白癜风病人的自身抗体检查

用间接免疫荧光法测定55例白癜风病人血清中ANA, AMA, ASMA, APCA, ATGA, ATMA 6种自身抗体.8例病人血清中查到1种以上抗体,阳性率14.5%,正常对照组55例中仅2例阳性,阳性率3.6%,两组间有显著差异(P<0.05).检出的自身抗体中,最多的是抗胃壁细胞抗体和抗甲状腺成分抗体.结合临床资料,说明部分白癜风病达的发病机制与自身免疫有关.     

Prevalence of autoantibodies in patients with endemic pemphigus foliaceus (fogo selvagem)

Objective The aim of the present study was to investigate a broad spectrum of autoantibodies in patients with endemic pemphigus foliaceus (EPF)—fogo selvagem—and to determine the possible association between EPF and other autoimmune diseases.Materials and methods Indirect immunofluorescence was used to test 120 patients with EPF and 200 healthy controls for the presence of the following autoantibodies: anti-desmoglein-1 (APF), anti-neutrophil cytoplasmic (ANCA), anti-smooth muscle (SMA), anti-mitochondrial (AMA), anti-nuclear (ANA), anti-liver kidney microsomal (LKM), anti-gastric parietal cells (GPCA) and anti-thyroid microsome (TMA).Results APF antibodies were detected in 62.5% of the patients (75/120), ANA and SMA in 0.8% (1/120), and TMA in 1.6% (2/120). None of the patients was positive for ANCA, AMA, LKM or GPCA. In the control group, a positivity of 2% was observed for SMA (4/200), 1.5% for TMA (3/200), and 0.5% (1/200) for ANA and GPCA. None of the controls was positive for APF, LKM, AMA or ANCA.Conclusions The prevalence of the autoantibodies ANA, SMA, AMA, GPCA, LKM and ANCA in patients with EPF was similar to that observed in the control group. No association with clinical or laboratory manifestations of other concomitant autoimmune diseases was observed in EPF patients. These results confirm the concept that EPF is an organ-specific autoimmune disease.     

Vitiligo and autoantibodies: a systematic review and meta‐analysis

Many studies have reported the prevalence of autoantibodies in patients with vitiligo; however, results were inconsistent for some autoantibodies. This study aimed to conduct a systematic review and meta‐analysis of the prevalence of autoantibodies in vitiligo patients. A systematic review and meta‐analysis of the literature published from inception to Dec 31, 2016 was conducted. Case‐control studies with vitiligo patients and a control group were included. The prevalence of anti‐thyroperoxidase (ATPO) antibodies, anti‐thyroglobulin (ATG) antibodies, antinuclear antibodies (ANA), anti‐gastric parietal cell antibodies (AGPCA), anti‐smooth muscle antibodies (ASMA), anti‐mitochondrial antibodies (AMA), and anti‐adrenal antibodies in vitiligo patients were 15.1 %, 9.7 %, 12.5 %, 11.7 %, 12.6 %, 0.2 %, and 2.5 %, respectively. The prevalence of ATPO antibodies (odds ratio [OR]: 3.975; 95 %; confidence interval [CI]: 3.085–5.122), ATG antibodies (OR: 3.759; 95 % CI: 2.554–5.531), ANA (OR: 1.797, 95 % CI: 1.182–2.731), AGPCA (OR: 2.503; 95 % CI: 1.497–2.896), and anti‐adrenal antibodies (OR: 9.808, 95 % CI: 1.809–53.159) (Figure 2a–e) were significantly higher in vitiligo patients than in the control group. The routine screening of anti‐thyroid antibodies should be performed in vitiligo patients to identify those at high risk of developing autoimmune thyroid disease.     

