Acquired Skin Disease Research Articles

A Comparative Review of Traditional and Prospective Methods for Vitiligo Treatment

INTRODUCTION. Vitiligo is an acquired skin disease characterized by loss of pigmentation with the destruction of epidermal melanocytes. The etiology and pathogenesis of this disease are still poorly understood. The course of vitiligo affects the patient's quality of life, his psychological state and self-esteem. In this regard, there is a need to develop new and promising methods aimed at stimulating and modulating the reparative processes of damaged tissues. AIM. To review the scientific literature on traditional therapy and new approaches to the treatment of vitiligo. MATERIALS AND METHODS. The literature review was conducted using the RINTS, PubMed and ScienceDirect databases. Query dates — March–July 2024, query depth — 1964–2024. MAIN CONTENT OF THE REVIEW. Conservative treatment methods are aimed at inhibiting the pathological process, preventing the appearance of new spots and reducing the cosmetic defect. Thus, patients are prescribed topical and systemic glucocorticosteroids, calcineurin inhibitors, immunosuppressants, phototherapy both in monotherapy and in combination. In recent years, technologies based on transplantation of autologous suspension of regenerative skin cells have been considered the most promising. CONCLUSION. Innovative methods of regenerative medicine are a good alternative to traditional treatments for patients with stable vitiligo, especially for those who do not respond to standard drug therapy.

A pilot study of tofacitinib citrate with 308-nm excimer laser for the treatment of vitiligo.

Vitiligo is a clinically prevalent acquired skin disorder characterized by depigmentation. Currently, the therapeutic options for vitiligo are restricted, and numerous issues exist, such as a prolonged treatment course, unsatisfactory therapeutic efficacy, adverse reactions, and a high propensity for recurrence after treatment cessation. To assess the safety and efficacy of combined treatment involving oral tofacitinib citrate (TC) and a 308-nm excimer laser (EL), with the aim of discovering a rapid and effective treatment approach to minimize the side effects of various drugs. A total of 63 patients with progressive vitiligo and a Vitiligo Disease Activity Score (VIDA) score of four from January 2022 to January 2024 were enrolled and divided into three groups. The three groups were the TC combined with 308-nm EL and methylprednisolone treatment group, the TC and 308-nm EL treatment group, and the methylprednisolone treatment alone group. The treatment was continued for 24 weeks. Finally, assessment of therapy outcomes was performed. When TC was combined with 308-nm EL and methylprednisolone treatment, the effect was more rapid. When TC was combined with 308-nm EL, it had a more favorable treatment effect than that of methylprednisolone alone, despite having a slower effect onset. After 24 weeks of treatment, there was no significant difference between the two groups in terms of the total response rate or significant efficiency. However, when only methylprednisolone treatment was applied, the effect is relatively slow and inefficient. This study confirmed the rapid and efficient treatment of vitiligo through the combination of TC and 308-nm EL, and no serious adverse reactions were reported, which could offer an optimal treatment plan for patients with vitiligo.

Impact of Vitiligo on Fasting Blood Sugar and Thyroid Hormone Profile on Libyan Patients

Vitiligo is a common acquired skin disease characterized by the development of circumscribed white patches of skin. It affects 1-2% of the general population. Autoimmunity plays a significant role in the pathophysiology of vitiligo. This study was intended to assess the prevalence and association of fasting blood sugar and thyroid function abnormalities among Vitiligo patients and healthy controls. A case-control study was carried out among thirty patients with a confirmed diagnosis of vitiligo (53.3% female and 46.7% male) who attended Tripoli Central Hospital (TCH) and Tajoura Hospital for follow-up, and a matched number of control subjects were recruited randomly. All blood samples were collected to assay for the FBS test, triiodothyronine (T3), thyroxin (T4), and thyroid-stimulating hormone (TSH). According to the recent data, the mean age of patients who were involved in this study was 34.4±16.51 years, while the mean age of onset was 20.13 ±14.19. Additionally, the data revealed that there were significant differences in FBS between vitiligo patients and healthy control groups (p-value = <0.001). Moreover, there were statistically significant differences between vitiligo patients and non-vitiligo subjects in T4 (p-value = 0.042). Furthermore, there was no significant correlation between the vitiligo phenotypes and thyroid hormone levels. P-value = 0.911 Chi-Square = 0.186. According to the results of the present study, it appears that vitiligo affects both sexes, especially women. It has also been noted that generalized vitiligo was more common, and there was no correlation between patterns of vitiligo and thyroid state.

