白癜风与染色体畸变

对５８例白．癜风患者同时进行染色体畸变和自由基清除系统水平的测定。结果表明，白癜风患者染色体断裂和结构重排现象显著增加，同时伴血浆中脂质守氧化物丙二醛的高和红细胞中超氧化物岐化酶的铜蓝蛋白水平的降低。     

Retinoic acid synergistically enhances the melanocytotoxic and depigmenting effects of monobenzylether of hydroquinone in black guinea pig skin

Monobenzylether of hydroquinone (MBEH) has long been utilized for the depigmentation therapy of patients with extensive vitiligo. In this approach, the normally pigmented areas surrounding vitiligo lesions are depigmented to achieve a uniform skin tone. One of the important disadvantages of MBEH therapy, however, is the resistance of a considerable number of vitiligo patients against the depigmenting effect of this agent. We have previously proposed that the glutathione-dependent cytoprotection of melanocytes can be impaired through the inhibition of the enzyme glutathione S-transferase by retinoic acid (RA). The combination of RA with melanocytotoxic agents could thus lead to increased susceptibility of melanocytes to such compounds. In this study we have shown, for the first time, that the melanocytotoxic and depigmenting effects of MBEH are synergistically enhanced when it is combined with RA. The treatment of black guinea pig skin with RA (0.025%) alone induced no significant changes in the number of epidermal melanocytes and no skin depigmentation. On the other hand, MBEH (10%) produced mild to moderate skin depigmentation and reduced the average number of melanocytes from 76 (+/-5)/field (magnification: x 40) in control sites, to 42 (+/-6)/field in the depigmented skin. The RA (0.025%)-MBEH (10%) combination, however, produced a complete degree of depigmentation in the majority of treated sites after 10 days of application and reduced the average number of melanocytes to only 6 (+/-6)/field. RA-MBEH combination serves as a very potent skin depigmenting formula and now awaits future assessments of its potential use for the treatment of extensive vitiligo.     

An insertion/deletion polymorphism in the gene encoding angiotensin converting enzyme is not associated with generalised vitiligo in an English population

Vitiligo is an acquired hypomelanotic skin disorder characterised by circumscribed depigmented macules resulting from the loss of functional melanocytes from the cutaneous epidermis and autoimmunity has been suggested to play a role in the pathogenesis of the disease. Recently, an insertion/deletion (I/D) polymorphism of a 287-base pair repetitive sequence in intron 16 of the angiotensin converting enzyme (ACE) gene has been associated with autoimmune disease and with the development of vitiligo. In this study, the distribution of ACE gene I/D genotypes was investigated in a population of 106 English patients with generalised (non-segmental) vitiligo and 174 ethnically matched healthy controls using a restriction fragment length polymorphism-polymerase chain reaction genotyping method. No significant difference in the frequencies of II, ID and DD genotypes was detected between vitiligo patients and control subjects (P=0.35). The same result was evident for the genotype distribution in vitiligo patients with an autoimmune disease and for those without when compared with controls (P=0.33 and P=0.53, respectively). In addition, the results indicated that the D allele was not significantly over-represented in the group of patients with vitiligo compared with controls (P=0.42) and that this was also the case for patients with and without associated autoimmunity (P=0.40 and P=0.62, respectively).     

藏族白癜风527例临床特点分析

【摘要】 目的 分析西藏地区藏族白癜风患者的临床特点。方法 回顾性分析 2018年1月至2019年12月于西藏自治区人民医院皮肤科门诊就诊的527例藏族白癜风患者的临床资料。结果 527例藏族白癜风患者中, 男女性别比例0.97∶1;发病年龄在10 ~ 30岁的患者263例（49.9%）。进展期 335例（63.6%）,稳定期192例（36.4%）;节段型97例（18.4%）,寻常型293例（55.6%）,混合型79例（15%）,未定类型58例（11%）。皮损位于面颈部253例（48%）,躯干148例（28%）,上肢64例（12%）,下肢46例（9%）,会阴肛周黏膜16例（3%）。春季发病154例（29.2%）,夏季198例（37.6%）,秋季98例（18.6%）,冬季77例（14.6%）。140例（26.6%）伴发其他疾病,包括甲状腺疾病85例（16.1%）,且74例（14.0%）为亚临床甲状腺疾病与白癜风伴发;22例患者至少1项血清免疫球蛋白或补体水平异常,其中包括进展期18例。与稳定期相比,进展期患者中促甲状腺激素（TSH）检测水平显著升高,两组间差异有统计学意义（P = 0.004）。Spearman等级相关分析显示,海拔水平与白癜风分期（rs = -0.18,P < 0.001）呈低度相关。白癜风分期与TSH（rs = -0.12,P = 0.005）、补体C3（rs = -0.09,P = 0.041）呈低度负相关,分型与TSH（rs = -0.11,P = 0.011）呈低度相关。结论 西藏地区藏族白癜风患者以10 ~ 30岁发病为主,发病部位以面颈部为主,春夏季发病多见,甲状腺功能异常的发生率高。     

Association between the CTLA4 +49A/G (rs231775) and CT60 (rs3087243) gene variants with vitiligo: study on a Mexican population

BackgroundVitiligo is characterized by an autoimmune response targeting melanocytes, thus resulting in skin depigmentation. There are several genetic components involved in the development of vitiligo, of which various gene polymorphisms are currently considered as risk factors. For example, the CTLA4 (T-lymphocyte antigen 4) +49A/G (rs231775) and CT60 (rs3087243) gene variants have been associated with a predisposition for autoimmune diseases in different populations; however, their involvement in the development of vitiligo remains controversial.ObjectiveWe evaluated the association between vitiligo and the CTLA4 +49A/G (rs231775) and CT60 (rs3087243) gene variants in a Mexican population.MethodsA total of 116 vitiligo patients and 117 control subjects from northeast Mexico were included in the study and analyzed through PCR-RFLP to determine whether there is an association between vitiligo and CTLA4 +49A/G (rs231775) and CT60 (rs3087243) gene variants.ResultsNo statistical difference was observed for both gene polymorphisms between vitiligo patients and controls (p > 0.05). Otherwise, vitiligo activity, family history of vitiligo, personal history of autoimmune diseases, or sex did not show any difference (p > 0.05).ConclusionAs suggested by the analysis of a northeastern Mexican population, the CTLA4 +49A/G (rs231775) and CT60 (rs3087243) gene variants do not constitute a risk factor in the development of vitiligo.     