白癜风患者血清中抗酪氨酸酶IgG抗体及抗酪氨酸酶相关蛋白1 IgG抗体的检测

目的：探讨白癜风患者血清中抗酪氨酸酶IgG抗体（TYR IgG）和抗酪氨酸酶相关蛋白1 IgG抗体（TRP?1 IgG）与白癜风的关系。方法用酶联免疫吸附测定检测260例白癜风患者和50例健康对照血清中TYR IgG和TRP?1 IgG的含量。结果白癜风组TYR IgG和（或）TRP?1 IgG阳性率57.31%（149/260），TYR IgG阳性率37.3%（97/260），TRP?1 IgG阳性率33.5%（87/260），均明显高于对照组（χ2=25.441、21.630，P＜0.01）。TYR IgG阳性与TRP?1 IgG阳性不相关（r=-0.032，P＞0.05）。白癜风组TYR IgG阳性率男女间差异无统计学意义（P＞0.05），但TRP?1 IgG阳性率女性高于男性（χ2=5.811，P＜0.05）。白癜风TYR IgG阳性率≤20岁（35.9%）与＞20岁（38.3%）比较，差异无统计学意义（P＞0.05），而TRP?1 IgG阳性率≤20岁组明显高于＞20岁组（χ2=6.498，P＜0.05）。结论检测TYR IgG和TRP?1 IgG可为白癜风的诊断和治疗提供一定依据。     

Differences between familial and sporadic cases of vitiligo

Background Most cases of vitiligo are sporadic, but about 10–36% of the patients have positive family history. Objective The aim of our study was to describe differences between familial and sporadic cases of vitiligo. Methods A total of 186 adult vitiligo patients were examined, in 173 of whom the level of thyroid peroxidase antibodies, gastric parietal cell antibodies (PCA), antinuclear antibodies (ANA), anti‐adrenal cortex antibodies and rheumatoid factor in blood was measured. All patients were divided in two groups: the cases with positive family history of vitiligo (51) and the sporadic cases (135). Results The risk of onset of the disease up to 20 years of age was higher in the familial group (P = 0.008). Patients in familial group showed more widespread depigmentation compared with sporadic cases [body surface area (BSA) over 10%: P = 0.004; BSA over 50%: P = 0.001]. In familial group, patients had darker skin phototype (P = 0.045) and the disease had started more often as a vulgar vitiligo (P = 0.008). In sporadic vitiligo group, female gender was a risk factor for more widespread depigmentation (BSA over 10%, P = 0.001). Extensive depigmentation was associated with reported triggering factors and mucosal involvement in both groups and with leukotrichia only in familial group. Widespread depigmentation related to the risk of presence of autoantibodies (P = 0.03) in sporadic cases of vitiligo (especially of PCA: P = 0.04 and ANA: P = 0.0002). Conclusions In this study, we demonstrated first time that patients with familial vitiligo have a higher risk for vulgar type at the beginning of the disease and female gender increases the risk for more extensive depigmentation in sporadic cases.     

Possible association of the CD4 gene polymorphism with vitiligo in an Iranian population

Background. Vitiligo is an acquired idiopathic and polygenic disorder with progressive depigmentation of circumscribed patches. Its exact pathogenesis is unknown. The CD4 gene plays an important role in the cell‐mediated immune response and its association with type 1 diabetes mellitus, which is an autoimmune disease, has been previously reported. Methods. Based on the assumption that autoimmunity is also involved in vitiligo, the CD4 gene was selected for study using a candidate gene approach. The pyrimidine‐rich pentanucleotide repeat length polymorphism located in the promoter of the gene was studied. We screened 144 unrelated Iranian patients with vitiligo and 144 healthy matched controls by PCR. Results. The CD4*A4 allele has a susceptibility association with the development of vitiligo in the Iranian population (OR = 1.68, 95% CI 1.18–2.42; P < 0.01, P_c = 0.02). When we compared CD4*A4‐containing genotypes in the case and control groups, even more significant positive association was identified (OR = 2.02, 95% CI 1.26–3.22; P < 0.01 and P_c < 0.01). The CD4 gene polymorphism has a modest association with the development of vitiligo in Iranian patients.     

