Cases Of Vitiligo Research Articles

N-Acetyltransferase 2 gene polymorphism and its serum levels in vitiligo patients.

Although numerous mechanisms are involved in vitiligo pathogenesis, few studies correlate N-acetyltransferase 2 to this disease. To assess the N-acetyltransferase 2 (rs1799929) gene and its serum levels in vitiligo patients. In this case-control study, 65 vitiligo cases were compared to 65 age- and sex-matched healthy controls. Serum NAT2 levels and the NAT2 gene polymorphism (rs1799929) were evaluated using ELISA and real-time PCR, respectively. Serum N-acetyltransferase 2 levels were significantly lower in cases than in controls, 1.24 ± 0.31 vs. 2.01 ± 0.46 (p = 0.001). CC genotype was more dominant in controls (58.5%) than in cases (20%). TT and CT genotypes were more dominant in cases (30.8% and 49.2%) than in controls (13.8% and 27.7%), respectively (p = 0.001). The C allele was more prominent in controls (72.3%) than in cases (44.6%) while the T allele was more dominant in cases (55.4%) than in controls (27.7%) (p = 0.001). N-acetyltransferase 2 slow acetylator phenotype (TT genotype) was higher in cases (30.8%) than in controls (13.8%) and rapid acetylator phenotypes (CC and CT genotypes) were higher in controls (86.2%) than in cases (69.2%) (p = 0.035). Slow acetylator genotype (TT) of NAT2 gene (rs1799929) and low serum levels of NAT2 enzyme might play a role in the susceptibility and pathogenesis of vitiligo.

Zinc, copper, and selenium levels in vitiligo: a systematic review and meta-analysis

Vitiligo is a dermatological disease characterized by loss of melanocytes, causing non-scaly white macules on the skin. Zinc, copper, and selenium are important micronutrients that play a role in the normal functioning of the body and have been found to potentially aid in vitiligo treatment, although the relationship between their serum levels and vitiligo is not yet fully understood. This is a systematic review aimed at assessing the levels of serum zinc, copper, and selenium and their association with vitiligo. This review was performed following the Preferred Reporting Items of the systematic Review and Meta-Analysis (PRISMA) checklist and Cochrane guidelines. A comprehensive literature search was conducted on PubMed, Google Scholar and 41 studies published between 1970 and 2022 including 3353 vitiligo cases and 10,638 controls were included in the meta-analysis conducted from August 2022 till September 2023. The quality of the studies was assessed using the National Heart Lung and Blood Institute Study Quality Assessment tool, and the risk of bias was represented using the RobVis tool. The statistical analysis was performed using Review Manager (RevMan) Version 5.4. This meta-analysis indicate a significant decline in serum zinc levels (Z = 4.97; P < 0.0001; SMD = − 0.86; 95% CI − 1.19 to − 0.52) in vitiligo group with high statistical heterogeneity (Tau2 = 0.74; Chi2 = 513.95, d.f. = 26 [P < 0.00001]; I2 = 95%). Similarly for serum copper levels there was decline (Z = 2.43; P < 0.0001; SMD = − 0.50; 95% confidence interval [CI] − 0.91 to − 0.10) in vitiligo group and high statistical heterogeneity (Tau2 = 0.92; Chi2 = 475.10, d.f. = 22 [P < 0.00001]; I2 = 95%). On the other hand, there was a increase of serum selenium levels in the vitiligo group (Z = 0.56; P < 0.0001; SMD = 0.23; 95% confidence interval [CI], 0.58 to 1.04) and the results reveals high statistical heterogeneity among studies (Tau2 = 1.93; Chi2 = 406.44, d.f. = 11 [P < 0.00001]; I2 = 97%) in vitiligo patients compared to healthy controls. Publication bias was not found for the studies analysed. This study analyses the association of serum micronutrient levels and vitiligo among patients and controls from published research along with sub-group analysis specific to Asian populations using a meta-analysis. Low serum levels of Zinc and copper and high selenium levels are associated with Vitiligo.

