Stable Patches Research Articles

Cross-Sectional Descriptive Study of the Utility of Dermoscopy in Assessing the Activity and Stability of Vitiligo

Introduction: Dermoscopy is an important noninvasive tool that helps to determine the stability and activity of vitiligo. Various dermoscopic findings help classify the disease as stable or unstable. This is important for the management of the disease, as surgical management requires disease stability. Objectives: We aimed to describe the dermoscopic findings in vitiligo and to assess the frequency of various dermoscopic findings in stable and unstable vitiligo. Methods: This was a hospital-based, cross-sectional, descriptive study of 100 vitiligo patients and various dermoscopic findings. Results are expressed as percentages. Results: The most common dermoscopic findings in stable vitiligo patches were sharp border, marginal and perifollicular pigmentation, and reticulate pigment network. Findings such as polka dot appearance, starburst appearance, comet tail, and satellite lesions were seen in unstable vitiligo patches. Conclusions: Dermoscopy is extremely helpful in determining the stability of vitiligo patches.

Spatial Aggregations of the Grey Field Slug Deroceras reticulatum Are Unstable Under Abnormally High Soil Moisture Conditions.

Deroceras reticulatum in arable fields display spatio-temporally stable slug patches that have been well documented under typical soil moisture conditions. The effect of abnormally high soil moisture on slug patch stability, however, is unknown. In this study, stepped gradient choice tests comparing soil moisture levels of 50-125% soil capacity showed slug preferences for levels in a range near to 125%. Activity became erratic, however, when given a choice of high moisture levels (125-370%), potentially because slugs searched for preferred conditions. Slug spatial aggregation was investigated in 21 commercial fields in 2023/24, a season of extreme rainfall, and then compared to years exhibiting typical rainfall (2015-2018). Slug patches occurred in 27.2% of assessment visits to fields during 2023/24 compared to 96.4% in typical years, suggesting weather conditions leading to abnormally high soil moisture are significantly associated with the breakdown of slug spatial aggregation behaviour. Random forest models identified the weather predictors (precipitation, relative humidity, temperature) with the highest impact on slug distribution and relative abundance, with the assessment date and region also related to relative abundance. However, a complex of environmental parameters affects soil moisture content, and no statistically significant effects of individual weather predictors emerged. The results are discussed in relation to slug behaviour in the context of their impact on targeted slug treatments.

Microneedling and 5-Fluorouracil in Treating Stable Vitiligo in Hitherto Unstudied High Prevalence Population

Abstract Background: Vitiligo, affecting 0.25% in India (>1% in Jharkhand), stigmatises and devastates self-esteem/relationships causing depression. Apart from medical treatment, surgical procedures like applying 5-fluorouracil after microneedling are to be confirmed in unstudied populations and across time periods. An interventional study was conducted among out-patients of a tertiary hospital in a high-prevalence population wherein earlier attempts were not conducted. Aims/Objectives: To assess the effect of microneedling and applying 5% 5-fluorouracil on stable vitiligo patches. Methods and Materials: Microneedling and topical application of 5-fluorouracil was planned on 30 subjects of 10–50 age-groups with stable vitiligo, from September 2019 to September 2021 every 15 days for 12 visits. Age, gender, site, size/stability of vitiligo patches, leukotrichia and vitiligo family history were studied. Repigmentation (overall and variable-wise) was measured at each visit using 76–100% (excellent), 51–75% (very good), 25 to 50% (good) and <25% (poor). Data was analysed with the Chi-square test or Standard Error of Difference between two proportions. Results: Under COVID restrictions (2020–2021), sample coverage was 77% (23/30) comprising 13 females and 10 males. Visits varied for each subject totalling 185 visits out of an expected 276 (67%). Significantly, 3 (13%) achieved excellent repigmentation, 10 (43%) very good, 8 (35%) good and only 2 (9%) poor repigmentation. Cumulatively, 13 (56%) attained excellent/very good repigmentation and 21 (91%) had excellent/very good/good repigmentation. Repigmentation ranged from 10% to 100% among 23 subjects, averaging 54% in average 8 visits (4 months). Repigmentation was equally achieved irrespective of age, gender, site, size and stability of the vitiliginous patch, presence/absence of leukotrichia and family history of vitiligo. Manageable pain (100%), itching (4%) and hyperpigmentation 43%, were side effects. Conclusion: Cumulative 91% (excellent/very good/good) repigmentation despite COVID-19 in the study period, and its comparability with other studies, strengthens evidence that microneedling and 5% 5-fluorouracil is effective in treating stable vitiligo in a high prevalence population.

