independently screened articles, extracted data, and evaluated the quality of selected literatures. All data were processed by Stata 14.0. RESULTS The results will be published in peer-reviewed journals. CONCLUSION Our study is expected to provide high-quality evidence-based medicine advice for the effects of cognitive behavior therapy on anxiety and depression in patients with psoriasis. ETHICS AND DISSEMINATION Ethical approval was not required for this study. The systematic review will be published in a peer-reviewed journal, presented at conferences, and shared on social media platforms. This review would be disseminated in a peer-reviewed journal or conference presentations. OSF REGISTRATION NUMBER DOI 10.17605/OSF.IO/APKVG.
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Marzabani R, Rezadoost H, Choopanian P, Kolahdooz S, Mozafari N, Mirzaie M, Karimi M, Nieminen AI, Jafari M. Metabolomic signature of amino acids in plasma of patients with non-segmental Vitiligo. Metabolomics 2021; 17:92. [PMID: 34562159 PMCID: PMC8464575 DOI: 10.1007/s11306-021-01843-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 09/15/2021] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Vitiligo pathogenesis is complicated, and several possibilities were suggested. However, it is well-known that the metabolism of pigments plays a significant role in the pathogenicity of the disease. OBJECTIVES We explored the role of amino acids in vitiligo using targeted metabolomics. METHODS The amino acid profile was studied in plasma using liquid chromatography. First, 22 amino acids were derivatized and precisely determined. Next, the concentrations of the amino acids and the molar ratios were calculated in 31 patients and 34 healthy individuals. RESULTS The differential concentrations of amino acids were analyzed and eight amino acids, i.e., cysteine, arginine, lysine, ornithine, proline, glutamic acid, histidine, and glycine were observed differentially. The ratios of cysteine, glutamic acid, and proline increased significantly in Vitiligo patients, whereas arginine, lysine, ornithine, glycine, and histidine decreased significantly compared to healthy individuals. Considering the percentage of skin area, we also showed that glutamic acid significantly has a higher amount in patients with less than 25% involvement compared to others. Finally, cysteine and lysine are considered promising candidates for diagnosing and developing the disorder with high accuracy (0.96). CONCLUSION The findings are consistent with the previously illustrated mechanism of Vitiligo, such as production deficiency in melanin and an increase in immune activity and oxidative stress. Furthermore, new evidence was provided by using amino acids profile toward the pathogenicity of the disorder.
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Affiliation(s)
- Rezvan Marzabani
- Department of Phytochemistry, Medicinal Plants and Drugs Research Institute, Shahid Beheshti University, Tehran, Iran
| | - Hassan Rezadoost
- Department of Phytochemistry, Medicinal Plants and Drugs Research Institute, Shahid Beheshti University, Tehran, Iran.
| | - Peyman Choopanian
- Department of Applied Mathematics, Faculty of Mathematical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Sima Kolahdooz
- School of Traditional Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Nikoo Mozafari
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehdi Mirzaie
- Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, 00290, Helsinki, Finland
| | - Mehrdad Karimi
- School of Traditional Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Anni I Nieminen
- Metabolomics Unit, Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, 00290, Helsinki, Finland.
| | - Mohieddin Jafari
- Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, 00290, Helsinki, Finland.
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D’Arino A, Picardo M, Truglio M, Pacifico A, Iacovelli P. Metabolic Comorbidities in Vitiligo: A Brief Review and Report of New Data from a Single-Center Experience. Int J Mol Sci 2021; 22:ijms22168820. [PMID: 34445526 PMCID: PMC8396221 DOI: 10.3390/ijms22168820] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 08/12/2021] [Accepted: 08/13/2021] [Indexed: 12/21/2022] Open
Abstract
Among disorders of pigmentation, vitiligo is the most common, with an estimated prevalence between 0.5% and 1%. The disease has gathered increased attention in the most recent years, leading to a better understanding of the disease’s pathophysiology and its implications and to the development of newer therapeutic strategies. A better, more integrated approach is already in use for other chronic inflammatory dermatological diseases such as psoriasis, for which metabolic comorbidities are well-established and part of the routine clinical evaluation. The pathogenesis of these might be linked to cytokines which also play a role in vitiligo pathogenesis, such as IL-1, IL-6, TNF-α, and possibly IL-17. Following the reports of intrinsic metabolic alterations reported by our group, in this brief review, we analyze the available data on metabolic comorbidities in vitiligo, accompanied by our single-center experience. Increased awareness of the metabolic aspects of vitiligo is crucial to improving patient care.
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Affiliation(s)
- Andrea D’Arino
- Laboratory of Cutaneous Physiopathology and Integrated Center of Metabolomics Research, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy; (A.D.); (M.T.)
| | - Mauro Picardo
- Laboratory of Cutaneous Physiopathology and Integrated Center of Metabolomics Research, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy; (A.D.); (M.T.)
- Correspondence: ; Tel.: +39-0652666257
| | - Mauro Truglio
- Laboratory of Cutaneous Physiopathology and Integrated Center of Metabolomics Research, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy; (A.D.); (M.T.)
| | - Alessia Pacifico
- Clinical Dermatology, Phototherapy Unit, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy; (A.P.); (P.I.)
| | - Paolo Iacovelli
- Clinical Dermatology, Phototherapy Unit, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy; (A.P.); (P.I.)
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Clinical Features, Immunopathogenesis, and Therapeutic Strategies in Vitiligo. Clin Rev Allergy Immunol 2021; 61:299-323. [PMID: 34283349 DOI: 10.1007/s12016-021-08868-z] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2021] [Indexed: 12/19/2022]
Abstract
Vitiligo is an autoimmune disease of the skin characterized by epidermal melanocyte loss resulting in white patches, with an approximate prevalence of 0.5-2% worldwide. Several precipitating factors by chemical exposure and skin injury present commonly in patients with vitiligo. Although the diagnosis appears to be straightforward for the distinct clinical phenotype and specific histological features, vitiligo provides many challenges including chronicity, treatment resistance, frequent relapse, associated profound psychosocial effect, and negative impact on quality of life. Multiple mechanisms are involved in melanocyte disappearance, including genetics, environmental factors, and immune-mediated inflammation. Compelling evidence supports the melanocyte intrinsic abnormalities with poor adaptation to stressors leading to instability and release of danger signals, which will activate dendritic cells, natural killer cells, and innate lymphoid cells to initiate innate immunity, ultimately resulting in T-cell mediated adaptive immune response and melanocyte destruction. Importantly, the cross- talk between keratinocytes, melanocytes, and immune cells, such as interferon (IFN)-γ signaling pathway, builds inflammatory loops that give rise to the disease deterioration. Improved understanding of the immune pathogenesis of vitiligo has led to the development of new therapeutic options including Janus kinase (JAK) inhibitors targeting IFN-γ signaling pathways, which can effectively reverse depigmentation. Furthermore, definition of treatment goals and integration of comorbid diseases into vitiligo management have revolutionized the way vitiligo is treated. In this review, we highlight recent developments in vitiligo clinical aspects and immune pathogenesis. Our key objective is to raise awareness of the complexity of this disease, the potential of prospective therapy strategies, and the need for early and comprehensive management.
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