Role of serum cd4+, cd25+, and foxp3+ cells’ segmental and nonsegmental vitiligo

Background Vitiligo is an autoimmune skin disease presented with depigmented macules and patches. Vitiligo has an impact on the quality of life. The etiopathogenesis of vitiligo is multifactorial, including genetic, immune dysregulation, and oxidative stress mechanisms. Lately, several researches have underlined the pivotal function of regulatory T cells (Tregs) in the vitiligo pathogenesis with lack of data regarding their role in segmental vitiligo (SV). Objective To investigate the role of Tregs in SV and nonsegmental vitiligo (NSV) pathogenesis and its correlation with disease activity and severity. Patients and methods This case–control study included 20 cases with NSV and 10 cases with SV in addition to 10 healthy volunteers. Vitiligo Area Scoring Index and Vitiligo Disease Activity scores were estimated for vitiligo cases and all the included participants were assessed for the percentage of serum CD4+, CD25+, and FOXP3+ T cells using flow cytometry staining buffer. Results There was significant reduction of the peripheral Tregs in NSV cases in comparison with healthy participants and negative correlation with their percentage to disease activity. On the other hand, there was insignificant difference between the percentage of peripheral Tregs in SV cases and healthy participants. Also, there was insignificant correlation between peripheral Tregs and both severity and activity of the disease among SV cases. Conclusion NSV cases showed significant reduction of the peripheral Tregs and negative correlation with disease activity, indicating the importance of Tregs in the etiopathogenesis of NSV and hence future targeting therapy. On the other hand, in SV cases, there was insignificant reduction of peripheral Tregs and insignificant correlation between their percentage and both severity and activity indicating mosaic etiopathogenesis.

Evidence of “Silent” Hepatitis B Virus Infection in Psoriasis, Vitiligo, and Pityriasis Rosea Cases: A Pilot Study

Abstract Background: Psoriasis (PS), vitiligo (VT), and Pityriasis rosea (PR) are chronic skin diseases often occurring as a consequence of exaggerated immune responses. These skin manifestations can be triggered as a result of the molecular mimicry between viral protein (s) and host protein (s), which could generate auto-antibodies. In addition, it can be hypothesised that skin diseases are manifestations of the reduced immunity that is observed in chronic hepatitis B virus (HBV)-infected individuals. Aims and Objective: To investigate the presence of HBV in PS, VT, and PR cases and Human Herpes Virus (HHV) 6 and 7 in PR cases. Materials and Methods: DNA extracted from healthy controls (n = 20), PS (n = 10), VT (n = 11), and PR (n = 12) were subjected to HBV-S gene-specific polymerase chain reactions (PCRs) and HHV 6-UL57 and HHV7-UL10 gene-specific PCRs. PCR products of positive samples (HBV and HHV 6 and 7 DNA) of expected length were bi-directionally sequenced using overlapping primers. Sequence identification was performed by NCBI BLAST and analysed by multiple sequence alignment. HBV DNA copy number was determined through quantitative real-time PCR. The blood samples were also tested for HBV serological markers and Interferon gamma (IFN-γ) by enzyme immunoassays. Results: The PCR data and Immunoassay study revealed that seven out of 12 PR, six out of 10 PS, and six out of 11 VT cases had signs of HBV infection. HHV 6 DNA was detected in four, whereas HHV 7 DNA was found in two of the 12 PR blood samples. PR6 presented the evidence of both HHV 6 and 7 co-infections. Conclusion: Observing the correlation of HBV with skin diseases, albeit at the pilot level, a larger study is warranted to identify HBV infection in skin disease patients. The evidence of HHV 6 and HHV 7 DNA in PR cases supports the HHV infection linkage with PR.

The lifetime risk and impact of vitiligo across sociodemographic groups: a UK population-based cohort study.