To study the efficacy of autologous non-cultured nontrypsinized epidermal cell grafting (Jodhpur technique) by using of suction blister membrane in stable vitiligo.

This study aimed to evaluate the efficacy of autologous non-cultured non-trypsinized melanocytekeratinocyte grafting (JT) with suction blister membrane as biological dressing in stable vitiligo patches. The study was conducted at Mathura Das Mathur Hospital (MDM), Jodhpur, on 43 patches of Stable vitiligo. It was a prospective single-arm interventional study. All patients were examined clinically and history and informed consent were taken before starting the procedure. About 95% of patches showed >50% repigmentation with 83.72% having good to excellent repigmentation. About 88% of patches showed good color matches with an excellent decline in Dermatology Life Quality Index (DLQI). No serious complication was observed in the present study. The most common complication observed both in the donor and recipient area was pain. Our study indicates that combining JT with suction blister epidermal grafting is a comparatively effective technique in terms of good repigmentation (≥75% extent of repigmentation), color match, fewer side effects, good patient satisfaction, and DLQI reduction.

Fragile futures: Evaluating habitat and climate change response of hog badgers (Mustelidae: Arctonyx) in the conservation landscape of mainland Asia.

The small mammalian fauna plays pivotal roles in ecosystem dynamics and as crucial biodiversity indicators. However, recent research has raised concerns about the decline of mammalian species due to climate change. Consequently, significant attention is directed toward studying various big flagship mammalian species for conservation. However, small mammals such as the hog badgers (Mustelidae: Arctonyx) remain understudied regarding the impacts of climate change in Asia. The present study offers a comprehensive analysis of climate change effects on two mainland hog badger species, utilizing ensemble species distribution modeling. Findings reveal concerning outcomes, as only 52% of the IUCN extent is deemed suitable for the Great Hog Badger (Arctonyx collaris) and a mere 17% is ideal for the Northern Hog Badger (Arctonyx albogularis). Notably, projections suggest a potential reduction of over 26% in suitable areas for both species under future climate scenarios, with the most severe decline anticipated in the high-emission scenario of SSP585. These declines translate into evident habitat fragmentation, particularly impacting A. collaris, whose patches shrink substantially, contrasting with the relatively stable patches of A. albogularis. However, despite their differences, niche overlap analysis reveals an intriguing increase in overlap between the two species, indicating potential ecological shifts. The study underscores the importance of integrating climate change and habitat fragmentation considerations into conservation strategies, urging a reassessment of the IUCN status of A. albogularis. The insights gained from this research are crucial for improving protection measures by ensuring adequate legal safeguards and maintaining ecological corridors between viable habitat patches, which are essential for the conservation of hog badgers across mainland Asia. Furthermore, emphasizing the urgency of proactive efforts, particularly in countries with suitable habitats can help safeguard these small mammalian species and their ecosystems from the detrimental impacts of climate change.

Ice-inhabiting species of Bdelloidea Rotifera reveal a pre-Quaternary ancestry in the Arctic cryosphere.

Historical climate data indicate that the Earth has passed through multiple geological periods with much warmer-than-present climates, including epochs of the Miocene (23-5.3 mya BP) with temperatures 3-4°C above present, and more recent interglacial stages of the Quaternary, for example, Marine Isotope Stage 11c (approx. 425-395 ka BP) and Middle Holocene thermal maximum (7.5-4.2 ka BP), during which continental glaciers may have melted entirely. Such warm periods would have severe consequences for ice-obligate fauna in terms of their distribution, biodiversity and population structure. To determine the impacts of these climatic events in the Nordic cryosphere, we surveyed ice habitats throughout mainland Norway and Svalbard ranging from maritime glaciers to continental ice patches (i.e. non-flowing, inland ice subjected to deep freezing overwinter), finding particularly widespread populations of ice-inhabiting bdelloid rotifers. Combined mitochondrial and nuclear DNA sequencing identified approx. 16 undescribed, species-level rotifer lineages that revealed an ancestry predating the Quaternary (> 2.58 mya). These rotifers also displayed robust freeze/thaw tolerance in laboratory experiments. Collectively, these data suggest that extensive ice refugia, comparable with stable ice patches across the contemporary Norwegian landscape, persisted in the cryosphere over geological time, and may have facilitated the long-term survival of ice-obligate Metazoa before and throughout the Quaternary.

