The polymorphism of catalase T/C codon 389 in exon 9 and vitiligo susceptibility: a meta‐analysis

Background The exact aetiology of vitiligo has not yet been established. Oxidative stress is involved in the pathophysiology of vitiligo. It has been described that some polymorphisms in the catalase (CAT) gene may affect the risk of vitiligo. However, the results were inconsistent. Objective We performed a meta‐analysis of the published studies to derive a more precise estimate of the association between CAT T/C at codon 389 in exon 9 polymorphisms and vitiligo risk. Methods The PubMed, Medline, Cochrane Library, China National Knowledge Infrastructure (CNKI) databases were searched to identify relevant published studies. Results Four case–control studies (cases, 645; controls, 689) that investigated the association between C/T polymorphisms of CAT exon 9 and the risk of vitiligo were retrieved and analysed. Our findings suggested a significant association between the CAT T/C exon 9 polymorphism and vitiligo risk (CT + TT vs. CC pooled odds ratio, 1.43; 95% confidence interval, 1.14–1.80; P = 0 .002). Conclusion We found a significant correlation between the CAT T/C exon 9 polymorphism and the risk of vitiligo.     

Photo(chemo) therapy for vitiligo

Vitiligo has always been difficult to treat. Several modes of treatment are available, but the therapeutic effect varies greatly, and rarely does one achieve complete repigmentation. One of the most efficient treatment methods is photo(chemo) therapy. Already in ancient Egypt, vitiligo lesions were treated with extracts of the Ammi maius plant followed by exposure to the sun. This principle is at the basis of the photochemotherapy or PUVA therapy, whereby UVA irradiations are given 2 h after administration of 8-methoxypsoralen, a photosensitizer. Another efficient treatment form is UVB phototherapy, particularly narrow-band UVB. This not only gives good therapeutic results but also has the advantage of eliminating the need for a photosensitizer. All these treatments must be applied for many months to be efficient. They can also be combined with various surgical skin-grafting techniques. A newer approach is targeted UVB phototherapy, whereby xenon-chloride lasers or monochromatic excimer light is used.     

Cosmetic camouflage advice improves quality of life

BACKGROUND: The subjective benefit of attendance at cosmetic clinics has not previously been reported. OBJECTIVES: To assess the effect on perceived quality of life (QoL) of cosmetic camouflage advice. METHODS: In a three-centre study, 135 individuals were invited to complete a dermatology-specific QoL measure, the Dermatology Life Quality Index (DLQI), before and 1 month after their first visit to a cosmetic camouflage clinic. RESULTS: Eighty-two completed DLQI questionnaires were returned before the camouflage clinic appointment, and 56 corresponding questionnaires were returned 1 month after. The mean age of responders was 50 years, and the mean duration of their skin conditions was 15 years. The main conditions seen were pigmentary disorders (29%), scars (22%) and vascular disorders (13%). There was a significant difference in mean DLQI scores before and after the clinic visit (9.1 vs. 5.8, P = 0.0001). CONCLUSIONS: When assessed at 1 month, attendance at a cosmetic camouflage clinic appears to improve QoL significantly.     

Evaluation of cosmetic tattooing in localised stable vitiligo

Thirty patients with localised stable vitiligo were selected from the Out Patient Department for cosmetic tattooing. Of them, 19 cases (63.3%) had skin patches, 9 cases (30%) had mucosal patches, and 2 cases (6.7%) had both skin and mucosal involvement. After complete clinical evaluation, cosmetic tattooing was performed on these patients, and they were followed up for 6 months. As results, 23 cases (76.7%) had excellent color matching, 2 cases (6.7%) had good color matching, and 5 cases (16.6%) had pigment shedding. Excellent results were seen in all mucosal patches. Dark complexion cases showed better results than fair complexion ones.     

白癜风浓缩丸和澳能乳膏治疗白癜风临床观察

目的 观察白癜风浓缩丸与澳能乳膏治疗白癜风的疗效.方法 治疗组服用白癜风浓缩丸和局部外用澳能乳膏治疗白癜风28例,并与对照组服用白癜风丸和局部外用澳能乳膏治疗白癜风26例作对照观察.结果 两组疗效比较,两组总有效率有显著性差异(P＜0.05),治疗组优于对照组.结论 白癜风浓缩丸与澳能乳膏合用,疗效好,副作用少,是治疗白癜风有效的方法.     