Vitiligo is an autoimmune skin disorder characterised by depigmented patches of skin, which can have significant psychological impacts. To estimate lifetime incidence of vitiligo, overall, by ethnicity, and across other sociodemographic subgroups, and to investigate the impacts of vitiligo on mental health, work, and healthcare utilisation. Incident vitiligo cases were identified in the Optimum Patient Care Database of primary care records in the UK between 01/01/2004 and 31/12/2020. Lifetime incidence of vitiligo was estimated at age 80 using modified time-to-event models with age as the timescale, overall and stratified by ethnicity, sex and deprivation. Depression, anxiety, sleep disturbance, healthcare utilisation and work-related outcomes were assessed in the two years after vitiligo diagnosis compared to matched unaffected controls. 9,460 adults and children were newly diagnosed with vitiligo. Overall cumulative lifetime incidence was 0.92% at age 80 years (95% Confidence Interval [CI] 0.90, 0.94). Cumulative incidence was similar in females 0.94% (95%CI 0.92, 0.97) and males 0.89% (95%CI 0.86, 0.92). There were substantial differences in lifetime incidence across ethnic groups; Asian 3.58% (95%CI 3.38, 3.78), black 2.18% (95%CI 1.85, 2.50), mixed 2.03% (95%CI 1.58, 2.47), other 1.05% (95%CI 0.94, 1.17) and white ethnicity 0.73% (95%CI, 0.71, 0.76).People with vitiligo had an increased risk of depression (adjusted Odds Ratio [aOR] 1.08; 95%CI 1.01, 1.15), anxiety (aOR 1.19; 95%CI 1.09, 1.30), depression or anxiety (aOR 1.10; 95%CI 1.03, 1.17) and sleep disturbance (adjusted Hazard Ratio [aHR] 1.15; 95%CI 1.02, 1.31) compared to matched controls. People with vitiligo also had a greater number of primary care encounters (adjusted incidence rate ratio 1.29; 95%CI 1.26, 1.32) and a greater risk of time off work (aHR 1.15; 95%CI 1.06, 1.24). There was little evidence of disparities in vitiligo related impacts across ethnic subgroups. Clinicians should be aware of the markedly increased incidence of vitiligo in people of non-white ethnicity. The negative impact of vitiligo on mental health, work and healthcare utilisation highlights the importance of monitoring people with vitiligo to identify those who need additional support.The study protocol for this retrospective observational study was registered with ClinicalTrials.gov (Identifier: NCT06097494).

Impact of Consanguinity and Familial Aggregation on Vitiligo Epidemiology in Saudi Arabia: A Case-Control Study.

Background Vitiligo, characterized by depigmented patches due to melanocyte loss, involves genetic, autoimmune, and environmental factors. Recent studies suggest a link between family history, consanguinity, and vitiligo prevalence, particularly in regions with prevalent consanguineous marriages. This study explored the relationship between consanguinity and familial vitiligo prevalence in Saudi Arabia. Methods A case-control study enrolled 792 participants from Saudi dermatology clinics (382 vitiligo cases, 408 controls). Family histories and consanguinity levels were assessed. Logistic regression analysis, adjusting for relevant variables, evaluated associations. Results Significant associations were found between vitiligo and both parental consanguinity and family history. Cases had higher consanguinity rates, with 246 out of 382 (64.4%), compared to controls, with 161 out of 408 (39.5%). A positive family history of vitiligo was more common in cases, with 184 out of 382 (48.2%)than in controls, with 90 out of 408 (22.1%). Logistic regression identified parental consanguinity and positive family history as significant risk factors for vitiligo, with adjusted odds ratios (aOR) of 2.39 and 2.92, respectively. Their synergistic effect notably amplified the risk (aOR = 7.58), indicating a complex genetic and familial influence on vitiligo in Saudi Arabia. Conclusions Consanguinity showed a significant association with vitiligo prevalence, highlighting genetic factors' role. Further genetic research is needed to identify specific mutations in vitiligo among consanguineous populations. Genetic counseling and awareness programs are crucial in regions with high consanguinity rates to mitigate vitiligo and other genetic disorders' risks.