Combination of Fractional Carbon Di Oxide Laser with Narrow Band Ultravoilet B Therapy to induce repigmentation in stable resistant vitiligo- A split-lesional study

Context: Resistant vitiligo is challenging to treat and needs new therapeutic approaches such as combining fractional carbon dioxide (CO2) laser and narrow-band ultraviolet B (NB-UVB) therapy. Aims: The study aimed to determine the efficacy and safety of combining fractional CO2 laser and NB-UVB therapy to induce repigmentation in resistant localized vitiligo patches. Materials and Methods: In this open, prospective, split-lesional study, 40 stable resistant vitiligo patches in 30 patients were included and assessed. After an initial assessment, a few resistant patches of vitiligo were identified, and a symmetrical half of it was given two sessions of fractional CO2 laser 1 month apart, followed by NB-UVB sessions to both sides thrice weekly for 3 months. Photographs were taken at baseline and 12 weeks, and repigmentation responses were assessed by calculating the mean percentage of improvement and mean grade of pigmentation on the fractional CO2 laser with NB-UVB site (test) and the only NB-UVB site (control) and then compared using Wilcoxon signed-rank test, with significance determined by P value <0.05. Results: The mean grade of pigmentation (1.8±0.88) and mean surface area improvement (8.40 ± 6.82 cm2) on the fractional CO2 laser with NB-UVB site (test) were statistically better than the mean grade of pigmentation (1.27 ± 0.71) and mean surface area improvement (5.37 ± 6.76 cm2) on the NB-UVB site. A better grade of pigmentation was noted over sun-protected areas with fractional CO2 and NB-UVB therapy, while NB-UVB therapy fared better in sun-exposed areas. Conclusions: Fractional CO2 laser with NB-UVB therapy is an effective treatment in resistant vitiligo patches, especially for sun-protected areas.

Comparing the efficacy of 308-nm light-emitting diode and 308-nm excimer lamp for treating vitiligo: A randomized controlled trial.

In previous studies, the 308-nm light-emitting diode (LED) has been proven safe and effective for treating vitiligo. However, direct comparisons between the 308-nm LED and 308-nm excimer lamp (308-nm MEL) for the treatment of vitiligo are lacking. To compare the efficacy of the 308-nm LED and 308-nm MEL for treating nonsegmental stable vitiligo. This randomized controlled trial was conducted between January 2018 and August 2023. Enrolled patients were randomly assigned to either the 308-nm LED or the 308-nm MEL groups, both receiving 16 treatment sessions. Adverse events that occurred during the treatment were documented. In total, 269 stable vitiligo patches from 174 patients completed the study. A total of 131 lesions were included in the 308-nm LED group, and 138 lesions were included in the 308-nm MEL group. After 16 treatment sessions, 38.17% of the vitiligo patches in the 308-nm LED group achieved repigmentation of at least 50% versus 38.41% in the 308-nm MEL group. The two devices exhibited similar results in terms of efficacy for a repigmentation of at least 50% (p = .968). The incidence of adverse effects with the two phototherapy devices was comparable (p = .522). Treatment of vitiligo with the 308-nm LED had a similar efficacy rate to the 308-nm MEL, and the incidence of adverse effects was comparable between the two devices.

Soil organic carbon stocks and belowground biomass in patches in heterogeneous grassland

AbstractBackgroundSelective grazing creates stable patches of contrasting sward height, thereby providing different growth conditions for the grass sward above and below ground and potentially affecting soil organic carbon (SOC) stocks. We hypothesized that the presence of patches leads to greater spatial variability in belowground biomass (BGB) and SOC stocks than occurs between pastures managed under different stocking intensities.MethodsA long‐term grazing experiment consisting of three stocking intensities was used for this study. We studied BGB, SOC, and soil total nitrogen (Ntot) stocks in the 0–15 cm soil depth. Shannon diversity of plant species, soil bulk density, soil phosphorus, potassium, and magnesium contents were considered.ResultsThere were no significant effects of patch or stocking intensity on BGB, SOC, and Ntot stocks. Short patches had a greater Shannon diversity than tall patches (p < 0.05) and plant‐available nutrients in soil correlated positively with sward height (p < 0.05).ConclusionsWe conclude from the current results and previous studies that higher plant species diversity with lower soil nutrient contents in short‐patch areas and higher nutrient contents together with light competition in tall‐patch areas might balance each other out with respect to BGB and SOC stocks.