ANTISMOOTH MUSCLE AND ANTIPARIETAL CELL ANTIBODIES IN INDIANS WITH ALOPECIA AREATA

Background. Alopecia areata is suspected to be an autoimmune disease. We studied 104 consecutive patients with alopecia areata for the presence of autoantibodies and associated autoimmune diseases. Methods. A detailed history and examination was carried out in all patients to look for associated atopy, diabetes mellitus, hypertension, rheumatoid arthritis, vitiligo, lupus erythematosus, and thyroid disorders, etc. in the patients or their family members. Venous blood for estimation of fasting and postprandial blood glucose was collected in 30 patients, especially in those with family history of diabetes mellitus. Antimitochondrial (AMA), antismooth muscle (SMA), antinuclear antibodies (ANA), antiparietal cell antibody (PCA), and antibody against thyroid microsome (TMA) were detected employing indirect immunofluorescence on a composite section of rat liver, stomach, kidney, and human thyroid. Skin biopsy was processed for direct immunofluorescence by a conventional technique. Results. Disseminated discoid lupus erythematosus, lichen planus, urticaria, psoriasis, and seronegative spondylarthritis were associated with alopecia areata in one case each. Anti-smooth-muscle-antibodies and PCA were found in 36 (34.6%) and 44 (42.3%) patients respectively, followed by TMA in 8 (7.7%), AMA in 6 (5.7%), antithyroglobulin antibodies in 3 (2.8%), and ANA in 2 (1.9%) patients. The incidence of SMA was higher in men with alopecia areata (P< 0.001). Direct immunofluorescence carried out in 24 patients did not reveal significant findings, except for occasional immunoglobulin deposits around hair follicles and blood vessels. Conclusion. Alopecia areata in India is associated more often with antismooth muscle and antiparietal cell antibodies.     

抗心磷脂抗体和免疫异常在青斑样血管炎中的意义

目的探讨抗心磷脂抗体(ACA)和免疫异常在青斑样血管炎(LV)中的作用。方法两组均用药前取静脉血,用间接免疫荧光、免疫印迹、ELISA等方法测定LV患者体内抗核抗体、循环免疫复合物、免疫球蛋白、ACA、抗β2糖蛋白1(β2GP1)抗体的水平。结果LV组4例抗核抗体阳性,3例免疫复合物阳性,2例免疫球蛋白升高,其中2例诊断为系统性红斑狼疮。ACA阳性13(43.33%)例,β2GP1水平增高9(30.00%)例,其中3例合并下肢网状青斑样改变。对照组ACA阳性1例,无抗β2GP1抗体阳性者。两组ACA及抗β2GP1抗体阳性率差异有显著性意义(P均<0.01)。结论LV的发病与免疫复合物、免疫反应无明显相关性,ACA与LV血栓形成有关,与合并严重网状青斑患者的ACA和抗β2GP1抗体尤其相关。说明LV的发病与血凝异常及血栓形成有一定关系。     

白癜风患者血清甲状腺球蛋白抗体和甲状腺过氧化物酶抗体的检测

目的 探讨白癜风患者甲状腺球蛋白抗体（ATG）和甲状腺过氧化物酶抗体（ATPO）检测的临床意义。方法 采用化学发光法检测87例白癜风患者和年龄、性别相匹配的90例正常人对照组血清ATG、ATPO、游离T3、游离T4和促甲状腺激素（TSH）水平,并按年龄、性别分层进行比较。结果 白癜风组的血清ATG和ATPO阳性率以及TSH平均浓度显著高于正常人对照组,且ATG和ATPO阳性者均为寻常型白癜风。白癜风组11 ～ 20岁和21 ～ 40岁年龄段ATG和ATPO阳性率显著高于同年龄段的正常人对照组,且白癜风组女性ATG和ATPO阳性率均为34.1%,显著高于正常人对照组女性（8.5%和10.6%）,χ2值分别为8.90和7.29,P值 < 0.01和0.05;在白癜风患者中,11 ～ 20岁年龄段ATG和ATPO阳性率最高,达53.3%,其次为21 ~ 40岁年龄段,为34.5%;20例ATG和ATPO阳性的白癜风患者中,14例（70%）随后诊断为自身免疫性甲状腺疾病, 显著高于ATG和ATPO阳性的正常人对照组发病率（16.7%）,χ2 = 5.4,P < 0.05。结论 ATG和ATPO出现在青少年女性寻常型白癜风患者中,并与自身免疫性甲状腺疾病的发生相关。     

Molecular heterogeneity of the fourth component of complement (C4) and its genes in vitiligo.