Target area treatment ratio of varied lesions in the cultured pure melanocyte transplantation repigmentation of vitiligo: Aretrospective study.

Autologous cultured pure melanocyte transplantation (CMT) can be utilized to treat stable vitiligo cases, but clinical data are insufficient to improve its efficacy. To evaluate the influence of various factors on the therapeutic effect of CMT, this single-center retrospective study enrolled stable vitiligo patients who underwent CMT between 2009 and2020. Univariate and multivariable analysis were used to determine the factors affecting the outcome of repigmentation. The study included 491 patients with long-term follow-up data (6-120 months). It was found that 69.7% of patients achieved an excellent re-color effect and 18.4% achieved a good re-color effect. There were statistically significant differences in pigmentation between patients with stable disease course, vitiligo type, and lesion site. Overall, a significant positive correlation between the target area treatment ratio of varied lesions and the percentage of repigmentation was found. CMT is effective and well tolerated in the treatment of stable vitiligo. Various factors, especially the target area treatment ratio of varied lesions, should be carefully assessed before using CMT. As the target area treatment ratio of varied lesions could further improve the post-operative repigmentation other than type of vitiligo. This clinic trial was approved by Hangzhou Third People's Hospital (number 2023KA015, national clinical record number MR-33-23-034502).

Prevalence of Metabolic Syndrome in Vitiligo Patients and its Relation to Vitiligo Severity - A Cross-Sectional Study.

In vitiligo, there is a significant decrease in melanocytes and melanin. The decrease in melanin causes oxidative stress, with a chance of causing metabolic syndrome. Hence, there is a need to look for metabolic syndrome in vitiligo. To estimate the prevalence of metabolic syndrome in vitiligo patients and to evaluate the relationship between the severity and progression of vitiligo and metabolic syndrome. A hospital-based cross-sectional study was conducted on 178 vitiligo cases and 178 controls who were age- and sex-matched. The type of vitiligo, stability by vitiligo disease activity score (VIDA), and severity by vitiligo area severity index (VASI) were noted. The waist circumference, blood pressure, fasting lipid profile, and fasting blood sugar were measured for cases and controls. Metabolic syndrome was diagnosed based on Harmonization Asian criteria. The mean age in cases was 34.38 years, and in controls, it was 35.67 years. The majority were females in both cases (52.2%) and controls (55.6%). Most have a VIDA score of 2+ (41.6%). The mean VASI score was 2.54. The percentage of metabolic syndrome was higher in cases (36%) compared to controls (24.2%) (P = 0.015). The mean age was lower in vitiligo cases with metabolic syndrome (38.83 years) compared to controls with metabolic syndrome (43.14 years). Metabolic syndrome was more frequent in the vitiligo vulgaris type (48.9%) than in acral and segmental vitiligo. Metabolic syndrome was more common in patients with high VIDA (45%) and VASI (52.3%) scores compared to patients with low VIDA (25%) and VASI (27.3%) scores. It is a hospital-based study, so controls were not from the general population. The prevalence of metabolic syndrome was higher in vitiligo patients compared to controls, and it was higher in patients with active and severe disease. Screening and close monitoring of vitiligo patients help in the early diagnosis of metabolic syndrome and reduce the risk of cardiovascular disease.

Circulating immune cells and vitiligo: a bidirectional two-sample Mendelian randomization study.