Stable habitat supports long-term persistence of critically endangered western black crested gibbon

Stable habitat provides sufficient food to sustain large species populations, and becomes a refuge under increasing environmental stress. Stable habitat also becomes a population source and re-expand hotspot once the stress decreases. Thus, identifying and protecting stable habitat is key to species’ long-term persistence. We identified the stable habitat for critically endangered western black crested gibbon (Nomascus concolor) in Mt. Wuliang, where one of two largest populations of this species lives in. We collected gibbon historical distribution data, and modeled the potential habitat in Mt. Wuliang during 2000, 2010, and 2020. We identified the stable habitat by overlaying the potential habitat layers from the three time periods and excluded habitat patches smaller than the species’ home range. Gibbon habitats continuously expanded from 2000 to 2010 (+13%), and from 2010 to 2020 (+6%), indicating that gibbon habitats are recovering at Mt. Wuliang. Stable habitat was 304 km2, mainly located at mid-elevation (2 100 – 2 600 m). Nearly all (99%) gibbon groups occupied stable habitat in each period at a mean density of 0.34 groups/ km2. Gibbon population density in the Wuliangshan National Nature Reserve (WNNR, 0.44 groups/ km2) was 83% greater than that density outside WNNR (0.24 groups/ km2). However, only 50% of stable habitat was within WNNR. Thirteen stable habitat patches located outside WNNR require urgent conservation interventions. Stable habitat in protected area is sufficient to ensure the persistence of these gibbons, but we still need to involve stable habitat outside protected area to sustain population recovery in the future.

Variation of stretching tension and breaking tendency of floating fresh South Louisiana crude oil with slick thickness

Floating crude oil patches can separate from the main oil slicks depending on oil characteristics and sea conditions. The breaking tendency of smaller oil patches from the fresh crude oil slicks vary depending on oil type and thickness of the oil slick. Some oil slicks have high breaking tensions that can support significant weight. We investigated the breaking tension of fresh crude oil (South Louisiana crude oil (MC 252)) floating on water in relation to oil layer thickness. We observed that there is a critical thickness (CT) at which the floating oil exhibits significantly high breaking tension, and it becomes difficult for oil patches to break off. Below the CT, the floating oil layer was too thin and broke off easily. Above the CT, the oil layer was too thick, and external forces caused larger oil to stretch to form larger globules that broke off from the main floating oil until the oil layer thickness was reduced to CT. For the fresh crude oil tested, we estimate the maximum breaking tension as 0.23 ± 0.02 N/m and occurred at oil layer thickness of 0.16 mm. When the oil layer was thicker than the CT, the breaking tension was significantly lower (0.03 ± 0.02 N/m) and larger oil globules separated from the floating oil easily. These observations explain the conditions that lead to formation of highly stable oil patches at sea that can remain floating and travel long distances, some eventually depositing at beaches and in shallow waters as large oil patches.

DS13 A comparative study between recipient site preparation using manual dermabrasion and tattooing pen in autologous noncultured epidermal cell suspension procedure in stable vitiligo patients: a randomized double blinded study