A dermatological odyssey: Levamisole\'s Triumph over warts, vitiligo, dermatophytosis, and pityriasis versicolor in a young patient

In our case, we observe the presence of various conditions within the same patient, including prevalent benign lesions caused by the human papillomavirus (HPV) known as warts. These warts, occurring in both mucosal and skin regions, can contribute to significant morbidity for affected individuals. Additionally, the patient exhibits vitiligo, a common acquired skin disorder characterized by well-demarcated white patches resulting from the loss of melanocytes in the epidermis. Although different theories exist regarding the pathogenesis of vitiligo, the exact etiology remains unknown. Alongside, the patient presents with two common fungal infections, namely pityriasis versicolor and dermatophytosis. The coexistence of all these dermatological conditions in a single patient highlights the complexity of the case.

Association between the skin microbiome and lichen striatus hypopigmentation: Cutibacterium acnes as a potential cause.

Lichen striatus (LS) is an acquired skin disorder with a linear pattern along Blaschko's lines. It commonly occurs in childhood, and the lesions spontaneously regress within several months. Although up to 50% of LS cases exhibit hypopigmentation that can persist for several months to years, it is unknown why LS is associated with such a high incidence of hypopigmentation compared to other inflammatory skin diseases. Therefore, this study aimed to analyse the differences in the skin microbiome between LS patients with and without hypopigmentation. Differences in skin microbiome were analysed using whole genome sequencing of skin biopsies and subsequent bioinformatics analyses. Some microbes commonly found in hypopigmented skin disorders, including Cutibacterium acnes, were more abundant in patients with LS showing hypopigmentation than in those not showing hypopigmentation. The skin microbiota may be involved in the development of hypopigmentation in LS and may be considered a treatment target to reduce LS duration and hypopigmentation.

Polymorphic photodermatosis as a disease of failed apoptotic clearance in immune-mediated inflammation and the description of a clinical case

Polymorphic photodermatosis is the most common, acquired skin disease characterized by an abnormal, recurrent, and delayed response to sunlight.
 In this article, modern views on the etiology of pathogenesis are described clinical picture, differential diagnosis, principles of treatment and prevention of polymorphic photodermatosis. The pathogenesis of this disease is a form of delayed-type hypersensitivity reaction to photoantigens. The abnormal immune response has been attributed to the immunosuppressive effects of sunlight due to a breakdown in allergen tolerance and a disruption in the mechanisms of apoptosis.
 The main symptoms of the disease are erythema and highly itchy elements of skin lesions, which are very diverse, most often represented by macules, papules and vesicles, or vesiculo-bullous, urticarial, hemorrhagic rashes, hence the name of the disease polymorphic photodermatosis. Usually one morphology prevails in one patient. The article presents a clinical case and the results of their own observations.
 Studies of the pathogenesis of polymorphic photodermatosis have confirmed the presence of an abnormal immune response. The exact mechanism of immunosuppression caused by ultraviolet radiation and the relative contribution of UV-B and UV-A in healthy people are still unclear, but the expression of TNF-alpha, IL-4 and IL-10 and the depletion of Langerhans cells appear to be key phenomena.
 Diagnosis of the disease based on the clinical picture. The need for differential diagnosis of various forms of polymorphic photodermatosis is due to their clinical and sometimes histological similarity with other skin formations. For more accurate verification of the diagnosis, a biopsy of the examined skin area is possible, followed by histology. The histology of polymorphic photodermatosis is nonspecific, in accordance with the polymorphic clinical picture, as well as depending on the timing of the biopsy.
 Further studies of the pathological mechanisms underlying polymorphic photodermatosis may allow us to develop a more targeted approach to conservative treatment and prevention.