The pathogenesis of vitiligo remains elusive. Emerging evidence suggests that vitiligo is an immune-mediated disorder, in which a plethora of immune cells play pivotal roles. However, the association between circulating immune cells and vitiligo continues to be enigmatic. We extracted single nucleotide polymorphisms (SNPs) associated with immune circulating cells at a genome-wide significance level from the BLOOD CELL CONSORTIUM's genome-wide association study (GWAS) dataset. Summary data for 385,801 cases of vitiligo were obtained from a large-scale Finnish genome-wide association study (ncases=292, ncontrols=385,509). The inverse variance weighted (IVW) method was employed as the primary analytical approach for Mendelian randomization (MR) analysis. Additionally, heterogeneity was assessed using Cochran's Q value, and horizontal pleiotropy was evaluated using MR-Egger Mendelian Randomization Pleiotropy RESidual Sum and Outlier and leave-one-out analyses. The risk of vitiligo was found to increase with the elevation of 4 circulating immune cells, as evidenced by the odds ratios (ORs) and 95% confidence intervals (CIs): basophils (OR=1.81; 95% CI: 1.01-3.24, p=0.0450), monocytes (OR=1.67; 95% CI: 1.23-2.26, p=0.0009), eosinophils (OR=1.78; 95% CI: 1.22-2.59, p=0.0028), and neutrophils (OR=1.65; 95% CI: 1.08-2.54, p=0.0208). After removing outliers, the sensitivity analysis of the above indicators did not show heterogeneity and pleiotropy. Our findings illuminate the association between circulating immune cells and vitiligo, offering insights that could guide clinical practices in the treatment of vitiligo.

Vitiligo Causes and Treatment: A Review

Vitiligo is a chronic autoimmune disorder characterized by patches of skin losing pigment due to the destruction of melanocytes, the cells responsible for producing pigment. The condition can affect people of all ages and ethnicities, with symptoms including milky-white patches on the skin, premature graying of hair, and color loss in mucous membranes like the mouth or nose. Among the main causes of vitiligo are; Autoimmune Response: Vitiligo is primarily an autoimmune disease where the immune system mistakenly attacks melanocytes, leading to depigmentation. Factors like family history, genetic predisposition, and immune system disorders contribute to its development, Triggers: Events such as sunburn, emotional distress, or exposure to certain chemicals can trigger or exacerbate vitiligo. The treatment options are; Medications: Treatments include light therapy (phototherapy), oral medications like psoralen combined with UVA light (PUVA), and depigmentation therapy using monobenzone to match skin tones Surgery: Surgical options are available for some cases of vitiligo and Psychological Support: Counseling and mental health services can help individuals cope with the emotional impact of vitiligo, in conclusion, v is a multifaceted skin condition lacking a conclusive remedy, many types of vitiligo, but the most common one is Non-segmental Vitiligo (NSV), honmental and genetic are the most important causes of vitiligo. Important symptoms of vitiligo are; depigmented patches, hair discoloration, sensitivity to sunlight, treatment of vitiligo have many approach, among them are; topical Corticosteroids, phototherapy and Cosmetic Camouflage.

A Bioinformatics Analysis for Unveiling Novel Long Non-Coding RNAs and their Regulatory Impact on Key Genes Associated with Vitiligo

Vitiligo involves the gradual disappearance of melanocytes, causing skin depigmentation. Long noncoding RNAs (lncRNAs), a type of noncoding RNA, are important for regulating inflammation and immunity. Despite this significance, there needs to be more published research on how lncRNAs are expressed in vitiligo cases and their potential roles in the biology of this skin condition. This study aims to elucidate the molecular landscape of vitiligo by analyzing gene expression profiles of vitiligo skin and normal skin. Two datasets, RNA-seq and microarray, were thoroughly investigated to identify differentially expressed (DE) genes and lncRNAs associated with vitiligo development. Functional enrichment analysis revealed biological processes and pathways influenced by dysregulated genes, highlighting intricate processes such as melanin biosynthesis and melanogenesis, shedding light on the complex regulatory networks involved in pigmentation and immune responses. Protein-protein interaction analysis highlighted significantly downregulated hub genes, including TYRP1, MLANA, MC1R, SLC45A2, PAX3, TYR, DCT, OCA2, PMEL, and SOX10, revealing significant functional relationships among identified hub genes within the network. RNA-seq data analysis uncovered DE-lncRNAs, emphasizing the regulatory role of lncRNAs in vitiligo. Moreover, the correlation analysis between the expression of lncRNAs and key genes associated with melanogenesis (OCA2, TYRP1, and PMEL) unveiled novel upregulated lncRNAs such as CRTC3-AS1, LCMT1-AS1, LINC02178 contributing to vitiligo development. Additionally, lncRNA-gene networks constructed based on key melanocyte-related genes provided insights into the molecular relationships relevant to vitiligo. Overall, this study offers a comprehensive understanding of vitiligo pathogenesis, identifying potential therapeutic targets and laying the foundation for future research in this critical area.

