Stable Vitiligo Patients Research Articles

Efficacy of ultrathin epidermal grafting followed by narrow band ultraviolet B therapy for stable vitiligo: a novel therapy

<p class="abstract"><strong><span lang="EN-US">Background: </span></strong>Different surgical techniques in the form of tissue or cellular grafting procedures are used alone or in combination with narrow band ultraviolet B (NBUVB) to treat stable vitiligo resistant to medical treatment. The aim of the study was to assess the cosmetic results obtained with combination therapy of ultrathin split-thickness skin grafts and adjuvant NBUVB therapy in resistant, stable vitiligo.</p><p class="abstract"><strong><span lang="EN-US">Methods: </span></strong>Forty patients of stable vitiligo were treated with ultrathin split-thickness grafting and the patients were then put on NBUVB therapy. Extent of repigmentation and final cosmetic outcome at the recipient as well as donor sites were assessed<span lang="EN-US">.<strong></strong></span></p><p class="abstract"><strong><span lang="EN-US">Results: </span></strong>The initial evidence of repigmentation was noted in the second week after starting NBUVB. Results showed 85% of patients had more than 90% repigmentation and the overall cosmetic results at the recipient site was good to excellent in 90% patients at the end of NBUVB treatment. Perigraft halo of depigmentation was seen in five patients (12%) on the recipient site. Hypertrophic scarring was seen in two patients at the donor site.</p><p class="abstract"><strong><span lang="EN-US">Conclusions: </span></strong>Ultrathin split-thickness skin grafting, when combined with NBUVB therapy, leads to better cosmetic outcome with faster onset of repigmentation in resistant and stable vitiligo.</p>

Interleukin-17 level in patients with vitiligo: A systematic review and meta-analysis.

The role of the pro-inflammatory cytokine, interleukin (IL)-17 is being continuously explored in various autoimmune disorders. Studies have assessed the levels of IL-17 in vitiligo patients. This study aims to evaluate the IL-17 levels in vitiligo patients in comparison with the healthy controls by performing a meta-analysis. A systematic review of the existing literature was performed in PubMed, Scopus and Cochrane databases by two authors independently. The data required to calculate the pooled effect size in the form of standardised mean difference (SMD) with the corresponding 95% confidence interval (CI) were extracted from the eligible studies. Separate analyses for active and stable vitiligo were also performed. A total of 11 case-control studies with 626 vitiligo patients and 475 healthy controls were included. Random-effects meta-analysis found significantly higher serum IL-17 levels in vitiligo patients compared with the healthy controls (SMD=1.67, 95% CI 1.11 to 2.22, P<0.001). The IL-17 levels were higher in both active (SMD=1.31, 95% CI 0.76 to 1.86) and stable (SMD=1.47, 95% CI 0.59 to 2.35) vitiligo patients compared with the healthy controls. The skin IL-17 levels were also significantly higher in vitiligo patients (SMD=1.28, 95% CI 0.82 to 1.74). Heterogeneity in the baseline characteristics of the included studies was the major limitation of this study. These results suggest that vitiligo patients have significantly elevated IL-17 levels. Further examination of this association could have implications for the treatment of vitiligo.

Soluble CD27 and MIF as possible serum biomarkers of vitiligo activity in Egyptian patients in Sharkia Governorate.

Contrary to other inflammatory skin disorders like psoriasis or atopic dermatitis, vitiligo does not present with distinct inflammatory symptoms that can be easily evaluated by clinical examination. Identification of a putative biomarker to inform early and accurate treatment responses could be of considerable value. This study aims to validate levels of serum soluble CD27 (sCD27) and macrophage Migration Inhibitory Factor (MIF) as biomarkers of vitiligo to improve the quality of disease management. This cross-sectional study was conducted on 32 vitiligo patients, stratified into two subgroups of 22 active and 10 stable vitiligo patients; the stable group containing 1 segmental and 9 nonsegmental presentations, and 32 matched healthy individuals as the control group. Of the 32 patients in the study, 21 were female and 11 were male with a median age of 30 years. The measurements of the study parameters of sCD27 and MIF in the serum were carried out through blood sampling and followed up for three months at onemonth intervals for stable vitiligo cases. Mean serum levels of sCD27 and MIF were significantly higher in vitiligo patients than in the control group. A positive correlation was observed in active vitiligo cases between both serum MIF and sCD27 levels and the spreading item of Vitiligo European Task Force (VETF) score as an indicator of disease activity. Serum sCD27 and MIF levels in vitiligo patients were observed to be higher than that of controls with greater correlation found for sCD27 with disease activity.

