Saeedeh Farajzadeh; Mahin Aflatoonian; Saman Mohammadi; Hamid Sharifi; Maryam Khalili
Abstract
Background: Hyperhomocysteinemia and vitamin D deficiency maybe involved in the pathogenesis of vitiligo. This study comparedthe serum levels of vitamin D, homocysteine, vitamin B12, andfolic acid between vitiligo-affected children and healthy children.Methods: Using a case-control design, 30 children ...
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Background: Hyperhomocysteinemia and vitamin D deficiency maybe involved in the pathogenesis of vitiligo. This study comparedthe serum levels of vitamin D, homocysteine, vitamin B12, andfolic acid between vitiligo-affected children and healthy children.Methods: Using a case-control design, 30 children with vitiligoand 30 age and sex-matched healthy children were enrolledfrom April 2018 to August 2020. Serum levels of vitamin D,homocysteine, vitamin B12, and folic acid were analyzed in bothgroups during the same season of the year. Additionally, theassociation between serum levels of these factors with demographicand clinical features of the children (collected by interview andphysical examination) was evaluated. Data were analyzed usingthe independent T-test, Fisher’s exact test, and chi-squared test.Results: The vitiligo group had significantly lower vitamin Dand folic acid serum levels compared with the control group[95% CI -19.87 to -2.96 and -4.15 to -4.18, respectively]. Amongpatients, the vitamin D level was negatively correlated with age(r = -0.459, P = 0.011) and disease duration (r = -0.373, P = 0.042).Moreover, there was a significant association between vitiligoactivity and serum homocysteine levels (P = 0.027).Conclusion: Routine measurement of vitamin D and folic acidserum levels might be suggested, especially in children withlong-standing disease. Monitoring the homocysteine level maybe beneficial, particularly in children with progressive vitiligo.
Abdul Malik Hooshmand; Nasar Ahmad Shayan
Abstract
Background: Vitiligo is a chronic pigmentary disorder of the skin. Although predominantly asymptomatic and not life-threatening, vitiligo may considerably affect patients’ quality of life (QoL). It has been suggested that vitiligo patients suffer from low selfesteem and poor body image, which may ...
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Background: Vitiligo is a chronic pigmentary disorder of the skin. Although predominantly asymptomatic and not life-threatening, vitiligo may considerably affect patients’ quality of life (QoL). It has been suggested that vitiligo patients suffer from low selfesteem and poor body image, which may cause a lower level of QoL. The objective of this study was to evaluate the effect of vitiligo on patients’ QoL in Herat, Afghanistan.Methods: This descriptive study was conducted at Hooshmand Skin and Cosmetic Hospital and the associated phototherapy center from November 2015 to April 2017. A total of 170 patients above 16 years of age were recruited. A valid translated Persian version of the Dermatology Life Quality Index (DLQI) was completed by subjects, and data were collected using structured datasheets.Result: On average, patients were 27.84 ± 10.74 years old, and 40.6% were males. The overall mean DLQI score was 9.72 ± 5.82, including 9.93 ± 4.64 in women and 9.42 ± 6.11 in men. The DLQI score was significantly related to the age, type of disease, treatment history, and employment status. Compared to males’, females’ QoL was more impaired in feeling (Q2) and type of clothing (Q4) (P = 0.020 and P = 0.021, respectively).Conclusion: Vitiligo patients showed a moderate limitation in their QoL. Hence, the managing team should focus on the QoL and psychosocial well-being of vitiligo patients in addition to their clinical condition.
Mojgan Karbakhsh; Kosar Hedayat; Azadeh Goodarzi; Maryam Ghiasi; Narges Ghandi
Abstract
Background: Vitiligo is a stigmatizing, chronic, and usually progressive skin disorder that affects patients' quality of life and can interfere with their social participation. There are no studies in developing countries focusing on this aspect. Hence, we assessed social participation in patients with ...
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Background: Vitiligo is a stigmatizing, chronic, and usually progressive skin disorder that affects patients' quality of life and can interfere with their social participation. There are no studies in developing countries focusing on this aspect. Hence, we assessed social participation in patients with vitiligo and its associations with Vitiligo Quality of Life (VitiQoL), Vitiligo Area Score Index (VASI), and demographic and clinical characteristics. Methods: This cross-sectional study was conducted between 2013-2014 on 170 patients, in Razi Hospital, Tehran, Iran. In the pilot phase, the Persian version of the Participation Scale (P-scale) and VitiQoL questionnaire were validated with the backward-forward translation method. Results: Among 173 vitiligo patients, the mean participation score was 15.12 (SD=13.88, median=11). Overall, 91 patients (52.6%) had no significant restriction, 38 (22%) suffered from mild, 23 (13.3%) moderate, 20 (11.6%) severe, and 1 (0.6%) suffered from extreme restriction in participation. The association between VitiQol and P-scale was highly significant (r=0.58; p <0.001). This association was also observed with the three subscales of VitiQol, namely participation limitation (r=0.59, p <0.001), behavior (r=0.43, p <0.001), and stigma (r=0.23, P=0.002). We did not find a significant association between P-scale and demographic characteristics, overall VASI, and face, genitals, and exposed areas VASI. Conclusion: Although the majority of our patients perceived no or mild limitation in their social participation, the P-scale score was highly correlated with their quality of life and its components.