Optimal weekly frequency of 308-nm excimer laser treatment in vitiligo patients

BACKGROUND: Recently the beneficial effect of excimer laser treatment has been reported for patients with vitiligo. The influence of treatment frequency on this effect is not clear. OBJECTIVES: To determine the optimal frequency of 308-nm excimer laser therapy for vitiligo. METHODS: In this prospective, university-based hospital study over 12 weeks we enrolled 14 patients. Each had at least three stable vitiligo lesions in the same body area. The three stable vitiligo lesions in each subject were randomly assigned to receive excimer laser treatment once (1 x), twice (2 x) and three times (3 x) weekly, respectively. The initial ultraviolet (UV) dose was 50 mJ cm(-2) less than the 308-nm minimal erythematous dose in vitiligo skin. The UV dose was increased at each treatment session according to the erythematous response to the previous treatment. RESULTS: Thirteen subjects were treated for at least 6 weeks; seven were treated for all 12 weeks. At 6 weeks, the repigmentation rates for treated lesions were 8% (1/13) after 1 x weekly treatment, 23% (3/13) after 2 x weekly treatment and 62% (8/13) after 3 x weekly treatment (P = 0.0134; 3 x vs. 1 x weekly); at 12 weeks, these rates were 46% (6/13), 62% (8/13) and 69% (9/13), respectively (P = NS; 3 x vs. 1 x weekly). Repigmentation initiation correlated with treatment number, regardless of frequency (P = NS). As shown by Kaplan-Meier analysis, repigmentation occurred earliest in the most frequently treated lesions (P = 0.0336). At 12 weeks, the projected repigmentation rates for 1 x, 2 x and 3 x weekly treatment approached each other (60%, 79% and 82%, respectively); the mean repigmentation grades (on a scale of 0-5) for 1 x, 2 x and 3 x weekly treatment were 1.7, 2.4 and 3.3, respectively (P = 0.018; 3 x vs. 1 x weekly). Laser-induced repigmentation persisted in most cases over the entire follow-up of 12 months after the end of treatment. CONCLUSIONS: 308-nm excimer laser therapy is effective against vitiligo. Although repigmentation occurs fastest with 3 x weekly treatment, the ultimate repigmentation initiation seems to depend entirely on the total number of treatments, not their frequency. However, treatment periods of more than 12 weeks may be necessary to obtain a satisfactory clinical repigmentation, particularly when vitiligo lesions are treated only 1 x or 2 x compared with 3 x weekly.     

Treatment of Vitiligo with 308-nm xenon-chloride excimer laser: therapeutic efficacy of different initial doses according to treatment areas

Many preliminary data suggest that the 308-nm excimer laser can be a highly effective therapeutic alternative for treating vitiligo, inducing rapid repigmentation with minimal ultraviolet irradiation. We evaluated the clinical efficacy of the 308-nm excimer laser treatment for various body areas, using different initial UV doses. One hundred forty vitiligo patches from 69 patients were assigned to 4 groups; face and neck, trunk, extremities, and acral and joint areas. They were then treated twice a week, using different initial UV doses. The rate of repigmentation continued to increase with the number of treatments up to 20 sessions, and then showed plateaus between 20 to 30 sessions. On the other hand, the lesions in acral and joint areas showed the worst responses throughout the treatment sessions. Our findings extend previous observations that the 308-nm excimer laser is an effective treatment option for patients with vitiligo. However, further studies will be needed to determine the optimal dosing and administration method, especially for acral and joint areas.     

Management of dyschromias in ethnic skin

Pigmentary disorders are one of the most common skin disorders among people of color. Dyspigmentation in the form of either hyperpigmentation or hypopigmentation is often psychologically devastating to patients with darker skin. There is marked contrast between normally pigmented hyperpigmented, hypopigmented or depigmented skin in people of color. Despite being common, pigmentary disorders remain difficult to treat.     

Phototherapy and PUVA photochemotherapy in children

The use of phototherapy and photochemotherapy in children has been limited due to concerns over their long-term carcinogenic potential. Furthermore, the method of administration is disconcerting to some children, particularly as phototherapy treatment units are seldom rendered 'child-friendly'. Despite these reservations, ultra-violet therapies can be useful treatment options for children with selected dermatological conditions provided they are used under carefully controlled conditions.     

Vitiligo skin types in Koreans

There is uncertainty and controversy about the relationship between skin type and development of vitiligo. The present study was undertaken to study whether vitiligo patients have a different skin type than the control group. We investigated the skin types of 201 Korean vitiligo patients and 70 healthy Korean volunteers. Skin type was determined by the skin phototyping method proposed by Fitzpatrick. Compared to normal controls, skin type II was significantly less frequent and skin type V was quite common in the vitiligo group. These results suggest that people with dark skin have a higher probability of developing vitiligo than people with light skin.