A prospective observational study of follicular unit excision grafting for the management of stable vitiligo

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Vitiligo is a common acquired idiopathic and often, familial hypomelanosis, which is characterized by pale white macules that enlarges centrifugally over time. In India, vitiligo is associated with marked social stigma, thus demanding its effective management. Stable vitiligo lesions known to be relatively refractory medical therapy require surgical therapies like skin grafting or grafting of invitro cultured and non-cultured melanocytes or follicular unit excision (FUE) grafting.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; A prospective observational study was done on patients of stable vitiligo. A total of 20 patients were enrolled and underwent FUE grafting for study of effectiveness and complication.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; A total of 20 patients of stable vitiligo were studied with or without leukotrichia in which good to excellent response was seen in 13 (65%), fair in 6 (30%) and poor in 1 (5%) patients.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; FUE is a superior and upcoming methodology which is cost effective, reliable, less disfiguring, very low morbidity and results in good color match in patients with stable vitiligo.&lt;/p&gt;

Evaluation of the effect of combined intralesional injection of prostaglandin F2α with narrow band UVB phototherapy in treatment of resistant cases of vitiligo

Background Vitiligo is a chronic cutaneous disease characterized with hypopigmented patches that leave psychological impact on the patients. There is increasing need for new treatment modalities to shorten the duration of treatment of vitiligo with the least side effects. Objective To explore the effect of intralesional injection of prostaglandin F2α on the outcome of narrow band ultraviolet rays B (NBUVB) for patients with stable vitiligo. Patients and methods The study included 27 stable vitiligo patients with overall symmetrical lesions. For each patient, one patch was treated with NBUVB alone (control side), while another symmetrical patch was treated with combined intralesional injection of prostaglandin F2α with NBUVB therapy, weekly for 3 months. Results There was statistically significant improvement in the repigmentation in the combination group compared with NBUVB group. Side effects were minimal. Conclusion Intralesional injection of prostaglandin F2α in combination with NBUVB therapy could be considered as safe and tolerable technique for treatment of vitiligo, it shortens the duration of NBUVB therapy. Longer follow up is needed.

Six-year follow-up of vitiligo patients successfully treated with autologous non-cultured melanocyte-keratinocyte transplantation.

Although autologous non-cultured melanocyte-keratinocyte transplantation is a treatment option for stable vitiligo, there is lack of long-term maintenance data for this specific treatment. To search for factors associated with long-term maintenance of patients with stable vitiligo successfully treated with melanocyte-keratinocyte transplantation. This was a single-centre retrospective study including stable vitiligo patients who underwent successful melanocyte-keratinocyte transplantation in the National Center for Vitiligo, Riyadh, Saudi Arabia, between 1 January 2004 and 30 June 2015. Cox proportional hazard model was used to estimate factors associated with relapse at 6 years of followup. Co-variates included, gender, type of vitiligo, age at vitiligo onset, age at surgical procedure, disease duration, disease stability, affected body surface area, treated surface area, fingertip involvement, type of recipient area treatment and recurrence defined as the onset of new lesions on previously untreated areas. The risk of developing relapse defined as re-appearance of more than 10% depigmentation in a previously treated and repigmented site was considered as the main outcome. In total, 602 patients were included in the study of whom 410 (67%) were women. Mean age was 24.25 years [4.0-67.0]. Affected body surface area of less than 1% (adjusted HR = 0.37; P = 0.04) and mechanical dermabrasion (adjusted HR = 0.26; P = 0.03) were independently associated with lower rates of relapse. On the contrary, non-segmental type of vitiligo (adjusted HR = 2.11; P = 0.03) and fingertip involvement (adjusted HR = 3.75; P = 0.01) were independently associated with higher rates of relapse. Criteria for selecting patients with stable vitiligo for surgery should include careful assessment of vitiligo type including body surface area of vitiligo and involvement of fingertip before undergoing surgical procedure.