Abstract Vitiligo is a common acquired disorder of depigmentation that occurs as a result of melanocyte loss. Surgical therapies are indicated in patients with stable disease who fail to respond to medical therapies. This mostly includes autologous grafting techniques both tissue and cellular (both cultured and noncultured). Common techniques of recipient site preparation include dermabrasion, suction blistering, liquid nitrogen, electrofulguration and microneedling. The aim was to assess the difference in extent of repigmentation with manual dermabrasion and tattooing pen in a noncultured epidermal cell suspension on stable vitiligo patches. This was a prospective intraindividual comparative study. Thirty-six patients with stable vitiligo were recruited. Patients had a clinical diagnosis of segmental or nonsegmental vitiligo and had two independent patches of 3 × 3 cm or more present either symmetrically or unilaterally over the same body site or a single patch of 6 × 6 cm or more. Vitiligo lesions had been stable for ≥ 1 year. At week 24, the proportion of patients achieving > 75% repigmentation with manual dermabrasion was 86%. In contrast, 61% of patients in the tattooing pen group achieved > 75% repigmentation. At week 24, the proportion of patients achieving > 50% repigmentation with manual dermabrasion was 89% vs. 72% of patients in the tattooing pen group. Eighty per cent of patches at acral sites in patients in the manual dermabrasion group achieved > 75% repigmentation vs. 94% in nonacral patches, whereas in the tattooing pen group, 47% of patches at acral sites achieved > 75% repigmentation vs. 73.3% in nonacral patches. In terms of colour matching, at 24 weeks, good colour matching with the surrounding normal skin was obtained in 80% of patches in both groups. There was a significant difference in efficacy between the two methods in favour of manual dermabrasion. Tattooing pen for melanocyte delivery has the advantage over manual dermabrasion in that it is less time consuming and also reduces cell loss. Recipient site preparation by manual dermabrasion showed a higher rate of infection vs. the tattooing pen at 4 weeks (25% vs. 6%). Recipient site preparation in terms of colour matching and halo phenomena was comparable in both the groups, with no significant difference seen. Patient satisfaction in terms of physician global assessment score and Vitiligo Quality of Life index (VitiQoL) was comparable for both methods, with no significant difference seen.

Living woody vegetation as a storage element for large wood in the channel

The stability of large wood (LW) in the channels is a prerequisite for its persisting geomorphic and ecological effects. This study analysed the factors influencing the storage of LW by living woody vegetation while still interacting with the active channel (and consequently, having potential geomorphic and ecological impact in the channel). It was conducted through field inventory of sixteen European channel reaches across various environmental settings. On the reach scale, the volumes of LW pinned by woody vegetation per channel area (0.1–18.2 m3/ha) followed global trends for total LW volumes., As the catchment area and channel width increased, and bed slope decreased, LW volumes pinned by vegetation decreased. However, the volumetric proportion of LW pinned by vegetation (1.5–30.3 %) did not increase solely as a simple function of the increasing LW mobilisation rate (represented by the increasing catchment area and channel width) or the increasing density of woody vegetation in the fluvial corridor. Instead, the specifics of the disturbance regime had an additional impact on the distribution of LW and its potential pinning on living vegetation in fluvial corridors. Moreover, stable vegetated patches in the channel were detected as significant features responsible for the pinning of LW. Only two tested reaches indicated significantly smaller dimensions of LW pinned by vegetation compared to unattached LW. This implied a possible equimobility mode of LW transport based on their sizes during flood pulses, suggesting somewhat ‘random’ dimensions of LW trapped by woody vegetation. This study demonstrated that woody vegetation occupying fluvial corridors cannot be solely regarded as sources of LW recruitment, but these trees and shrubs also play a crucial role as retention elements for mobilised wood during floods or other hydrogeomorphic events.

Cations make a difference: Soil nutrient patches and fine‐scale root abundance of individual species in a mountain grassland

Abstract Root densities in the field vary at the centimetre scale, but we have no information on whether this variation is linked to the variation in nutrient concentrations and availability. Roots of many species are able to proliferate in nutrient‐rich patches in controlled conditions in culture, but because data on nutrient concentrations and, in particular, on their temporal stability in the field are scarce, we do not know to what extent root distribution in the soil bears traces of such a response. Here, we linked centimetre‐scale measurements of soil nutrient concentrations over 6 weeks with estimation of root biomass and its species composition at the same points to determine whether there is any association between the two. In addition to phosphorus, nitrate and ammonium, we determined the concentrations of metal cations (magnesium, calcium and potassium). We used qPCR to determine the quantities of individual species in the root biomass samples. We found that calcium and magnesium (and to a lesser degree phosphorus and potassium) showed fine‐scale patchiness that was stable throughout the study (6 weeks) and was consistent over all these elements. Nutrient patches were associated with high root biomass and the occurrence of roots of several species. Such patches are formed primarily by elements with known low mobility in soil (cations, phosphorus). In contrast, nitrogen ions showed overwhelmingly high temporal variation with no relationship between root density and nitrogen concentration. Soil nutrient concentrations, thus, constitute a multidimensional signal. Some elements strongly vary in time, while some are much more stable and, thus, form stable patches that permit root response over periods of weeks or months. Among them, calcium and magnesium play an important role in forming soil heterogeneity at a scale comparable with the scale at which fine root densities also vary. As these cations affect a number of plant functions, their association with higher root densities confirms their role in the growth dynamics of terrestrial ecosystems. Read the free Plain Language Summary for this article on the Journal blog.