Akbar Mokhtarpour neilagh; Farzam Alizadeh; Mehdi Aghazadeh Barenji; Shahin Behrouz Sharif; Amin Sedokani
Abstract
Background: Vitiligo is an acquired disorder characterized by the selective destruction of melanocytes, culminating in white macules on the skin. It usually begins at an early age; however, late-onset vitiligo also may occur. The disease burden arising from the psychological effects, ...
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Background: Vitiligo is an acquired disorder characterized by the selective destruction of melanocytes, culminating in white macules on the skin. It usually begins at an early age; however, late-onset vitiligo also may occur. The disease burden arising from the psychological effects, especially during childhood, highlights the importance of epidemiological studies of this disease and investigations of differences of disease features between earlyonset and late-onset forms.Methods: A total of 234 vitiligo patients were included in this study and divided into two groups considering the age of onset. The disease characteristics and clinicopathological features of the patients were obtained and compared using written questionnaires.Results: Overall, 25.6% of patients were early-onset and the mean of age in this group was 18.86 years compared with 37.14 years in the late-onset group. The most frequent involvement sites for the early-onset and late-onset groups were the eyelid and hand, respectively. A significant difference was observed between the groups regarding thyroid disorder as a comorbid disease.Conclusion: Marked differences in clinical features were present between patients with early-onset and late-onset vitiligo. Females were more prevalent in the early-onset group and the frequency of thyroid disorder was less relative to the late-onset group. Further studies with different age cut-offs for categorizing early and late-onset vitiligo seem necessary.
Sonal Agarwala; Shashikant Malkud
Abstract
Background: Vitiligo is an acquired condition resulting from the progressive loss of melanocytes. It may be associated with disorders of pigmented tissues of the eyes and ears, and withdisorders of the endocrine organs. Aim: To study the clinico-demographic profile of vitiligo patientsand ...
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Background: Vitiligo is an acquired condition resulting from the progressive loss of melanocytes. It may be associated with disorders of pigmented tissues of the eyes and ears, and withdisorders of the endocrine organs. Aim: To study the clinico-demographic profile of vitiligo patientsand its association with endocrine disorders and audiological and ocular abnormalities. Materials and Methods: This was a case-control study conducted at a tertiary care hospital; 261 vitiligo patients were enrolled together with 100 age- and gender-matched healthy individuals without vitiligo as the controls. A detailed history and clinical examination, including audiological and ocular examination, was undertaken; blood investigations like random blood sugar, thyroid function tests, and serum cortisol levels were requested for all subjects. Results: Vitiligo vulgaris was the most common type of disease detected in 146 (55.93%) patients, followed by focal vitiligo in59 (22.60%), mucosal vitiligo in 31 (11.87%), acrofacial vitiligo in 16 (6.13%), segmental vitiligo in 8 (3.06%), and universal vitiligo in one (0.38%) patient. Endocrine disorders were noted in 40 (15.32%) patients, which included hypothyroidism in 27, hyperthyroidism in 5, and diabetes in 8 patients. Sensorineural hypoacusis andocular abnormalities were noted in 56 (21.45%) and 49 (18.77%) vitiligo patients respectively. The association of hypothyroidism, sensorineural hypoacusis, and ocular abnormalities with vitiligowas statistically significant. Conclusion: Vitiligo is not limited to cutaneous melanocytes; it also affects pigment cells throughout the body. Patients with increased age, prolonged duration of disease, and greater bodysurface area involvement are at increased risk for systemic associations. A thorough clinical evaluation seems necessary for all vitiligo patients.
Mohammad Ahmad Abdalla; Mohammad Shahatha Nayaf; Sura Zahim Hussein
Abstract
Background: Vitiligo is a skin disease caused by the destruction of melanocytes of the epidermis, leading to well-defined white patches that are often distributed symmetrically. The presentstudy aimed to determine the correlation relationship between the α-MSH and vitamin D serum levels among Iraqi ...
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Background: Vitiligo is a skin disease caused by the destruction of melanocytes of the epidermis, leading to well-defined white patches that are often distributed symmetrically. The presentstudy aimed to determine the correlation relationship between the α-MSH and vitamin D serum levels among Iraqi vitiligo patients. Materials and Methods: This study was done on outpatients who attended the Dermatology and Venereology Consulting Clinic of Salah-Al Deen General Hospital from November 2017 to March 2018. One hundred and ninety individuals were stratified into 110 cases of vitiligo and 80 healthy controls. Serum assays for α-MSH and vitamin D levels were sent for all subjects. Results: Vitiligo patients had significantly lower α-MSH levels and vitamin D levels than the controls (P ≤ 0.01). There was a significant, positive correlation between α-MSH and vitamin D levels in vitiligo patients overall (r = 0.236; P ≤ 0.01), though this correlation was negative within the male and female subgroups (r = -0.392 and -0.661, respectively; P ≤ 0.01). Conclusion: Compared to normal controls, vitiligo patients had significantly lower levels of α-MSH and vitamin D. These findings may back the normalization of both α-MSH and vitamin D levels in vitiligo patients as an important step toward disease recovery.