A Study of Autologous Epidermal Non-cultured Cell Suspension in Stable Vitiligo Patients

Introduction To study the extent of repigmentation after autologous epidermal non-cultured cell suspension in stable vitiligo patients. Patients and Methods A prospective, longitudinal study was conducted to study the extent of repigmentation after autologous epidermal non-cultured cell suspension in 30 stable vitiligo patients Results By subjective assessment, 10% (3) patients showed poor response, 30% (9) showed good response and 60% (18) patients showed excellent response after follow-up at 6 months with good patient satisfaction. By objective assessment 10% (3) patients showed poor response, 13.3% (4) showed fair response and 23.3% (7) patients showed good response, 53.3% (16) patients showed excellent response after follow-up at 6 months. Extent of repigmentation was evaluated as-10% (3) showed poor response, 10% (3) showed fair response and 20% (6) patients showed good response, 60% (18) patients showed excellent response after follow-up at 6 months. Conclusion Autologous non-cultured epidermal cell suspension in stable vitiligo is a safe, effective, simple method, with superior quality of repigmentation.

A study of autologous epidermal non-cultured cell suspension in stable vitiligo patients

A study of autologous epidermal non-cultured cell suspension in stable vitiligo patients

Use of platelet-rich plasma to suspend noncultured epidermal cell suspension improves repigmentation after autologous transplantation in stable vitiligo: a double-blind randomized controlled trial.

Noncultured epidermal cell suspension (NCES) is an effective surgical modality for stable vitiligo which involves transplantation of the basal layer of epidermal cells onto the dermabraded vitiliginous patch. Platelet-rich plasma (PRP) has growth factors which may stimulate melanocyte migration and proliferation of keratinocytes and fibroblasts. The objective of this study was to compare the extent of repigmentation achieved by transplantation of NCES suspended in PRP with that of NCES suspended in phosphate buffered saline (PBS). Twenty-one patients of stable vitiligo with at least two lesions of comparable size were included. The two vitiligo patches were randomized to receive NCES suspended in PRP or PBS. Postoperatively after 1 week, patients were given heliotherapy for 15 minutes daily. At 6 months follow-up, mean repigmentation by area method in PRP arm was 75.6 ± 30% SD and in non-PRP arm was 65 ± 34% SD (P = 0.0036). Patient satisfaction by visual analogue scale at 6 months also showed better results in PRP arm (P = 0.001). Assessment by three independent observers showed better repigmentation in PRP side both at 3 and 6 months. Suspending NCES in PRP can result in significantly greater mean repigmentation and patient satisfaction than suspending in PBS.

Neural and Endocrinal Pathobiochemistry of Vitiligo: Comparative Study for a Hypothesized Mechanism.