Efficacy of using oral methotrexate with phototherapy in the treatment of vitiligo in comparison with single phototherapy treatment: A double-blinded randomized controlled trial.

Vitiligo is an acquired skin disease with a worldwide prevalence of 0.5%-2% and a tendency to involve both genders. Although the exact pathologic mechanism is unknown, there is some evidence for the role of autoimmunity in this disease. Based on this theory, various immunosuppressive agents, such as topical or systemic corticosteroids and phototherapy (including narrowband ultraviolet B), are used. Methotrexate is another immunosuppressant that has recently become popular as a single treatment for vitiligo; however, the synergistic effect and its superiority over other treatments are two crucial factors that are still obscure. This study aimed to compare the efficacy of methotrexate+ NB-UVB versus placebo+ NB-UVB in vitiligo patients. In this double-blinded, randomized controlled trial, 42 patients were randomly allocated into two groups: the first group received three times weekly NB-UVB plus placebo, and the second group was treated with three times weekly NB-UVB in combination with a weekly dose of 12.5 mg MTX. The total duration of treatment was 6 months, patients were followed up every 2 months, and the assessment tools were VASI (repigmentation indicator) and VIDA (disease activity indicator) scores. Both treatment groups showed improvement in VASI and VIDA scores during 6-month follow-up, but no statistical significance was found between the two treatment methods. This study demonstrated that both treatment modalities were equally effective, and further studies are required to evaluate the efficacy of MTX with other medications with longer follow-up and a larger sample size.

Platelet-Rich Plasma Injection Versus Combined Fractional Carbon Dioxide Laser with Platelet-Rich Plasma in Treatment of Vitiligo: A Comparative Study

Vitiligo is an acquired skin disorder characterized by depigmented macules and patches due to the loss of functioning melanocytes in the skin, with a global prevalence around 1%. Vitiligo does not produce direct physical impairment; however, it has a negative social and psychological impact on the afflicted patients when the depigmented lesions occur in exposed areas, such as face, neck, and extremities.

Evaluation of the Additional Effect of Vitix® Gel on Vitiligo Lesions in Patients Treated with Narrow-Band Ultraviolet-B Phototherapy

Vitiligo is a polygenic acquired skin disorder resulting from the destruction of melanocytes in epidermal cells. Conventional therapeutic options include covering agents, topical corticosteroids, topical immunomodulators, phototherapy with psolaren ultraviolet A (PUVA) and narrowband ultraviolet B (NBUVB). However, successful repigmentation with these modalities is expected only in half of the patients. This study aimed to compare the efficiency of topical Vitix® gel combined with NB-UVB versus NB-UVB alone in the treatment of vitiligo lesions. Thirty patients with vitiligo were enrolled in this study. All patients had relatively symmetrical lesions and received topical Vitix® gel in combination with NB-UVB on one side and NB-UVB alone on the other side. Data were analyzed using Wilcoxon and Mann-Whitney tests. Twenty-five patients completed the course of study (68% female, age: 32.3 ± 13.5 years). Five patients were excluded due to noncompliance to follow-up. The highest treatment response rate was observed in the upper limb’s lesions. However, no statistical difference was observed in patients treated with Vitix® gel combined with NB-UVB versus NB-UVB alone after adjusting for age, sex and lesions’ site (p > 0.05). Significant additional clinical repigmentation was not observed by adding Vitix® gel to NBUVB therapy in treatment of vitiligo lesions.