Nasrin Saki; Alireza Heiran; Elham Sheikhi Ghayur
Abstract
Vitiligo is a pigmentation disorder involving 1% of the population. One of the first line depigmenting agents is monobenzyl ether of hydroquinone (MBEH). Repigmentation following sun exposure; however, can occur after successful treatment with MBEH. This study describes a 54-year-old gentleman who presented ...
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Vitiligo is a pigmentation disorder involving 1% of the population. One of the first line depigmenting agents is monobenzyl ether of hydroquinone (MBEH). Repigmentation following sun exposure; however, can occur after successful treatment with MBEH. This study describes a 54-year-old gentleman who presented with a 7-year history of hyperpigmented lesions on his face following depigmentation therapy with MBEH. The patient was successfully treated with intralesional injections of tranexamic acid.
Nahidi Yalda; Layegh Pouran; Naser Tayyebi Meibodi; Vida Vakili; Golsan Kardan
Abstract
Background: Vitiligo is a pigmentation disorder of the skin characterized by the loss of melanocytes through different mechanisms. Narrow band UVB (NBUVB) is a safe and effective treatment for vitiligo that acts by inducing the synthesis of cytokines involved in melanogenesis. NBUVB appears to be involved ...
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Background: Vitiligo is a pigmentation disorder of the skin characterized by the loss of melanocytes through different mechanisms. Narrow band UVB (NBUVB) is a safe and effective treatment for vitiligo that acts by inducing the synthesis of cytokines involved in melanogenesis. NBUVB appears to be involved in the treatment of vitiligo by increasing the synthesis of vitamin D, which prevents the apoptosis of melanocytes; accordingly, we set out to compare the serum level of vitamin D and its variations following NBUVB treatment according to the degree of response to treatment.
Methods: Thirty-eight patients with vitiligo were subject to phototherapy with NBUVB. Photographs of vitiligo lesions were taken prior to and after completing 60 phototherapy sessions. Further measured were the serum level of 25-hydroxyvitamin D3, VASI score and repigmentation rate before and after the treatment period. Finally, the relationship between the changes in serum vit D3 levels and variations of VASI score was investigated.
Results: Mean serum level of vitamin D3 was 20.78 ng/ml after treatment, which is significantly more compared to the period before the treatment (15.42, P=0.001). Mean VASI score was 5.45 before the treatment, yet was reduced to 2.24 after treatment, which is a significant change (P<0.001); however, the changes in vitamin D3 levels were not significantly correlated with VASI score (P=0.137).
Conclusion: The repigmentation rate in vitiligo lesions are not significantly correlated with serum vitamin D3 levels. Therefore, NBUVB is not likely to improve vitiligo lesions through the increase in serum vitamin D levels.
Maghami Zohreh; Mozhdeh Sepaskhah; Sarani Ebrahim Moghimi; Bagheri Zahra; Maghami Mohamad
Abstract
Background: Vitiligo is a common pigmentary disorder affecting mental health, and alexithymia is a trait associated with multiple cutaneous disorders. This study was conducted to compare vitiligo patients and controls as concerns alexithymia. Methods: Fifty-two patients with vitiligo and 61 non-vitiligo ...
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Background: Vitiligo is a common pigmentary disorder affecting mental health, and alexithymia is a trait associated with multiple cutaneous disorders. This study was conducted to compare vitiligo patients and controls as concerns alexithymia. Methods: Fifty-two patients with vitiligo and 61 non-vitiligo individuals were recruited. They completed Toronto alexithymia score-20 questionnaire. Independent sample t-test and Chi-square tests were used for comparing numerical and categorical variables, respectively. P value ? 0.05 was considered statistically significant. Results: Twenty vitiligo patients were alexithymic, while 14 were borderline alexithymic. Thirteen, 16, and 32 control people were alexithymic, borderline alexithymic and non-alexithymic, respectively (p value: 0.096). Although alexithymia and borderline alexithymia were not significantly more prevalent in vitiligo patients (p value: 0.57), they were more likely to be high alexithymic (TAS ? 61) compared with the control group (p value: 0.02). Comparisons with the controls, patients obtained significantly higher scores associated with subscales of difficulty in identifying feelings (DIF) and difficulty in describing feelings (DDF) (p value: 0.002 and 0.02 respectively). Patients with lower education obtained higher alexithymia scores (p value: 0.009). Conclusion: High alexithymia and higher DIF and DDF subscales are more prevalent in vitiligo patients in comparison with control population. Patients with lower levels of education are more alexithymic.