In view of evidence suggesting vitiligo is an autoimmune disease, we investigated whether vitiligo is associated with inherited deficiencies of the fourth (C4) and second (C2) component of complement and with certain human leukocyte antigens (HLA). Analysis of functional activities of C4 and C2 in sera of patients with vitiligo (n = 42) showed that 17% of them had a heterozygous C4 deficiency and 5% had a heterozygous C2 deficiency. In the normal control group (n = 30), 3% had a heterozygous C4 deficiency and none had a C2 deficiency. C4 typing by Western blot analysis showed the frequency of the C4A*Q0 allele in the vitiligo patient group to be close to normal. However, the frequency of one C4B*Q0 allele was three times higher, and that of two C4B*Q0 alleles five times higher in the vitiligo patient group than the reported frequencies in normal control groups. Southern blot analysis of Taq1 digests of DNA using C4 and 21-hydroxylase probes showed that two patients with two C4B*Q0 alleles had a deletion of a 21-OHA-C4B segment. In the other patients, having one or two C4B*Q0 alleles, these null alleles probably occurred due to a loss of C4 gene expression. HLA analysis did not show any allelic association of C4A*Q0 or C4B*Q0 with any HLA antigen in vitiligo, but confirmed the previous findings of a negative association with HLA-DR3 and a positive association with HLA-DR4. These results suggest that abnormalities of the C4B gene and the above-mentioned associations with HLA antigens may be some of the risk factors in vitiligo.     

白癜风患者病程与抗酪氨酸酶抗体的相关分析

目的 应用酪氨酸酶表达肽TYR240-479作为抗原,检测654例白癜风患者血清抗酪氨酸酶IgG抗体水平,分析白癜风患者病程与体内抗酪氨酸酶抗体水平的关联性。方法 以TYR240-479作为包被抗原,应用ELISA法检测白癜风患者血清中抗酪氨酸酶IgG抗体的滴度。不同病程患者抗体阳性检出率的差异以及病程与抗体水平的关联性分析应用卡方检验,多组率的两两比较应用Bonferroni校正。平均滴度差异比较应用one-way ANOVA,组间两两比较应用LSD－t检验。结果 各病程组抗体检测总阳性率具有显著性差异,P＝0.027,r＝0.112。其中病程1～5年（含5年）组与5～10年（含10年）组具有显著性差异,P＝0.007。病程是否超过5年与抗体水平的关联强度分析表明病程与抗体水平有关联,P＝0.025,OR＝1.473,95％CI（1.049-2.068）,但各病程组间抗体平均滴度无显著性差异。 结论 与病程超过5年的患者相比,病程5年之内的患者抗体阳性率更高,与抗体水平的关联更为紧密。白癜风病程与患者抗酪氨酸酶抗体水平有一定的关联性。     

Autoantibodies other than antineutrophil cytoplasmic antibodies are not positive in patients with psoriasis vulgaris