Clinico-epidemiological profile of childhood vitiligo: Experience from a tertiary care center of Northeast India

Background: Vitiligo is a common acquired skin disease characterized by depigmented macules and patches due to loss of functional melanocytes. Childhood-onset vitiligo has distinct epidemiological and clinical characteristics as compared to that of late-onset disease. Studies on childhood vitiligo are rare from the North-eastern part of the country. Aims and Objectives: The aim of the study was to study the clinical pattern of childhood vitiligo and its systemic association. Materials and Methods: All children up to 13 years presenting with childhood vitiligo were taken as study participants. A detailed history, general physical examination, cutaneous examination including hair, nail, genitalia, mucosae, and systemic examination to note down associated diseases was done. Relevant investigations were carried out whenever necessary. Eye and ear examination was performed for each patient. The findings were recorded in a pro forma for analysis and interpretation of data. Results: A total of 2544 pediatric patients attended the dermatology outpatient department during the study period, of which 52 cases had vitiligo. Thus, the occurrence of childhood vitiligo in the outpatient pediatric population was 2.04%. The most common age group at presentation was between 5 and 10 years (29; 55.77%). The most common initial site of involvement was head and neck (27; 51.92%). Vitiligo vulgaris was the most common type seen in 26 (50%) patients. A positive family history of vitiligo was obtained in 10 (19.23%) of the vitiligo patients. Seven (13.46%) childhood vitiligo patients were reported to have other associated diseases. Conclusion: Childhood vitiligo is a common entity in this part of the country. Most patients of childhood vitiligo have a limited body surface area involvement and therefore have to be treated accordingly; avoiding systemic treatments whenever not necessary. Autoimmune and cutaneous associations are rare in childhood vitiligo, though may develop later on, lest the disease progresses.

Investigating the Association of Poly (ADP-Ribose) Polymerase-1 (PARP-1) and Nuclear Factor-κB (NF-κB) Polymorphisms with Vitiligo Susceptibility

Background: Poly (ADP-ribose) polymerase-1 (PARP-1) is a co-activator of nuclear factor-κB (NF-κB) and is also strongly activated by DNA damage. PARP has also been found to be associated with several autoimmune disorders. Vitiligo is a polygenic, multifactorial, acquired skin disorder caused due to loss of epidermal melanocytes. Among others, genetic and immunological factors are associated with vitiligo pathogenesis. Aim: To investigate the association of PARP1 exon 17 (rs1136410; V762A) and promoter CA microsatellite repeat (rs1136410) polymorphisms, and NF-κB promoter -94 indelATTG (rs28362491) polymorphism with vitiligo pathogenesis in Gujarat population. Methods: Genotyping of PARP1 17T/C (rs5030870) polymorphism was done by PCR-RFLP.PARP1 CA microsatellite and NF-κB-94 indel (rs28362491) polymorphisms were genotyped by Real-Time PCR. Anti-PARP antibody levels were assessed by ELISA. Results: The results suggested no significant difference in allele and genotype frequencies of PARP1 17 T/C (p=0.5094 and p=0.4201, respectively), PARP1 CA microsatellite polymorphisms (p=0.9519 and p=0.9338, respectively) and NF-κB-94 ATTG indel polymorphism (p=0.1482 and p=0.3784, respectively) in patients as compared to controls. Conclusion: This study suggests no association of PARP1 17 T/C, PARP1 CA microsatellite and NF-κB-94 ATTG indel polymorphisms with vitiligo susceptibility in Gujarat population. Additionally, anti-PARP1 antibody levels were not significantly different among patients and controls. These findings suggest the need for additional studies to explore the role of PARP1 in vitiligo pathogenesis. Keywords: Vitiligo, poly (ADP-ribose) polymerase-1(PARP-1), nuclear factor-κB (NF-κB), polymorphisms, Autoimmunity