Lajevardi Vahideh; Ghiasi Maryam; Falahati Ali Asghar; Goodarzi Azadeh
Volume 20, Issue 3 , 2017, , Pages 69-74
Abstract
Background: Vitiligo is an acquired skin discoloration with melanocytic destruction. Vitiligo is associated with other autoimmune disorders; hence, an autoimmune etiology is among the most important theories for this disorder. The nails can be involved in numerous cutaneous or systemic non-cutaneous ...
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Background: Vitiligo is an acquired skin discoloration with melanocytic destruction. Vitiligo is associated with other autoimmune disorders; hence, an autoimmune etiology is among the most important theories for this disorder. The nails can be involved in numerous cutaneous or systemic non-cutaneous disorders. We have taken into consideration previous studies on nail abnormalities in vitiligo and alopecia areata (AA), which are ethologically closely-related, in addition to the few, notwell designed studies on nail changes in vitiligo, and lack of similar studies in Iran. This case-control study was conducted to evaluate the autoimmune etiology of vitiligo with a larger number of participants.Methods: In this case-control study, we assessed the nail characteristics of 303 participants at Razi Hospital, Tehran, Iran from 2013-2014. These changes were also assessed in terms of diseases properties of the case group and included distribution, duration, and presence of other concomitant cutaneous disorders.Results: There was a statistically significant odd’s ratio (OR) for leukonychia in the case and control groups. The relationship between the prevalence of leukonychia and disease duration was meaningful (P0.05). There was no other significant difference between each type of nail abnormality in the case and control groups. We observed no association between these abnormalities and disease duration. None of the nail abnormalities, including leukonychia, had an association with distributionpattern of the disorder.Conclusion: Leukonychia was the most common abnormality in nails of vitiligo patients that had a relation to disease duration.
Ghiasi Maryam; Lajevardi Vahide; Farahbakhsh Abbas
Volume 18, Issue 2 , 2015, , Pages 45-50
Abstract
Background and Aim: Vitiligo is a hypopigmentation disorder of the skin that is associated with depression and an impaired quality of life. There has been conflicting reports on the association between the disease and the serum levels of homocysteine, vitamin B12, and folic acid.In this study,serum levels ...
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Background and Aim: Vitiligo is a hypopigmentation disorder of the skin that is associated with depression and an impaired quality of life. There has been conflicting reports on the association between the disease and the serum levels of homocysteine, vitamin B12, and folic acid.In this study,serum levels of homocysteine, vitamin B12, and folic acid were evaluated in patients with vitiligo.Methods: Thirty patients with vitiligo and 30 age- and sex-matched healthy controls were recruited. Venous blood samples wereobtained from the study subjects and the levels of homocysteine, vitamin B12, and folic acid were measured. Data were analyzedusing non-parametric statistical tests.Results: No significant differences were found in the levels of serum homocysteine, vitamin B12, and folic acid between vitiligo patients and healthy controls. Moreover, there were no associations between these factors and age, body weight, gender,as well as the extent, duration, and type of vitiligo.Conclusion: It seems that vitiligo is not related to serum levels of homocysteine, vitamin B12, and folic acid.
Yalda Nahidi; Naser Tayyebi Meibodi; Habibollah Esmaili
Volume 17, Issue 3 , 2014, , Pages 81-84
Abstract
Background: Vitiligo is a common cutaneous depigmentation disorder caused by the destruction of melanocytes. The exact etiopathogenesis of this disorder is not well known, but a complex of genetic, immunologic, inflammatory, and cytotoxic factors have been implicated. According to ...
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Background: Vitiligo is a common cutaneous depigmentation disorder caused by the destruction of melanocytes. The exact etiopathogenesis of this disorder is not well known, but a complex of genetic, immunologic, inflammatory, and cytotoxic factors have been implicated. According to reports on the role of vitamin B12 and folic acid deficiency as important co-factors in the metabolism of homocysteine, we expected an increase in homocysteine levels in patients with vitiligo; therefore, our aim was to investigate the serum levels of homocysteine in Iranianpatients with vitiligo.Method: Forty patients with vitiligo and 40 healthy controls matched for age and sex were studied. After exclusion of cases with diseases that could affect the homocysteine level, serum homocysteine levels were measured by ELISA.Result: Males comprised 57.5% of the participants in both groups and 42.5% were female. The mean age of the patients was 24.68 ± 12.44 years. The level of homocysteine in the case andcontrol groups was 18.56 ± 5.69 and 10.19 ± 4.40, respectively, which was significantly higher in patients with vitiligo (P ? 0.001). There was no correlation between homocysteine levels and age,sex, history of previous treatment, duration of disease, and the extent of body surface involvement. Serum homocysteine levels in patients with regressive vitiligo (13.8) were lower thanprogressive (18.4) and stable (20.4) cases (P = 0.05).Conclusion: We found that the increase in serum homocysteine level in patients genetically susceptible to vitiligo could be a predisposing factor for the development of vitiligo. The serumhomocysteine level is associated with disease activity, and may be used as a prognostic factor for disease activity.