The etiology of vitiligo is still unclear. The aim is to investigate a neural and hormonal etio-pathology of vitiligo. Sixty acrofacial vitiligo patients were divided into two subgroups as active vitiligo patients group (AVPs; n = 35) and stable vitiligo patients group (SVP; n = 25). Forty healthy subjects without any systemic or dermatological disease were used as controls. Blood samples were collected, and the samples were used for measurement of free triiodothyronine (fT3), free thyroxine (fT4), thyroid-stimulating hormone (TSH), adrenocorticotrophic hormone (ACTH), cortisol, estrogen, testosterone, melatonin, and prolactin levels by ELISA, while norepinephrine (NE), epinephrine (Epi), dopamine (DA), homo-vanillic acid (HVA), serotonin, and 5-hydroxyindoleacetic acid (5-HIAA) by high-pressure liquid chromatography. The current results showed a significant increase in plasma levels of Epi, NE, DA, HVA, serotonin, 5-HIAA, melatonin, and in serum level of TSH and prolactin either in SVP or AVP groups than the control group and in AVP than SVP group. The serum levels of fT3 and fT4 were significantly decreased either in SVP or AVP groups than the control group. A significant increase in estradiol levels was observed in females within AVP than females in either SVP or control groups. There was a significant increase in serum level of cortisol in AVP than either SVP or control group. There was a significant decrease in serum level of ACTH in either AVP or SVP than control and in AVP than SVP group. In conclusion, there are some neural and endocrine markers that play a pivotal role in pathogenesis and/or consequences of vitiligo. The abnormally disturbed levels of theses markers lead to melanocyte destruction and/or depigmentation.

Association of interleukin 1 receptor antagonist intron 2 variable number of tandem repeats polymorphism with vitiligo susceptibility in Gujarat population.

Vitiligo is a multifactorial, polygenic, autoimmune skin disorder caused by selective destruction of melanocytes. Interleukin 1 receptor antagonist intron 2 polymorphism was found to be associated with various autoimmune disorders. We aimed to investigate the association of interleukin 1 receptor antagonist intron 2 variable number of tandem repeats polymorphism (rs2234663) with vitiligo to assess interleukin 1 receptor antagonist transcript levels and to perform possible genotype-phenotype correlation. Three hundred and seven vitiligo patients and 316 controls were enrolled in the study, genotyping of interleukin 1 receptor antagonist rs2234663 was performed by polymerase chain reaction, and relative gene expression of interleukin 1 receptor antagonist was carried out in peripheral blood mononuclear cells from patients (n = 36) and controls (n = 36) by real-time-PCR. A significant difference was observed in the frequency of interleukin 1 receptor antagonist *A (1/2) genotype among patients with active and stable vitiligo (P = 0.0172). Interleukin 1 receptor antagonist*A (2/2) genotype and allele frequencies were significantly different between SV patients and controls (P = 0.0246 and P = 0.0046, respectively). Significant difference was also observed for interleukin 1 receptor antagonist*A2 (allele) in active and stable vitiligo patients (P = 0.0060). However, other comparisons did not show any significant difference in genotype and allele frequencies. Moreover, interleukin 1 receptor antagonist*A (3/2) genotype was observed only in patients whereas interleukin 1 receptor antagonist*A (5/2) was observed only in controls. Gene expression analysis showed no significant difference in interleukin 1 receptor antagonist transcript levels in patients compared to controls (P = 0.5962). Interestingly, genotype-phenotype correlation analysis revealed that individuals with IL1RN*A (2/2) exhibited higher interleukin 1 receptor antagonist expression compared to other major genotypes interleukin 1 receptor antagonist*A (1/2) (P = 0.01) and interleukin 1 receptor antagonist*A (1/1) (P = 0.03). More case-control studies on interleukin 1 receptor antagonist rs2234663 polymorphism and gene expression from different ethnic populations are required to explore the impact of interleukin 1 receptor antagonist in vitiligo susceptibility. Interleukin 1 receptor antagonist*A2 might be a risk factor for progressive vitiligo.

Role of chemokines and the corresponding receptors in vitiligo: A pilot study.