A Comparative Study between Autologous Noncultured Trypsinized Melanocytes-Keratinocytes Cell Suspension and Autologous Noncultured Nontrypsinized Epidermal Cells Grafting (Jodhpur Technique) in Stable Vitiligo.

Noncultured epidermal cell suspension (NCES) and Jodhpur technique (JT) are two treatment options in vitiligo, in which the basic principle is the transfer of melanocytes from uninvolved skin to stable vitiligo patch in the form of either tissue graft or cellular graft. The aim of this study was to evaluate effectiveness of two different treatment methods (NCES and JT) in stable vitiligo. This was a randomized comparative study, which included 45 patients with 153 stable vitiligo patches. Cases were randomly divided into two groups. Appropriate statistical analysis was done. A value of P < 0.05 was considered statistically significant. Of 45 cases, female-to-male ratio was 1.36:1. Mean duration of disease and stability were found to be 10.44 ± 5.24 and 3.83 ± 2.31 years, respectively. Mean size of treated area for NCES and JT was 10.11 ± 10.31 and 10.13 ± 10.29 cm2, respectively. Earliest repigmentation was found at 3 weeks in NCES and 6 weeks in JT. At 6 weeks, repigmentation was better in NCES, whereas later JT showed better pigmentation. Follow-up was done at 8 days and 6, 10, 14, and 24 weeks. With respect to color match at 6 weeks, JT was found superior; however, at 24 weeks both showed similar efficacy. Mean reduction in daily life quality index was significantly decreased post-surgery. This was a single-center, small sample size study. Melanocyte plus keratinocyte cell transfer is very effective in the treatment of stable vitiligo. On the basis of the results, JT may show significant contribution in vitiligo.

Molecular Dynamics Simulation of KIT Mutation in a Patient wıth Piebaldism, Congenital Cataract and Aphakic Glaucoma

Background: Piebaldism (OMIM #172800) is a rare autosomal dominant genodermatosis characterized by congenital poliosis and stable patches of leucoderma. Piebaldism is caused by mutations in the KIT and SNAI2 genes. The most common mutations are detected in the KIT gene. Case presentation: A 5-year-old boy, who was followed-up for aphakic glaucoma after congenital cataract surgery, was consulted to the medical genetics and dermatology departments due to premature graying of the hair, white forelock in the frontal region of the scalp, whitening in the inner part of the eyebrows and eyelashes and patchy leukoderma with hyperpigmented islands inside on the extremities and trunk. DNA sequencing revealed a heterozygous missense c.1861G&amp;gt;A mutation in the KIT gene. Mutation was evaluated using in silico 3D-structure analysis and bioinformatics tools Conclusion: KIT gene has a critical role in melanoblast migration, proliferation, differentiation and survival and molecular dynamics simulation and modeling proved that this variant inhibits the migration of melanoblasts and melanocytes by reducing the enzymatic activity of the KIT protein.

High‐Rate Fluid Injection Reduces the Nucleation Length of Laboratory Earthquakes on Critically Stressed Faults in Granite

AbstractWe conducted fluid injection experiments on cylindrical low‐permeability granite samples with a critically stressed sawcut fault at local injection rates of 0.2 and 0.8 mL/min and confining pressures of 31 and 61 MPa. A local array of six strain gauges attached close to the faults allows us to estimate the nucleation length of each injection‐induced dynamic slip event (i.e., laboratory earthquake). We find nucleation lengths decrease from approximately 90% to &lt;15% of the fault length with higher injection rate and increased effective normal stress. Injection‐induced laboratory earthquakes with smaller nucleation lengths show generally higher peak slip rates and larger fault slip displacements, signifying an intensified seismic hazard. Our results also indicate that initially stable fault patches may be reactivated to slip seismically by increasing injection rates. This study systematically demonstrates that higher injection rates constitute dynamic loading, which increase the seismic hazard by shrinking the earthquake nucleation length.

Effect of Polymers and Permeation Enhancers in the Release of Quetiapine Fumarate Transdermal Patch through the Dialysis Membrane.