Lajevardi Vahideh; Nazemi Mohammad Javad; Khodashenas Zohreh; Ebadi Mohammad-Sadegh
Volume 17, Issue 2 , 2014, , Pages 59-62
Abstract
Background: Generalized vitiligo is characterized by autoimmunedestruction of melanocytes, which results in patches of thedepigmented skin and the overlying hair. Vitamin D is an essentialhormone synthesized in the skin and is responsible for skinpigmentation. Low vitamin D levels have been noted in ...
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Background: Generalized vitiligo is characterized by autoimmunedestruction of melanocytes, which results in patches of thedepigmented skin and the overlying hair. Vitamin D is an essentialhormone synthesized in the skin and is responsible for skinpigmentation. Low vitamin D levels have been noted in patientswith a variety of autoimmune diseases. A recent study showedthat low vitamin D levels may be associated with vitiligo. Theaim of this study was to compare 25-hydroxyvitamin D (25[OH]D) levels in Iranian patients with vitiligo with normal controls.Method: In this case-control study, we studied 30 newly diagnosedpatients with vitiligo and 30 healthy controls through a casecontrol design. Two groups were matched for gender, age, andthe season in which the serum levels of 25-hydroxy vitamin Dwere measured. The serum levels were categorized as sufficient,insufficient and deficient.Result: The mean serum level of vitamin D was 10.24±1.27 ng/mL in patients compared to 18.31±7.39 ng/mL in the controlgroup. Male patients had lower levels of vitamin D compared tocontrols (7.25 ng/mL vs. 13.31ng/mL, P=0.03), while no significantdifference was observed between females and controls (14.12 ng/mL vs. 16.25 ng/mL, P=0.51).Conclusion: The present study demonstrated that there may be anassociation between low levels of Vitamin D3 and vitiligo in men.
Shahzad Shahid; Taheri Ahmad Reza; Javidi Zari; Dorgalaleh Akbar; Tabibian Shadi; Bamedi Taregh; Dorgalaleh Saeed; Moemeni Mohammad
Volume 17, Issue 1 , 2014, , Pages 22-26
Abstract
Background: Vitiligo is a common acquired disorder of the skin. The disease is characterized by depigmented macules and patches on the skin. Autoimmunity has a crucial role in the pathogenesis of the vitiligo. Vitiligo is frequently associated with different autoimmune diseases such as thyroid abnormalities ...
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Background: Vitiligo is a common acquired disorder of the skin. The disease is characterized by depigmented macules and patches on the skin. Autoimmunity has a crucial role in the pathogenesis of the vitiligo. Vitiligo is frequently associated with different autoimmune diseases such as thyroid abnormalities and diabetes. This study aimed to evaluate the association between vitiligo and diabetes mellitus.Method: This case-control study was conducted on 70 patients with established vitiligo disorder and 70 non vitiligo individuals as the control group. In the case group, we performed two tests, fasting blood sugar (FBS) and oral glucose oral tolerance test (OGTT), while only FBS was checked in the control group.Result: The results of our study showed that out of 70 people in the case group, 18 (25.71%) had impaired FBS while only 4 (5.7%) had impaired GTT3. Statistical analysis showed p-value=0.015 which indicated a significant difference in impaired FBS between case and control groups. We had half and 1 hour GTT data (GTT1 and GTT2) and all patients with impaired GTT1 (4 individuals) and GTT2 (5 individuals) were females with a significant difference (P-value = 0.021 and 0.017, respectively).Conclusion: Periodical laboratory investigation for diabetes mellitus in vitiligo patients, particularly in females, seems to be necessary.
Handjani Farhad; Kalafi Amir
Volume 16, Issue 4 , 2013, , Pages 128-131
Abstract
Background: Chronic skin diseases such as vitiligo and psoriasis can impair the quality of life in the patients with these diseases. The impact of chronic and/or severe skin diseases on the lives of family members of the affected patients has only recently been addressed. The tool used for this assessment ...
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Background: Chronic skin diseases such as vitiligo and psoriasis can impair the quality of life in the patients with these diseases. The impact of chronic and/or severe skin diseases on the lives of family members of the affected patients has only recently been addressed. The tool used for this assessment is the Family Dermatology Life Quality Index (FDLQI). The aim of this study was to use the FDLQI to assess the impact of four skin diseases (pemphigus, psoriasis, vitiligo, and cutaneous leishmaniasis) on family members of the affected patients.Method: Fifty healthy family members of 50 patients with pemphigus, psoriasis, vitiligo, and cutaneous leishmaniasis were included in this study. The patients had to have an extensive disease with disease duration of at least one month. One family member of each patient completed the 10- item Persian version of the FLDQI questionnaire. The score of this index ranged from 0 to 30.Result: The mean duration and mean FDLQI score of the diseases were as follows: psoriasis (mean duration=4.1±2.7, mean FDLQI score=14.7±5.01), pemphigus (mean duration=3.6±2.3, mean FDLQI score=15.4±4.7), vitiligo (mean duration=5.1±4.05, mean FDLQI score=14.4±5.08) and cutaneous leishmaniasis (mean duration=0.62±0.23, mean FDLQI score=12.0±4.3). There was no significant difference among the groups (p=0.562). In addition, no strong correlation was observed between the mean duration of the disease and mean FDLQI scores for each condition (r=0.051, p=0.726).Conclusion: This small-scale study demonstrated that although not statistically significant, inflammatory diseases like pemphigus had a higher FDLQI score when compared to non-inflammatory conditions like vitiligo and short-term conditions such as leishmaniasis.