There is a great deal of evidences that a link may exist between psoriasis and autoimmunity. In this study, thirty-six patients with psoriasis vulgaris and twenty healthy controls were screened for antinuclear antibody (ANA), anti-ds-DNA antibodies, anti-SSA (anti-Ro), anti-SSB (anti-La), anti-Scl-70, anti-Jo-1, rheumatoid factor (RF), C3 and C4 levels, IgG and IgM anti-cardiolipin antibodies (aCL) and anti-neutrophil cytoplasmic antibodies (pANCA and cANCA) in order to determine the role of autoimmunity in the pathogenesis. In addition, the MPO-ANCA test was performed on pANCA-positive patients. In ANA screening, one patient showed 1/80 granular positivity. No positive results were obtained from either the study or control groups for anti-dsDNA, anti-SSA, anti-SSB, anti-Scl-70, or anti-Jo-1 determinations. For RF, 5.8% of the patients had positive values. Both C3 and C4 levels were found to be significantly elevated in psoriasis patients compared to healthy controls (p<0.001). IgG-aCL and IgM-aCL positivity was not significantly different between the two group. pANCA was positive in 33.3% of the patients and a significant difference was observed between study and control groups (p<0.05). MPO-ANCA was negative in all the pANCA-positive patients. In conclusion, only serum C3 and C4 levels and pANCA determinations showed significant differences when compared to healthy controls. Our findings may be evidence of associations between autoimmunity and psoriasis vulgaris. However, more detailed studies in this field need to be done to determine the relationship between them.     

Autoantibodies against tyrosine hydroxylase in patients with non-segmental (generalised) vitiligo

Vitiligo is an acquired idiopathic hypomelanotic skin disorder characterised by depigmented macules because of loss of cutaneous melanocytes. Although the exact cause of vitiligo remains obscure, evidence suggests that autoimmunity plays a role in the pathogenesis of the disease. Previously, tyrosine hydroxylase (TH) was identified as a putative autoantigen in vitiligo using phage-display technology. In this study, the prevalence of TH antibodies in patients with vitiligo was investigated. A radioimmunoassay (RIA) was used to detect TH antibodies in sera from patients with either non-segmental vitiligo (n=79), segmental vitiligo (n=8) or other autoimmune diseases without concomitant vitiligo (n=91). Sera from healthy individuals (n=28) were also tested. Patients with segmental vitiligo, healthy controls and patients with other autoimmune diseases without concomitant vitiligo were all negative for TH antibody reactivity. Of 79 patients with non-segmental vitiligo, 18 (23%) were positive for TH antibodies in the RIA, and a significant increase in the prevalence of TH antibodies in patients with non-segmental vitiligo was evident when compared with controls (P=0.003). TH antibody prevalence was also significantly elevated in patients with active vitiligo compared to those with stable disease (P=0.009). Overall, the results indicate that TH is an antibody target in non-segmental but not in segmental vitiligo and that TH antibodies appear to be more frequent in patients with active vitiligo.     

An approach to the correlation between vitiligo and autoimmune thyroiditis in Chinese children

Background. Vitiligo is a common skin depigmenting disease, which is thought to have, at least partly, an autoimmune aetiology. Aim. To explore the correlation between paediatric vitiligo and other associated diseases, with an emphasis on autoimmune thyroiditis (AT). Methods. In total, 363 paediatric patients (198 boys, 165 girls) with vitiligo and 93 healthy children (55 boys, 38 girls) were screened for autoimmune thyroiditis. The two groups were matched for age and gender. Children with vitiligo were split into two groups according to type (segmental and nonsegmental vitiligo). Demographic data, clinical features and examinations were recorded using questionnaires. Thyroid function tests including free triiodothyronine, free thyroxine and thyroid‐stimulating hormone were performed. Anti‐thyroid peroxidase antibody) and anti‐thyroglobulin antibody levels were assessed as well. Other associated diseases were also monitored in this study. Results. Of the 363 patients, 43 (11.8%) had abnormal levels of studied thyroid parameters, compared with 4 of the 93 controls (4.3%); the difference was significant (P = 0.04). The alterations of thyroid parameters and the incidence of AT in patients with nonsegmental vitiligo were both significantly different (P < 0.05, P = 0.04) relative to the segmental vitiligo group. Of the 363 patients, 67 (18.5%) had other associated diseases. There were no differences in the rates of other associated diseases between patients with segmental vitiligo and those with nonsegmental vitiligo (P > 0.05). Conclusions. A significant incidence of thyroid dysfunction was found in paediatric patients with nonsegmental vitiligo. As vitiligo usually appears before the development of the thyroid disease, it may be advantageous to screen thyroid functions and antibody levels in all paediatric patients with vitiligo, especially those with nonsegmental vitiligo.     