The effect of narrowband ultraviolet B on tissue level of interleukin-15 and interleukin-15 receptor alpha subunit in active nonsegmental vitiligo cases: an interventional cohort study

Background Vitiligo is an acquired depigmenting skin disorder in which CD8 effector and memory T-cells contribute to its pathogenesis and recurrence. Interleukin (IL)-15 contributes to CD8 effector T-cell cytotoxicity and CD8 memory T-cell survival and maturation. Objective To evaluate the effect of total narrowband ultraviolet B (NB-UVB) on tissue levels of IL-15 and IL-15 receptor alpha (IL-15Ra) in active nonsegmental vitiligo. Patients and methods The patients were assessed clinically for vitiligo extent and activity before and after treatment. Perilesional skin biopsies were taken from 30 vitiligo patients before and after 48 sessions of NB-UVB and from 30 healthy controls. Tissue levels of IL-15 and IL-15 Ra were evaluated by enzyme-linked immunosorbent assay before and after treatment to evaluate the effect of NB-UVB on them. Results Before NB-UVB treatment, the tissue levels of both IL-15 and IL-15Ra were significantly higher in vitiligo patients than controls; moreover, they were significantly higher than those after NB-UVB treatment. In contrast, after NB-UVB treatment, no statistically significant difference was detected between the patients and controls. The levels of IL-15 and IL-15Ra were significantly correlated, whereas they were not correlated with either vitiligo activity or extent. Conclusion IL-15 and IL-15Ra were higher in vitiligo patients than controls before treatment. However, their tissue levels were normalized after treatment with NB-UVB, emphasizing its therapeutic potential.

Association of Vitiligo with ABO/Rh System and its Influence on Thyroid Stimulating Hormone and Vitamin D

This study was conducted to determine if there is a relationship between vitiligo and ABO blood groups, the Rhesus (Rh) factor, thyroid stimulating hormone (TSH) and vitamin D. For vitiligo analysis, two hundred subjects participated in this study, 100 vitiligo patients and 100 control cases (without vitiligo). ABO blood grouping and Rh typing were tested by a slide method. TSH testing involved 80 vitiligo patients and 80 controls (without vitiligo) and the hormone was analyzed by separating the serum in a centrifuge for two minutes and the results were obtained by Beckman fully automatic analyzer. For vitamin D, 50 vitiligo patients and 50 healthy people (without vitiligo) were included. The data on vitamin D were obtained from private laboratory services. Statistical analysis was performed using IBM SPSS version 26. P&lt;0.05 was considered significant. Most patients with vitiligo had a significantly lower level of serum vitamin D compared with controls (p-value &lt; 0.05), while no statistically significant difference in TSH serum levels between vitiligo cases and controls, was found (p-value &gt; 0.05). Furthermore, despite showing that subjects with blood group O are more susceptible to vitiligo as compared to other groups, there was no significant association of vitiligo with ABO blood groups (p-value &gt; 0.05). Similarly, the incidence of Rh positive and Rh negative was not statistically different between the two groups (p-value &gt; 0.05). This study showed that vitiligo patients are often vitamin D deficient. This study highlights the need to evaluate vitamin D status in vitiligo patients to improve the level of skin pigment loss. It remains unknown whether vitamin D deficiency causes vitiligo. However, a collection of larger sample sizes of different ethnicities should be required to achieve a precise conclusion.