Mohammad Radmanesh; Nasibeh Sohrabian; Ramin Radmanesh
Volume 16, Issue 4 , 2013, , Pages 159-161
Abstract
The patients with universal vitiligo and residual pigmented patches usually do not benefit from available repigmenting methods and are better scheduled for depigmentation by medical, laser,and or freezing procedures. A 37-year-old lady with universal vitiligo and remaining pigmentation ...
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The patients with universal vitiligo and residual pigmented patches usually do not benefit from available repigmenting methods and are better scheduled for depigmentation by medical, laser,and or freezing procedures. A 37-year-old lady with universal vitiligo and remaining pigmentation in the left anterior chest wall, both ventral forearms, and diffuse mottled depigmentation of the face was scheduled for facial depigmentation by 532 nm Q-switched Nd-YAG laser. All residual pigmented facial areas were treated uniformly. Two months after laser therapy, we paradoxically observed considerable repigmentation of the treated areas with only some remaining scattered and round depigmented patches. Through an unknown mechanism, a true reverse Koebner phenomenon with its resultant repigmentation rather than depigmentation was observed in our patient.
Abbasi Ali; Toossi Parviz; Shakoei Safoura; Abolhasani Ehsan; Younespour Shima
Volume 16, Issue 3 , 2013, , Pages 83-88
Abstract
Background: Different modalities have been tried in order totreat stable vitiligo. Culturing melanocytes is time consumingand expensive. Therefore, new methods using autologousmelanocytes are sought. We aimed to compare the mixed nonculturedautologous melanocytes of the outer root sheath andthe bulge ...
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Background: Different modalities have been tried in order totreat stable vitiligo. Culturing melanocytes is time consumingand expensive. Therefore, new methods using autologousmelanocytes are sought. We aimed to compare the mixed nonculturedautologous melanocytes of the outer root sheath andthe bulge area of hair follicle transplantation plus dermabrasionwith dermabrasion alone in stable generalized vitiligo patchesrepigmentation.Method: Eight patients with stable generalized vitiligo wererecruited. Two patches were selected and assigned to one of thestudy groups: one was treated with dermabrasion alone, andthe other was treated with dermabrasion and transplantation.Uncultured melanocytes were extracted from the patients’ hairfollicle outer root sheath and bulge. The patches were assessedmonthly for the next six months. The primary outcome was todetermine the percentage changes of the depigmented patchesfrom the baseline.Result: Although the repigmentation changes were statisticallysignificant in transplantation patches, there was only one patchwith good and another with fair pigmentation. Furthermore,seven patches without and one patch with poor pigmentationwere observed as control lesions. The transplanted patchesdemonstrated a significantly better repigmentation rate in contrastto their controls (p=0.03).Conclusion: Although this method is fast and economic, theclinical response was not satisfactory.
Hassan Seirafi; Maryam Daneshpazhouh; Somayeh Khezri; Pardis Kiani; Sara Sabouri Rad; khadijeh Moghadam; Farzaneh Khezri
Volume 14, Issue 2 , 2011, , Pages 58-63
Abstract
Background: There is a large variety of therapeutic agents for the treatment of vitiligo, but it still remains a challenge. Narrow-band UVB phototherapy and 308-nm excimer laser have been shown to be safe and effective for the treatment of vitiligo. Topical calcipotriol has recently been reported to ...
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Background: There is a large variety of therapeutic agents for the treatment of vitiligo, but it still remains a challenge. Narrow-band UVB phototherapy and 308-nm excimer laser have been shown to be safe and effective for the treatment of vitiligo. Topical calcipotriol has recently been reported to enhance the efficacy of phototherapy, especially 8-methoxypsoralen plus UVA (PUVA). The goal of this study was to evaluate whether the addition of topical calcipotriol enhances the efficacy of 308-nm excimer laser in the treatment of vitiligo. Methods: The patients with symmetrical vitiliginous lesions received 308-nm excimer laser plus Calcipotriol ointment 0.005% (Daivonex®) as the intervention group and 308 nm excimer laser plus vaselin as the control group on the lesions of the right side. All patients in the two groups applied vaselin on the lesions of the left side. The evaluation of the patients was performed at baseline and at 12th week (the last laser session). SPSS version 15.0 package software was used for statistical analysis. P-values< 0.05 were accepted as statistically significant. Results: Seventy out of 83 patients completed the study. The diameter of the right side lesions (308nm excimer laser + calcipotriol) changed from 27.21 cm2 to 15.82 cm2 in the intervention group and from 27.86 cm2 to 16.02 cm2 in the control group; This difference was not statistically significant (p-value=0.74). Conclusion: Our findings showed that 308-nm excimer laser was effective and safe in the treatment of vitiligo, and that topical calcipotriol had no additive or synergistic effect.