系统性红斑狼疮患者皮损中C_3沉积与病情活动的关系

目的探讨系统性红斑狼疮(SLE)患者皮损中C3的沉积与血清中抗体的阳性率、补体C3水平及病情活动之间的关系。方法用直接免疫荧光法(DIF)检测皮损部位的免疫反应物;常规方法检测患者血清中自身抗体及补体;根据临床表现和实验室检查指标,进行系统性红斑狼疮病情活动性评分(SLEDAI)。结果 65例SLE患者中,37例(56.92%)真表皮交界处有一种或几种抗体和/或补体沉积,即DIF阳性,将65例患者按皮损中C3的沉积情况分成3组:DIF阴性组28例(43.08%),C3沉积组21例(32.31%)和仅有其他抗体沉积而无C3沉积组16例(24.62%)。各组间血清抗体ANA,dsDNA,SSA,RNP和Sm的阳性率差异均无统计学意义(P>0.05)。而C3沉积组的血清C3水平明显低于其余两组(P<0.05),且C3沉积组的病情活动性明显高于其余两组(P<0.05)。结论 C3单独及与其他抗体在皮损部位的沉积,比DIF阴性组和仅有其他抗体而无C3沉积组具有更低的血清C3水平及更高的病情活动性。     

雌激素受体-α基因多态性与白癜风相关性研究

目的探讨雌激素受体-α(ER-α)基因多态性与白癜风的相关性。方法应用PCR-RFLP分析技术,检测690例汉族白癜风患者和700例汉族对照者ER-α基因内含子1PvuⅡT/C和XbaIA/G酶切位点基因多态性。结果白癜风组与对照组之间C/T基因型频率(P=0.000)差别有显著性意义,其C等位基因频率亦明显高于对照组(P=0.000,OR1.33,95%CI1.14~1.51);女性患者C/T基因型频率(P=0.001)、C等位基因频率(P=0.002,OR1.41,95%CI1.13~1.75)亦明显高于女性对照组;男性患者和男性对照组C等位基因频率(P=0.043,OR1.25,95%CI1.01~1.56)差别有显著性意义;ER-α基因内含子1XbaⅠA/G酶切多态性男性患者G等位基因频率(P=0.040,OR1.32,95%CI1.01~1.71)明显高于男性对照组;其余各组间差别无显著性意义(P>0.05)。结论ER-α基因PvuII酶切多态性与白癜风存在相关性,携带C等位基因的女性患者更易患白癜风。XbaI酶切多态性可能与男性白癜风患者之间存在相关性。提示ER-α可能是白癜风患者易感性的备选因素。     

Clinical Analysis of Thyroglobulin Antibody and Thyroid Peroxidase Antibody and their Association with Vitiligo

Background:

Recently, the abnormal presence of thyroglobulin antibody (TG-Ab) and thyroid peroxidase antibody (TPO-Ab) has been reported in vitiligo patients, but presence of TG-Ab and TPO-Ab in patients of different ages and gender, and its association with vitiligo and thyroid autoimmunity has rarely been reported. The aim of our research was to determine whether vitiligo was associated with thyroid autoimmunity and figure out its relationship with age and gender.

Materials and Methods:

We analyzed TG-Ab, TPO-Ab in age and gender matched 87 vitiligo patients and 90 healthy controls, the patients of vitiligo who were positive for the presence of TG-Ab and TPO-Ab were followed up to confirm autoimmune thyroid disease subsequently.

Results:

Results showed that the frequencies of TG-Ab (23.0%, 20/87) positivity and TPO-AB (24.1%, 21/87) in vitiligo patients were significantly higher than that in healthy controls (P < 0.05). Moreover, The positivity for of TG-Ab and TPO-Ab was higher in 11-20-year age group and 21-40-year age group than that in age matched healthy controls. We found female patients with vitiligo had higher positive frequencies of TG-Ab and TPO-Ab than healthy female controls. (34.1% vs. 8.8% and 34.1% vs. 11.1%, P = 0.000 and P = 0.011). When 20 patients with TG-Ab and TPO-Ab positivity were followed up for three monthes, 14 of them (70%) were diagnosed as having autoimmune thyroid disease compared with age-matched healthy controls (16.7%, χ² = 5.4, P = 0.02).