Treatment of recalcitrant vitiligo by autologous non-cultured and trypsinized melanocyte grafting in the west of Iran

BackgroundVitiligo is a common disease with a high burden, and its recalcitrant type is unresponsive to current medical treatments. Autologous non-cultured and trypsinized melanocyte grafting, which is a simple and experience-based procedure, has been suggested for the treatment of vitiligo.ObjectiveTo assess autologous non-cultured and trypsinised melanocyte grafting in recalcitrant vitiligo.MethodsThis clinical trial was done on 28 patients (20 females and 8 males). After demarcation and preparation of both donor and recipient sites, both sites were shaved by a curette. The materials harvested from the donor site were trypsinized and centrifuged. The resulting suspension was mixed with hyaluronic acid gel and was spread over the shaved recipient area.ResultsTwenty-eight patients with a total of 108 lesions and a mean age of 25.93 ± 7.11 years were included in the present study. Generalized vitiligo (57.1%) was the most common clinical type and the face and neck regions (38%) were the most frequent treated sites. Good to excellent repigmentation was seen in the face and neck, trunk, upper extremity, and genitals in 31 (57.4%), 11 (20.4%), 9 (16.7%) and 3 (5.5%) patients, respectively. Face and neck showed significantly better results (p < 0.05).Study limitationsLow sample size and single-center study.ConclusionAutologous non-cultured and trypsinized melanocyte grafting is a safe method with satisfactory outcomes in recalcitrant vitiligo. Appropriate training of physicians and proper use of specialists’ experiences can be effective in increasing the improvement rate.     

Investigation of optimal energy or density of a fractional CO2 laser system in the treatment of stable non-segmental vitiligo

BackgroundFractional carbon dioxide (CO2) laser has been considered to be an add-on to conventional treatments of vitiligo. Objective: This study aimed to evaluate the optimal energy and density of the fractional CO2 laser system in stable non-segmental vitiligo (NSV) patients. Method: 48 patients were treated with fractional CO2 laser and sequential phototherapies of narrowband ultraviolet B (NB-UVB), after the CO2 laser treatment, a compound betamethasone solution was topically applied. For the fractional CO2 laser, coverages of 8% and 12.6% were set as low density (Ld) and high density (Hd), and energies of 60 mJ and 80 mJ were set as low energy (Le) and high energy (He), respectively. The patients were randomly assigned to Group A (HeHd), Group B (HeLd) or Group C (LeLd). Results: Either after 3 or 6 months of enrollment, the efficacy of Group C was better than Group B (p < 0.05). No difference was seen between Group A and Group B or Group A and Group C (p > 0.05). More patients complained higher pain score in Group A as compared with Group C (p < 0.05). Conclusion: The optimal parameters of the fractional CO2 laser were energy at 60 mJ and density at 8%.     

153例儿童白癜风临床分析

分析了１５３例儿童白癜风的临床资料。结果显示儿童白癜风发病年龄早，以５－７岁娄病高峰平均发病年龄６、７岁，伴晕痣患儿病情发展快。其中节段性白癜风占１７．６５％。其临床表现不同于非节段性白癜风。     

Erythrocyte Malondialdehyde and Glutathione Levels in Vitiligo Patients

Background

Vitiligo is an acquired and progressive hypomelanotic disease that manifests as circumscribed depigmented patches on the skin. Although the precise mechanism remains to be elucidated, an imbalance of the oxidant/antioxidant system has been proposed as an important etiologic mechanism.

Objective

The objective of this study was to evaluate the oxidant/antioxidant status of vitiligo patients at the erythrocyte level.

Methods

Fifty-three vitiligo patients and 65 phototype-, age-, and sex-matched healthy controls were included in this study. Blood samples were collected from all subjects, and all patients were instructed to answer a questionnaire.

Results

Erythrocyte levels of malondialdehyde (MDA) and glutathione (GSH) were measured. All patients were told to answer a questionnaire regarding their habitual behavior, including frequency of smoking and type of diet. We observed significantly lower levels of GSH in vitiligo patients, but the levels of MDA did not differ between patients and controls. Vitiligo patients who smoked showed significantly lower GSH levels compared to non-smoking patients, but the levels of MDA were unchanged between the 2 groups.

Conclusion

From our results, we conclude that reduced erythrocytic or systemic GSH levels constitute a distinctive feature in vitiligo patients regardless of disease activity.     

自体表皮移植术加磨削术治疗白癜风的疗效观察

目的:探讨表皮移植术加磨削术对白癜风的疗效。方法:对126例白癜风患者采用自体表皮移植术加磨削术,其中局限型80例,节段型41例,泛发型5例,共移植白斑区386个,每皮瓣植入直径0.8cm～1cm,共植入皮瓣4632处。结果:皮瓣成活率95.12％,其中治愈119例,显效3例,有效2例,无效2例,总有效率98.41％。所有患者观察随访半年以上,移植后10天左右色素形成,1个月左右色素基本恢复正常,3个月左右色素完全恢复。结论:该法效果好、副作用少。