Fariba Ghalamkarpour; Reza Robati; Ghadeh Ghasir; Mohammad Saeedi; Nahid Mohtasham
Volume 14, Issue 1 , 2011, , Pages 12-15
Abstract
Background: Treatment of vitiligo remains an attractive topic and several therapies with varying degrees of success have been used. The aim of this study was to find out whether the combination of topical calcipotriol and excimer laser increases the efficacy of therapy compared to excimer laser alone. ...
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Background: Treatment of vitiligo remains an attractive topic and several therapies with varying degrees of success have been used. The aim of this study was to find out whether the combination of topical calcipotriol and excimer laser increases the efficacy of therapy compared to excimer laser alone. Methods: Twenty eight patients in two groups were treated with 308nm excimer laser alone (14 patients) and the combination of excimer laser–calcipotriol (14 patients). After 16 sessions, response rate, side-effects and compliance were assessed. Results: Repigmentation rate more than 50% was significantly higher in the laser- calcipotriol group. No differences were seen in complication rate between the two groups. Conclusion: Combination of calcipotriol and 308nm excimer laser might enhance the response rate without increasing treatment complications.
Mohammad Ali Mapar; Sarah Hashemzade; Reza Yaghoobi
Volume 14, Issue 1 , 2011, , Pages 20-24
Abstract
Background: Topical corticosteroids and oral psoralen plus ultraviolet A radiation (PUVA therapy) are two common treatment methods for vitiligo. The aim of this study was to compare the efficacy, complications and patterns of repigmentation of these two methods. Methods: This prospective randomized clinical ...
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Background: Topical corticosteroids and oral psoralen plus ultraviolet A radiation (PUVA therapy) are two common treatment methods for vitiligo. The aim of this study was to compare the efficacy, complications and patterns of repigmentation of these two methods. Methods: This prospective randomized clinical trial was conducted from July 2007 to October 2008. Patients with disseminated vitiligo were divided into two groups. PUVA therapy was administered in one group and topical clobetasol was used in the other group. Results were recorded in 4 categories and therapeutic findings and complications were compared after 24 weeks. Results: Among 37 participants in the PUVA therapy group, 18 (48.6%) patients achieved marked and 14 (37.8%) patients showed good repigmentation. Similarly, among 35 participants in the clobetasol group, 6 (17.1%) patients showed marked and 8 (22.8%) patients showed good repigmentation. treatment complications were observed in 16.2% of the participants in PUVA group and 28.6% of the participants in clobetasol group. The patterns of repigmentation were different in the two groups. Conclusion: PUVA showed better therapeutic effects, and did not cause significant complications. Therefore, it could be used as one of the first line medications in the treatment of vitiligo.
Pouran Layegh; Hamid Reza Arshadi; Sara Shahriari; Fakhrolzaman Pezeshkpour; Yalda Nahidi
Volume 13, Issue 4 , 2010, , Pages 106-111
Abstract
Background: Due to their chronic nature, influences on the body image, hopelessness toward complete recovery and frequent recurrences, dermatological diseases seem to be one of the important predisposing factors in depression and suicidal ideation. Thus, the present study aimed at evaluating the degree ...
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Background: Due to their chronic nature, influences on the body image, hopelessness toward complete recovery and frequent recurrences, dermatological diseases seem to be one of the important predisposing factors in depression and suicidal ideation. Thus, the present study aimed at evaluating the degree of depression and suicidal ideation in patients with psoriasis, acne, alopecia areata and vitiligo.Methods: The study was carried out on 300 patients with psoriasis, acne, alopecia and vitiligo who were referred to the dermatology clinic of Ghaem Hospital in Mashad. Beck depression questionnaire was used to collect the data which was then statistically analyzed with ANOVA and T-test, using SPSS software.Results: In this study, 35.7% (107) of the subjects were female and 64.3% (193) were male with a mean age of 26.55±10.81 years. The prevalence rate of clinical depression was found to be 47.4% in patients with acne; 69.4% in those with psoriasis; 70.1% in those suffering from vitiligo; 50% in diffuse alopecia areata; 60% in universalis alopecia areata; 100% in ophiasis alopecia areata and 68.3% in patients with localized alopecia areata. As for suicidal ideation, there was no sign in 88.3% (265); however, 6.3% (19) of the patients reported to have thought of suicide but they had no desire for the attempt while 4% (12) of them had some desire for suicide and 1.3% (4) were seriously determined to commit suicide if only they would find themselves in an appropriate situation.Conclusion: As shown by the findings of the study, there was a close relationship between dermatological diseases and psychological factors; thus, it is important to immediately diagnose concurrent psychological effects, especially those of depression and suicidal ideation. We found that there was a significant relationship between the prevalence rate of dermatological conditions and psychological effects; i.e. depression (P=0.008) and suicidal ideation (P=0.001). We also found out that the rate of suicide attempt was highest among the patients with universalis alopecia, diffuse alopecia areata and vitiligo, respectively.