537 - The distribution of thyroid disease by age in pediatric vitiligo

Abstract Background Thyroid disease is a comorbid autoimmune disorder linked to vitiligo. Objective To identify the age distribution of pediatric vitiligo cases in order to understand when screening should begin. Methods An IRB-exempt survey of pediatric vitiligo patients. Results Thyroid disease was reported in 14 children out of 205 children who specifically responded regarding presence of thyroid disease, Of the 14 children reporting sex with thyroid disease, 12 were female (85.7%) and 2 were unknown. Race/ ethnicity included 8 Caucasian (57.1%), Indian 2 (14.2%), Unknown 3 (21.4%), and Black 1 (7.1 %). Average age of diagnosis of thyroid disease in vitiligo patients (self-reported) was 9.7 years (Range 6 years-18 years). Limitations The survey design has limitations, and the number of reported cases is low overall. Conclusion and Relevance Thyroid disease appears uncommon as a comorbidity in pre-school children. All races may be at risk. The role of family history is unknown. Presentation is almost exclusively in girls. This data suggests that screening can be reserved for females and guided by age and symptoms.

Tofacitinib citrate delivery through pharmaceutical formulations for divergent therapeutic treatments

The aim of article is to provide prompt and brief information on all available types of formulations of Tofacitinib citrate. Tofacitinib in the form of Tofacitinib citrate belongs to a new class of therapies called Janus kinase (JAK) inhibitors. Tofacitinib citrate is a medication used to treat rheumatoid arthritis, psoriatic arthritis and ulcerative colitis. Tofacitinib is available in the form of a tablet, an extended-release tablet and as an oral solution. Janus kinase inhibitors (JAKi) belong to a new class of oral targeted disease-modifying drugs which have recently revolutionized the therapeutic panorama of rheumatoid arthritis (RA) and other immune-mediated diseases, placing alongside or even replacing conventional and biological drugs. This article elaborates on the information related to patents of Tofacitinib citrate for its formulation. A survey data for the marketed formulations of Tofacitinib citrate is tabulated. Based on this it is estimated that very less type of formulations pertaining to conventional formulations as tablet or gel is only available in the market. Hence, there is an immediate demand for different type of tofacitinib formulations needed for treatment of extensive cases of arthritis or vitiligo. An extensive literature survey is done on pharmaceutical formulations of Tofacitinib citrate. Based on obtained data it was found these researched and developed formulations can be focused and further initiations can be done to make these formulations marketable. Wholesome, this article assists the reader to quickly grab information on marketed formulations and researched formulations of Tofacitinib citrate.

Comparing quality of life, anxiety, depression, sleep disturbance, and associated factors in vitiligo and alopecia areata patients.

Vitiligo and alopecia areata (AA) are two autoimmune skin diseases that affect patients' quality of life (QoL) and give rise to psychosocial complications, such as depression, negative self-image, less joyful social engagements, and low self-esteem. These two disorders have common and uncommon characteristics. Therefore, in this study, we tried to evaluate the similarities and differences in the psychological parameters including quality of life, sleep disturbance, anxiety, and depression levels between, vitiligo and AA patients. Patients with either vitiligo or AA visiting the outpatient dermatology clinic from November 2017 to December 2020 have been included in this study. Persian versions of three questionnaires including the dermatology life quality index (DLQI), hospital anxiety and depression scale (HADS), and Pittsburgh sleep quality index (PSQI), have been used to assess the QoL, sleep disturbance, anxiety, and depression levels in patients. In total, 188 patients, including 94 (50%) cases of AA and 94 (50%) patients with vitiligo, met the criteria. In AA patients, a significantly higher DLQI score was found (p-value = 0.002) compared to the vitiligo cases, which means a better QoL in vitiligo patients. Additionally, AA patients had higher scores of anxiety (P-value<0.001) and depression (p-Value<0.001). However, sleep disturbance (64.9% of AA patients vs. 59.3% of vitiligo patients; p-Value = 0.4888) was not significantly different between the two groups. Our data showed lower QoL and higher levels of anxiety and depression in AA patients compared to vitiligo cases, but no difference was seen in sleep disturbance in the PSQI-P score.