Conclusion:

TG-Ab and TPO-Ab are likely to be found in female teenagers with vitiligo, and are relevant with respect to subsequent development autoimmune thyroid disease.     

儿童白癜风临床及免疫学研究

目的 探讨儿童白癜风与免疫的关系.方法 采用统一设计的儿童白癜风临床特点调查表对本院门诊的14岁以下患儿及其家属进行调查.对270例患儿检测外周血免疫球蛋白、补体水平和T细胞亚群.结果 白癜风患儿620例中男302例(48.71%),女318例(51.29%),平均就诊年龄8.81岁,平均发病年龄7.57岁,平均病程8.14个月.累及头颈部453例,占73.06%.节段型160例,占25.81%.发病季节和疾病进展均以春夏季为多.73例患儿伴有晕痣,占11.77%,以散发型者居多.有家族史者84例,占13.55%.节段型患儿中,进展期的患儿血C3、c4水平明显低于稳定期患儿(P<0.05).寻常型患儿中,进展期的患儿血CD3+,CD4+细胞水平和CD4+/CD8+比值明显低于稳定期患儿(P<0.01).结论 白癜风患儿体内存在某些免疫指标的异常,可能与免疫紊乱有关.     

The effectiveness of excimer laser on vitiligo treatment in comparison with a combination therapy of Excimer laser and tacrolimus in an Iranian population

Abstract

Objectives: Usage of 308-nm excimer laser (EL) is an effective treatment in vitiligo. As genetic predispositions along with type of skin and rate of sun exposure are known factors influencing the treatment outcomes, we tried to evaluate the treatment results of using 308 nm-excimer laser alone in comparison with the combined therapy of EL and topical tacrolimus in Iranian patients with vitiligo. Methods: We reviewed the medical files of 150 patients with vitiligo who were referred to the Behsima Laser Center between April 2012 and April 2013. Seventy five patients who received combined therapy of 308 nm EL and topical tacrolimus three times a week entered the study. Seventy-five controls with matched characteristics and who received only EL were also selected. The amount of repigmentation was estimated by an expert dermatologist and was classified in 5 ranks. Results: In the case group, 33.3% (n: 25) showed 50–75% repigmentaion and 49.3% (n:37) had more than 75% response to therapy, whereas among the patients in the control group 29.3% (n: 22) showed no repigmentation and only 8% (n: 6) demonstrated more than 75% repigmentation response. The higher efficiency of the combination therapy on repigmentation was statistically significant (P: 0.006). Conclusion: Our study shows that Iranian patients with vitiligo who received a combined treatment course with 308-nm EL and tacrolimus 0.1% experienced significantly higher levels of repigmentation in comparison with laser therapy alone.     

儿童白癜风与甲状腺功能指标异常及其他免疫性疾病的关系

目的 探讨儿童白癜风与甲状腺功能指标异常及其他免疫性疾病的关系。方法 对363例白癜风儿童（男198例 ,女165例 ）和 93 例对照儿童（男55例,女38例）进行甲状腺功能指标的检查。结果 363例白癜风儿童中有43例（11.8%）儿童有不同程度的甲状腺功能指标的异常,93例对照组正常儿童中有4例儿童甲状腺功能指标异常,两者比较差异有统计学意义。白癜风儿童甲状腺功能指标异常发生率明显增高（P < 0.05）。而43例甲状腺功能异常的白癜风儿童中,寻常型白癜风儿童为39 例（13.6%）,节段型白癜风儿童为4 例（5.3 %）,寻常型比节段型白癜风儿童甲状腺功能指标异常发生率有明显增高（P < 0.05）。结论 儿童寻常型白癜风患者的甲状腺功能指标异常的发生率明显增高。