Features of the quality of life in patients with vitiligo

BACKGROUND: Vitiligo is an acquired skin disease whose etiology is still unknown. It is observed in 0.51% of the world population. Medical and social significance is due to the impact on the psychological state of the patient and the quality of his life.
 AIMS: Analysis of the quality of life index in patients suffering from vitiligo.
 MATERIALS AND METHODS: The results of questionnaires filled out by 150 patients (95 women and 55 men) suffering from vitiligo were studied in the work. The average age of the subjects was 34.561.73 years. A survey was conducted among the subjects: patients were asked questions from a questionnaire specially developed by us. The work also used the Dermatological Life Quality Index (DIQI). The questionnaire was filled in by all patients independently at the initial examination. The results were processed using Microsoft Excel from the Microsoft Office software package and the Statistica software package for statistical analysis.
 RESULTS: The data obtained indicate that in all responses to the questions, the largest number of statements were classified as strongly/very strongly. This fact indicates a significant impact of this pathology on the quality of life of the subjects. The DLQI results also confirmed that the presence of vitiligo limits a persons quality of life to the maximum (in 41.3% of cases) and has a large negative impact (in 53.3% of cases).
 CONCLUSION: Performing further research on the study of quality of life in patients suffering from vitiligo is one of the promising areas for developing a personalized approach to managing this group of patients.

Intradermal injection of tranexamic acid combined with topical hydroquinone cream versus topical hydroquinone cream alone in the treatment of melasma

Background: Melasma is a common acquired skin disorder that presents as a bilateral, blotchy, brownish facial pigmentation due to a dysfunction in melanogenesis. It is most common in people who tans easily or have naturally brown skin (Fitzpatrick’s skin phototypes III, IV). Although several treatments are currently used, it remains a great challenge. Aim: This study aims to compare the efficacy of intradermal injection of tranexamic acid (TA) combined with topical hydroquinone cream versus hydroquinone (HQ) cream in the treatment of melasma. Materials and Methods: In thisinterventional prospective comparative clinical trial study, 31 patients with facial melasma were divided randomly into 2 groups, A (16 patients) and B (15 patients). Group A received the combination treatment of intralesional tranexamic acid and topical hydroquinone cream, while group B received topical hydroquinone cream alone. Both groups were assessed by MASI score at baseline and weeks 2, 4, 6, and 8. Results: Thirty-one patients (16 in group A and 15 in group B) completed the study. According to the decline in MASI score, the combination of tranexamic acid and hydroquinone was more effective than hydroquinone alone in the treatment of melasma. Conclusion: Injection of TA intradermally combined with topical HQ cream can be an effective treatment for melasma.

Is there a correlation between the second to fourth digit ratio and vitiligo? A cross-sectional study.

Vitiligo is a multifactorial, acquired skin disease of unknown etiology characterized by depigmented patches caused by melanocyte loss. The ratio of the second to fourth digits (2D:4D) is believed to be a marker of prenatal androgen exposure. Among the many hypotheses for melanocyte loss, one is that sex hormones may play a role in the development of vitiligo. In this study, we aimed to investigate a possible relationship between vitiligo and 2D:4D ratios. The participants in this study were healthy volunteers and patients with vitiligo. This study included 100 patients with vitiligo and 110 healthy controls. An electronic Vernier caliper was employed to measure the finger lengths. The Vitiligo Extent Tensity Index was used to rate the severity of vitiligo (VETI). The study included 100 patients with vitiligo and 110 healthy volunteers of similar age and gender. The mean age of patients with vitiligo was 27.000 ± 13.000 years for females and 30.612 ± 9.112 years for males, and the study sample included 54 (49.09%) females and 56 (50.91%) male patients. Patients' 2D:4D ratios were significantly lower than those of the controls for right hands (p=0.0001). For left hands, there was no correlation between the 2D:4D ratio (p=0.740). There was no statistically significant correlation between the VETI score and the 2D/4D ratio (left hand, p=0.136; right hand p=0.329). To our knowledge, this is the first study to look at the link between 2D:4D ratios and vitiligo in the literature. The findings obtained in this study suggest that the 2D:4D ratio may be a predictor of vitiligo development.