Quetiapine Fumarate is potent, and the daily therapeutic dose can be delivered easily across the skin with the help of permeation enhancers. Quetiapine Fumarate-loaded transdermal patches were prepared by solvent evaporation technique. Various formulation parameters, excipients, and their combinations were optimized to get thin, translucent, smooth, stable, and high permeable character patches. A total number of 10 formulations were prepared. All formulations were subjected to various physicochemical evaluations. Three different formulations were prepared and F1, F2, and F3. Various physicochemical studies were carried out and found no significant difference between the three batches. The in vitro release study showed 74.29%, 82.73%, and 77.27%, respectively, up to 24 h. From the results, F2 has been selected as an optimized formulation and evaluated for skin irritation test. The results revealed that there is no irritation produced. The stability study results showed that there is no significant change from its initial nature till the period of three months in both temperatures. Quetiapine Fumarate Transdermal Patch F2 has achieved the goal of extended-release, cost-effectiveness, lowering the dose and frequency of drug administration, and thus may improve patient compliance.

Evaluation of needling/microneedling as an adjunct to phototherapy in the treatment of stable acral vitiligo: a comparative clinical and immunohistochemical study

Objectives To evaluate the efficacy and tolerability of needling/microneedling as an adjunct to NB-UVB phototherapy in the treatment of stable refractory patches of acral vitiligo, based upon clinical and immunohistochemical assessment of melanocyte count and distribution in response to needling/microneedling. Materials and methods Twenty patients with stable acral vitiligo (≥2 patches) were enrolled. One of the two index patches was randomized to receive needling or microneedling in conjunction with NB-UVB. Patients received phototherapy sessions 3 times weekly, while needling was carried out on biweekly basis for 6 months. Assessment was done clinically using point counting method, VESTA, and global patients’ satisfaction, and immunohistochemically by quantitative assessment of melanocyte count by Melan-A. Results No statistically significant difference was observed between NB-UVB monotherapy and either of the combined therapy regimens as regards the mean percentage change in vitiligo surface area (p = .451), mean change in absolute melanocyte count from baseline (p = .589), and mean VESTA (p = .916). Patches subjected to adjuvant microneedling/needling were afflicted by koebnerization in 50% and 20% of cases, respectively. Conclusion Neither microneedling nor needling appear to confer an added therapeutic value to NB-UVB phototherapy in the treatment of stable acral vitiligo. Moreover, both carry the risk of koebnerization.

Tertiary Health Care-Based Randomized Controlled Study to Compare Autologous, Non-cultured, Non-trypsinized Epidermal Cell Transplant (Jodhpur Technique) with Split-Thickness Skin Grafting (STSG) in Stable Vitiligo.

Background:Surgical treatment of vitiligo is reserved for stable recalcitrant vitiligo patches. Split-thickness skin grafting (STSG) is an important established modality for the surgical treatment of vitiligo, whereas autologous, non-cultured, non-trypsinized epidermal cell transplant, also known as Jodhpur technique (JT), is an unconventional innovative surgical modality for the treatment of stable vitiligo.Aims:To compare the two techniques, JT and STSG, with regards to the extent and pattern of repigmentation achieved, color matching of the repigmented area, patient satisfaction (Dermatology Life Quality Index [DLQI] questionnaire and patient global assessment), and adverse events (if any) in patients with stable vitiligo.Materials and Methods:It was a randomized comparative study. We randomized 32 patients with 180 stable vitiligo lesions into two groups. Patients in group 1 were treated with JT, and those in group 2 with STSG. They were subjectively evaluated 20 weeks post-surgery for the extent of repigmentation, color match, change in DLQI score, and patient satisfaction. The categorical data were presented as number (percent) and were compared among groups using Chi-square test. Mean and standard deviation were calculated for demographic data, and they were also compared by using student t-test. Probability P value < 0.001 was considered statistically significant.Results:The extent of repigmentation was excellent (90%–100% repigmentation) in 72.5% of lesions in the JT group and in 40% of lesions in the STSG group (P < 0.001). Seventy-five percent repigmentation (good repigmentation) was observed in 95% of lesions in the JT group and in 83.75% of lesions in the STSG group (P = 0.040). There was a highly significant decline in DLQI score. Post-procedure DLQI (0.79 ± 1.13) and pre-procedure DLQI (15.39 ± 4.76) in the JT group were compared with post-procedure DLQI (3.85 ± 2.89) and pre-procedure DLQI (16.19 ± 4.56) in the STSG group. The mean decline among groups differed significantly (P < 0.001). Adverse events were significantly higher in the STSG group at the recipient site.Conclusions:JT is found to be significantly better than STSG with regard to the degree of repigmentation.