To determine the levels and sources of chemokines in the serum and epidermis of vitiligo patients, we examined 80 active patients, 80 stable patients and 40 healthy controls. First, the serum levels of candidate chemokines were measured by Luminex assay, and levels of CCR5, CXCR1 and CXCR3 were measured in peripheral mononuclear cells (PMBC) by flow cytometry. Then, the local epidermis levels of elevated chemokines in vitiligo were tested by Luminex. Finally, the mRNA and protein expression levels of elevated chemokines in HaCaT cells stimulated with interferon (IFN)-γ or tumor necrosis factor (TNF)-α were tested by quantitative real-time polymerase chain reaction and Luminex. The serum levels of CCL5, CXCL8 and CXCL10 in active vitiligo were significantly elevated compared with those in stable vitiligo patients. Furthermore, the levels of CCL3 and CCL4 had weak and positive correlations with the Vitiligo Area Scoring Index. In the peripheral blood of active vitiligo patients, the percentages of CD3+ CD8+ CCR5+ and CD3+ CD8+ CXCR3+ T cells were significantly increased compared with those in stable vitiligo and healthy controls. In the epidermis of lesions, the expression levels of CCL5 and CXCL10 in active vitiligo were significantly increased. In addition, the mRNA and protein levels of CCL5, CXCL8 and CXCL10 were significantly elevated in HaCaT cells after stimulation with TNF-α or IFN-γ. The CCR5/CCL5 and CXCR3/CXCL10 axes may play an important role in the progression and maintenance of vitiligo. Moreover, keratinocytes stimulated with TNF-α and IFN-γ may be a primary source of CCL5 and CXCL10.

Comparison of Repigmentation of Stable Vitiligo via Punch Grafting, Thin-thiersch’s grafting and Suction Blister Grafting

Background: Vitiligo is defined as an acquired melanocytopenia of obscure aetiology and is characterized by circumscribed hypomelanosis and depigmentation of skin and hair which is often progressive. The aim of present study is to compare between 3 surgical modalities i.e. miniature punch grafting, thin split-skin thickness grafting and suction blister grafting and to experiment a novel method according to the site, size and location of the lesion and to study the extent of re-pigmentation after doing these procedures and comparison of the results in patients of stable vitiligo. We also aim to assess the complications and disadvantages of different surgical techniques. Methods: The study was conducted on total 60 vitiligo patients, who were divided into 3 groups of 20 each, in the age group of 15-60 years, attending Dermatology Department of Katihar Medical College in the span of 2 yearsResults. Results are comparable overall but vary considerably according to site of lesions. Punch grafting is very good for mobile areas like elbow, ankle and other joints; Thin – thiersch’s skin grafting gives better results for flat areas like trunk, thigh, arms and face while Suction blister grafting gives satisfactory results for lips vitiligo and also over small, oval lesions over flat sites. Conclusions: Thus, it can be finally concluded from this study that the surgical modality for treating a case of vitiligo cannot be generalized. Every patient should be evaluated individually according to anatomical site involved, size and shape of lesion, time required to achieve pigmentation, infrastructure available and patient’s preferences.

Modified Technique of Cultured Epithelial Cells Transplantation on Facial Segmental Vitiligo.

Cultured epithelial cells transplantation is a known surgical technique for vitiligo. To evaluate the factors influencing efficacy and safety of cultured epithelial cells transplantation in 9-month follow-up. Demographic, clinical, and repigmentation outcomes were reviewed for patients with facial segmental vitiligo who had undergone cultured epithelial cells transplantation from November 2013 to July 2015 at the clinic of the Department of Dermatology, Huashan Hospital, China. Twenty-eight patients who had undergone cultured epithelial cells transplantation were included. A satisfactory result (>50% repigmentation) was achieved in 79% patients with facial segmental vitiligo in 9 months. The treatment effect was significantly different in 6th month (P = 0.032), 9th month (P = 0.006) compared with 3rd month. Disease stability did significantly affect repigmentation outcome in 9th month (Z = 2.113, P = 0.035). No significant difference was observed between single segmental type versus mixed type (Z = 1.081, P = 0.280). Adverse effects were nearly absent. Cultured epithelial cells transplantation is a relatively safe and effective therapy for facial segmental stable vitiligo patients.