Study of liver X receptor-alpha gene polymorphism (rs2279238) in a sample of Egyptian vitiligo patients

Background Vitiligo is an acquired skin disorder that results from selective destruction of skin melanocytes. It is characterized clinically by the development of depigmented macules and patches. More than 150 genes have been identified to affect the pigmentation of the skin, hair, and eyes. Liver X receptor-α (LXR-α) expression is upregulated in the melanocytes of the perilesional skin as compared with the normal skin of vitiligo patients suggesting its possible contribution in vitiligo pathogenesis. Objective To study LXR-α gene polymorphism (rs2279238) in a sample of Egyptian vitiligo patients. Patients and methods This case–control study was conducted on 25 vitiligo patients aged from 12 to 50 years compared with 25 age- and sex-matched controls. LXR-α gene polymorphism (rs2279238) (C>T) detection was done by allelic discrimination using fluorogenic 5’ Nuclease assay. Results LXR-α gene polymorphism was significantly associated with vitiligo among Egyptian patients but is not correlated with either severity or activity of vitiligo. Conclusion LXR-α gene polymorphism may be associated with vitiligo as found in a sample of Egyptian patients.

Differentiation of Human Induced Pluripotent Stem Cells into Keratinocytes.

Investigating basic biological mechanisms underlying human diseases relies on the availability of sufficient quantities of patient cells. As most primary somatic cells have a limited lifespan, obtaining sufficient material for biological studies has been a challenge. The development of induced pluripotent stem cell (iPSC) technology has been a game changer, especially in the field of rare genetic disorders. iPSC are essentially immortal, can be stored indefinitely, and can thus be used to generate defined somatic cells in unlimited quantities. Further, the availability of genome editing technologies, such as CRISPR/CAS, has provided us with the opportunity to create “designer” iPSC lines with defined genetic characteristics. A major advancement in biological research stems from the development of methods to direct iPSC differentiation into defined cell types. In this article, we provide the basic protocol for the generation of human iPSC‐derived keratinocytes (iPSC‐K). These cells have the characteristics of basal epidermal keratinocytes and represent a tool for the investigation of normal epidermal biology, as well as genetic and acquired skin disorders. © 2022 The Authors. Current Protocols published by Wiley Periodicals LLC. Basic Protocol: Directed differentiation of human iPSC into keratinocytes Support Protocol 1: Coating cell culture dishes or plates with Vitronectin XF™ Support Protocol 2: Freezing iPSC Support Protocol 3: Preparing AggreWell™400 6‐well plates for EB formation Support Protocol 4: Coating cell culture dishes or plates with Collagen IV Support Protocol 5: Immunofluorescence staining of cells

Urinary Proteomics Analysis of Active Vitiligo Patients: Biomarkers for Steroid Treatment Efficacy Prediction and Monitoring.

Vitiligo is a common acquired skin disorder caused by immune-mediated destruction of epidermal melanocytes. Systemic glucocorticoids (GCs) have been used to prevent the progression of active vitiligo, with 8.2–56.2% of patients insensitive to this therapy. Currently, there is a lack of biomarkers that can accurately predict and evaluate treatment responses. The goal of this study was to identify candidate urinary protein biomarkers to predict the efficacy of GCs treatment in active vitiligo patients and monitor the disease. Fifty-eight non-segmental vitiligo patients were enrolled, and 116 urine samples were collected before and after GCs treatment. Patients were classified into a treatment-effective group (n = 42) and a treatment-resistant group (n = 16). Each group was divided equally into age- and sex-matched experimental and validation groups, and proteomic analyses were performed. Differentially expressed proteins were identified, and Ingenuity Pathway Analysis was conducted for the functional annotation of these proteins. Receiver operating characteristic curves were used to evaluate the diagnostic value. A total of 245 and 341 differentially expressed proteins between the treatment-resistant and treatment-effective groups were found before and after GCs treatment, respectively. Bioinformatic analysis revealed that the urinary proteome reflected the efficacy of GCs in active vitiligo patients. Eighty and fifty-four candidate biomarkers for treatment response prediction and treatment response evaluation were validated, respectively. By ELISA analysis, retinol binding protein-1 and torsin 1A interacting protein 1 were validated to have the potential to predict the efficacy of GCs with AUC value of 1 and 0.875, respectively. Retinol binding protein-1, torsin 1A interacting protein 1 and protein disulfide-isomerase A4 were validated to have the potential to reflect positive treatment effect to GCs treatment in active vitiligo with AUC value of 0.861, 1 and 0.868, respectively. This report is the first to identify urine biomarkers for GCs treatment efficacy prediction in vitiligo patients. These findings might contribute to the application of GCs in treating active vitiligo patients.