Kuchangi Nischal; HB Basavaraj; Nischal Urmila; Khopkar Uday
Volume 13, Issue 3 , 2010, , Pages 96-98
Abstract
Vitiligo, an autoimmune disorder, is known to co-localize with other immunological disorders like lichen planus and psoriasis. However, there are no reports regarding the co-localization of an autoimmune disorder (vitiligo) and a developmental disorder (verrucous epidermal nevus). We hereby present a ...
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Vitiligo, an autoimmune disorder, is known to co-localize with other immunological disorders like lichen planus and psoriasis. However, there are no reports regarding the co-localization of an autoimmune disorder (vitiligo) and a developmental disorder (verrucous epidermal nevus). We hereby present a 10-month-old infant who was visited for white patches on the right buttock and adjoining anterolateral thigh since 2 months of age. Lesions started as flat depigmented patches which gradually became raised. Examination revealed depigmented verrucous plaques along Blaschko’s lines on the right buttock and adjoining thigh with depigmented macules and patches in the periphery. Histopathology revealed features of classical verrucous epidermal nevus in addition to focal interface dermatitis. Immunohistochemistry showed melanocytopenia. Hence, this was a rare case of verrucous epidermal nevus co-localized with a vitiliginous patch, clinically simulating a depigmented variant of verrucous epidermal nevus.
Sankha Koley; Atul Salodkar; Vikrant Saoji; Sanjiv Choudhary
Volume 12, Suppl.3 , 2009, , Pages 8-11
Abstract
Piebaldism is an autosomal dominant uncommon (<1 in 20,000) congenital pigmentary disorder. Depigmented patches are present since birth. They usually remain unchanged throughout life. Vitiligo is its closest differential diagnosis. We report a unique family in which these two dissimilar depigmentations, ...
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Piebaldism is an autosomal dominant uncommon (<1 in 20,000) congenital pigmentary disorder. Depigmented patches are present since birth. They usually remain unchanged throughout life. Vitiligo is its closest differential diagnosis. We report a unique family in which these two dissimilar depigmentations, i.e. piebaldism and vitiligo (with nevus depigmentosus), were noted in two brothers. To the best of our knowledge, this is the first report of this presentation in the literature.
Hefazi Mahyar T; Moslehi Homayon; Ehsani Amir H; Ostadrahimi Nima
Volume 12, Suppl.3 , 2009, , Pages 16-18
Abstract
Vitiligo and Lichen Planus, two common dermatologic disorders, are expected to coexist. This leads to diverse theories regarding their immunopathogenesis linkage. In this case, we report a twenty-year-old man suffering from simultaneous lichen planus and vitiligo which were both generalized at the time ...
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Vitiligo and Lichen Planus, two common dermatologic disorders, are expected to coexist. This leads to diverse theories regarding their immunopathogenesis linkage. In this case, we report a twenty-year-old man suffering from simultaneous lichen planus and vitiligo which were both generalized at the time of observation and also concomitant throughout their entire course of progression. Lichen Planus papules were located on sun-exposed areas and non sun-exposed areas; both on vitiligenous areas and non-vitiligenous areas diminishing current theories about the association of the two diseases. Since we did not have the patient’s consent to perform a series of biopsies, we were unable to evaluate dermatopathology of the two diseases at different sites in regard to sun exposure. Further extensive researches on larger scales seem warranted to propose any kind of theory regarding their interconnection.
Maleki Masoud; Javidi Zari; –rad Mohammad Ebrahimi; Hamidi Hamid
Volume 11, Issue 2 , 2008, , Pages 55-59
Abstract
Background: Surgical treatments of vitiligo are punch grafting, blister grafting, flip-top transplantation, split skin grafting, etc aiming at rebuilding of melanocytic population in those patients who do not respond to medical treatment . The objective of this study was determination of efficacy of ...
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Background: Surgical treatments of vitiligo are punch grafting, blister grafting, flip-top transplantation, split skin grafting, etc aiming at rebuilding of melanocytic population in those patients who do not respond to medical treatment . The objective of this study was determination of efficacy of blister grafting technique in the treatment of vitiligo. Methods: This study was done on 10 patients with vitiligo of face and /or distal extremities who had received different medical treatments including PUVA and had not responded, and their diseases were stable. Blister in recipient site was created by cryotherapy and in donor site by using vacuum device. Then donor site blister was transferred to the recipient site and both sites were covered by dressing. Results: 10 patients (8 females & 2 males) with mean age of 31.2±11.4 years entered the study. After 1-6 weeks, first signs of repigmentation were observed and after 4 months complete repigmentation occured in 7 patients (70%) In two patients, a repigmentation of more than 50% was observed while in one patient no pigmentation was seen which was related to errors in surgical technique. Conclusion: Blister grafting surgery in limited patches of vitiligo which have not responded to medical treatments gives excellent results of prolonged repigmentation without any scar formation.