Efficacy of Miniature Punch Grafting Followed by Puvasol Therapy in Refractory Stable Vitiligo

Introduction: Vitiligo affects approximately 2% of the worldwide population regardless of race, ethnic background or gender. When the medical methods are not successful, surgical procedures may be considered with the aim of placing a new source of pigment cells to reinitiate melanogenesis within the affected areas. This study was conducted to evaluate the efficacy of combining punch grafting followed by PUVASOL therapy in vitiligo patients. After punch grafting patients are given PUVA/PUVASOL exposure.Objective: To study the efficacy of miniature punch grafting followed by PUVASOL therapy in refractory stable vitiligo.Material and Methods: The present study was conducted in the Department of Dermatology and Venereology of Dayanand Medical College &amp; Hospital, Ludhiana from May 2005 to March 2007. Fifteen patients of chronic stable vitiligo not responding to medical treatment and attending the outpatient department of dermatology were included in study. Appropriate statistical methods were used to analyse the data.Conclusion: Patients subjected to Miniature Punch Grafting showed more than 80% acceptance in all selected age groups and among both the sex. There was an inverse relationship between number of grafts inserted and rejection rate. Most common side effect seen was cobblestoning (60%) with few patients showing graft displacement and hematoma formation too.

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To evaluate the efficacy and influential factors for 308 nm excimer laser in the treatment of stable vitiligo patients. A total of 207 stable vitiligo patients with 1 763 patches were treated with 308 nm excimer laser. Open-label study was carried out to investigate the efficacy and safety regarding the treatment with 308 nm excimer laser, and to compare the response under different conditions including gender, age, duration, lesion location, and hair color. After treatment, 560 (31.8%) patches achieved 100% repigmentation, 650 (36.9%) lesions showed 75%-99% repigmentation, 189(10.7%) showed 50%-75% repigmentation, 231(13.1%) showed 25%-49% repigmentation, 108(6.1%) showed 1%-24% repigmentation, 25(1.4%) displayed no response. The rates of total excellent response (50%-100% repigmentation) in underage patients was 86.9%, much higher than that in adult patients (P<0.001). Total excellent response rates was 90.6% in disease duration <2 years, and 40.7% in disease duration ≥2 years. Lesions on the faciocervical region responded better than trunk and limbs, showing 95.4%, 70.3%, and 41.7% total excellent response, respectively. Patients with poliosis showed 54.9% in total excellent response rate, much lower than 84.5% in patients without poliosis(P<0.001). No significant response differences in gender were found. 308 nm excimer laser is effective and safe in treatment of vitiligo. Aging, disease duration, lesion location, and hair color in lesion may be the influential factors for 308 nm excimer laser in treatment of vitiligo patients.

A Study of Noncultured Extracted Hair Follicle Outer Root Sheath Cell Suspension for Transplantation in Vitiligo.

Context:Vitiligo surgeries have come a long way from tissue grafts to cultured and non cultured cell transplantation. Extracted hair follicle outer root sheath cell transplantation (EHF ORS) suspension is more enriched with melanocyte. In a hair bulb, there is one melanocyte for every five keratinocytes which is much higher than the epidermal melanin unit.Aims:To analyse the effectiveness of cultured EHF ORS and to perform objective evaluation based on clinical improvement & photographic evidence. To observe any untoward events or side effects.Settings and Design:The study was open and uncontrolled. All the patients were screened at preliminary visit. Reviews were done every two weeks. The endpoint selected was six months post procedure.Materials and Methods:Twenty five patients of stable Vitiligo were included in the study and follicular unit were harvested by Follicular Unit Extraction method. Outer root sheath cells were extracted by trypsinization. The solution was transplanted over dermabraded recipient site. Pressure dressing was given. Patients were followed up regularly.Statistical Analysis Used:Descriptive Statistics, Chi-Square.Results:Mean ± SD repigmentation was 80.15% ± 22.9% with excellent repigmentation (90-100%) in 60% of patients.Conclusions:This method is safe, effective, and simpler than the other methods involving cell culturing and requiring a laboratory set-up but selection of patients is crucial for the success of the outcome.

Glutathione Peroxidase Level in Patients with Vitiligo: A Meta-Analysis.