Bioengineered Efficacy Models of Skin Disease: Advances in the Last 10 Years.

Models of skin diseases, such as psoriasis and scleroderma, must accurately recapitulate the complex microenvironment of human skin to provide an efficacious platform for investigation of skin diseases. Skin disease research has been shifting from less complex and less relevant 2D (two-dimensional) models to significantly more relevant 3D (three-dimensional) models. Three-dimensional modeling systems are better able to recapitulate the complex cell–cell and cell–matrix interactions that occur in vivo within skin. Three-dimensional human skin equivalents (HSEs) have emerged as an advantageous tool for the study of skin disease in vitro. These 3D HSEs can be highly complex, containing both epidermal and dermal compartments with integrated adnexal structures. The addition of adnexal structures to 3D HSEs has allowed researchers to gain more insight into the complex pathology of various hereditary and acquired skin diseases. One method of constructing 3D HSEs, 3D bioprinting, has emerged as a versatile and useful tool for generating highly complex HSEs. The development of commercially available 3D bioprinters has allowed researchers to create highly reproducible 3D HSEs with precise integration of multiple adnexal structures. While the field of bioengineered models for study of skin disease has made tremendous progress in the last decade, there are still significant efforts necessary to create truly biomimetic skin disease models. In future studies utilizing 3D HSEs, emphasis must be placed on integrating all adnexal structures relevant to the skin disease under investigation. Thorough investigation of the intricate pathology of skin diseases and the development of effective treatments requires use of highly efficacious models of skin diseases.

Permeation enhancer nanovesicles mediated topical delivery of curcumin for the treatment of hyperpigmentation

The main aim of the present study was to develop curcumin (CUR) loaded permeation enhancer-lipid vesicles for the treatment of hyperpigmentation. Hyperpigmentation is an acquired skin disorder characterized by uneven skin coloration, mainly in the regions of the facial skin, affecting millions of people worldwide. It often occurs in visible areas, hence causing significant negative psychological and social impacts. In the present study, curcumin-loaded permeation enhancer nanovesicles (PE-NVs) were developed by modified ethanol injection method and dimethyl sulfoxide was added as a penetration enhancer. PE-NVs were subjected to various physicochemical characterizations and drug permeation studies across the skin. The PE-NVs were tested for their efficacy in a sunlight-induced hyperpigmented rabbit skin model. Topical application of PE-NVs reduced symptoms of hyperpigmentation as compared with CUR methanolic solution because of higher accumulation because of better permeation into skin layers. Histopathological studies also confirmed the effectiveness of PE-NVs, since they reduced hyperpigmentation-induced lesions. Results confirmed that PE-NVs is a potential drug delivery system for topical administration drugs to treat skin-associated inflammatory disorders.

A gene-centric approach to biomarker discovery identifies transglutaminase 1 as an epidermal autoantigen.

Autoantigen discovery is a critical challenge for the understanding and diagnosis of autoimmune diseases. While autoantibody markers in current clinical use have been identified through studies focused on individual disorders, we postulated that a reverse approach starting with a putative autoantigen to explore multiple disorders might hold promise. We here targeted the epidermal protein transglutaminase 1 (TGM1) as a member of a protein family prone to autoimmune attack. By screening sera from patients with various acquired skin disorders, we identified seropositive subjects with the blistering mucocutaneous disease paraneoplastic pemphigus. Validation in further subjects confirmed TGM1 autoantibodies as a 55% sensitive and 100% specific marker for paraneoplastic pemphigus. This gene-centric approach leverages the wealth of data available for human genes and may prove generally applicable for biomarker discovery in autoimmune diseases.