Abnormality of glutathione peroxidase (GPx) is involved in the etiology and pathogenesis of vitiligo. However, the results were controversial. Aim. The purpose of this meta-analysis is to compare the levels of GPx between vitiligo patients and healthy controls. Methods. Relevant published articles were searched according to eligibility criteria. A meta-analysis was conducted to pool estimates of the standardized mean difference (SMD) with 95% confidence interval (CI). Results. Twenty-three studies with a total of 1076 vitiligo patients and 770 healthy controls were included. The pooled meta-analysis showed that patients with vitiligo had equivalent levels of GPx with the healthy controls (SMD = −0.47, 95% CI: −1.03 to 0.08, and p = 0.095). Further subgroup analysis showed that the GPx levels of Asian patients or segmental vitiligo patients were, respectively, lower than those of healthy controls (Asian: SMD = −0.47, 95% CI: −1.08 to 0.14, and p = 0.001; segmental: SMD = −3.59, 95% CI: −6.38 to −0.80, and p = 0.012). Furthermore, the GPx levels in serum/plasma were significantly decreased in either stable or active vitiligo patients, comparing to healthy controls (stable: SMD = −2.01, 95% CI: −3.52 to −0.49, and p = 0.009; active: SMD = −2.34, 95% CI: −4.07 to −0.61, and p = 0.008). Conclusion. This meta-analysis showed a significant association between low GPx level and vitiligo.

The effect of platelet‐rich plasma on the outcome of short‐term narrowband–ultraviolet B phototherapy in the treatment of vitiligo: a pilot study

Narrowband - ultraviolet B (NB-UVB) is an emerging, effective, and safe therapy for vitiligo, but the treatment course often requires a long duration of time which may carry a potential risk for various side effects and patients' noncompliance. To explore the effect of platelet-rich plasma (PRP) injection on the outcome of short-term NB-UVB therapy for the patients with stable vitiligo. The study included 60 stable vitiligo patients with overall symmetrical lesions. For each patient, the left side of the body was treated with NB-UVB alone (control side) while the right side was treated with NB-UVB therapy in addition to intradermal injection of PRP, every 2weeks for 4months. There was statistically highly significant improvement in the repigmentation in the combination group(PRP plus NB-UVB) compared with NB-UVB group. Intradermal PRP injection in combination with NB-UVB could be considered as a simple, safe, tolerable, and cheap technique for treatment of vitiligo. It shortens the duration of NB-UVB therapy and is expected to increase patient compliance. Longer follow-up is needed.

ASSESSMENT OF OXIDATIVE STRESS DURING NARROW BAND UVB PHOTOTHERAPY IN VITILIGO PATIENTS OF NORTH INDIA

Vitiligo is an acquired epidermal pigment loss which occurs anywhere in the body. The disease occurs worldwide with an estimated overall prevalence of less than 0.5%. The biological basis of vitiligo has been an intractable problem to confront. Among several therapies for the disease, narrow band UVB phototherapy is preferred modality and is effective. Recently, oxidative stress has been speculated to be the primary event in the pathogenesis of vitiligo. The ability of free radicals to destroy melanocytes is considered as missing link. This study is aimed to assess the oxidative stress and antioxidant status in vitiligo patients with and without NB-UVB phototherapy for 4 weeks. 30 Vitiligo patients were recruited for study from OPD of Department of Dermatology, Era’s Lucknow Medical College & Hospital, Lucknow. Blood of all subjects was investigated for anti-oxidant parameters such as Superoxide dismutase (SOD), Catalase (CAT), Glutathione peroxidase (GPx) and Lipid peroxides (LPO). Results indicated significant increase in the CAT and SOD activity in stable vitiligo patients after NB-UVB phototherapy as compared to its baseline activity. However, in active vitiligo patients, the increase in the CAT and SOD activity were found non-significant. GPx activity was found statistically non-significant in active vitiligo group after NB-UVB phototherapy compared to its baseline value, however in stable vitiligo patients the GPx activity was statistically significant. Following the NB-UVB phototherapy the LPO levels increased significantly in both active and stable vitiligo patients as compared to their baseline values.