The role of serum inflammatory factors in predicting treatment response in patients with vitiligo and concomitant Hashimoto's thyroiditis.

Vitiligo (VL) is associated with several autoimmune diseases, especially Hashimoto's thyroiditis, VL and concomitant Hashimoto's thyroiditis (HT) up to 34% in VL. To assess the predictive value of serum inflammatory factors in guiding treatment response among patients with concurrent VL and concomitant HT. This retrospective study enrolled 67 cases of VL and concomitant HT, and the patients according to treatment outcomes were divided into the unsatisfied group and the satisfied group. The serum thyroid parameters, autoimmune markers, and inflammatory factor levels were analysed and the correlation analysis of serum inflammatory factors was made. The study analysis of serum thyroid parameters showed elevated levels of thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), free thyroxine (FT4), thyroperoxidase (TPO), and thyroglobulin (Tg) (p < 0.05) in the group with unsatisfactory treatment response. Patients in the unsatisfied group exhibited elevated inflammatory factor levels of C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), interleukin-8 (IL-8), and interleukin-10 (IL-10) (p < 0.05) compared to their counterparts in the satisfied group. Correlation analysis showed that the levels of the above inflammatory factors were significantly negatively correlated with the treatment response. CRP, TNF-α, IL-6, IL-8, IL-10 showed the strongest correlation with VL and concomitant HT, and serum inflammatory factors levels can predict treatment response in patients with VL and concomitant HT.

Assessment of Clinical VIDA Score, Lesional and Perilesional Dermoscopy to Evaluate Stability of the Disease in Vitiligo

Abstract Introduction: Vitiligo is a complex dermatosis with an uncertain etiology, variable clinical presentations, an unpredictable course and prognosis, and difficult to treat. Surgical intervention is recommended for patients with a stable, nonprogressive vitiligo. Dermoscopy can detect the subtle changes in the pigmentary pattern and aid in the diagnosis of evolving lesions. This study was undertaken to measure the stability of the disease by classifying the patients as clinically stable and active and observing dermatological parameters. Objective: The aim of the study is to evaluate assess the correlation between the clinical and dermoscopic features in stable and active cases of vitiligo. Materials and Methods: Forty patients of vitiligo. Clinical VIDA score and six lesional and perilesional dermoscopic parameters were analyzed. Statistical analysis was done to determine their correlation. Results: Altered pigment network (91.6%) was the most observed dermoscopic feature followed by perifollicular depigmentation (66.7%) in clinically unstable patients and altered pigment network (87.5%) followed by leucotrichia (68.8%) was seen in clinically stable patients. However, vascularity and Koebner’s phenomena failed to produce the same. Conclusion: Lesional and perilesional dermoscopic examination together for the above four parameters (pigmentary network, perifollicular changes, perilesional hypopigmentary macules, and leucotrichia) will produce reliable diagnostic approach for differentiating patients as clinically stable or unstable along with clinical VIDA score.

Diabetes Mellitus &amp; Thyroid Dysfunction in Vitiligo of Terai Regions of Nepal

INTRODUCTION Vitiligo is common acquired disease. Clinically it present with depigmented, macules and patches. Vitiligo has been shown association with many autoimmune diseases like Diabetes mellitus, Thyroid disorders, Graves disease, pernicious anemia, etc. This study was undertaken to assess the prevalence and association of diabetes mellitus and thyroid dysfunction in vitiligo patient. MATERIAL AND METHODS This study was a case control study carried out in Dermatology Department, Universal College of Medical Sciences – Teaching Hospital (UCMS-TH) from Dec 2022 to Nov 2023. 70 cases of Vitiligo and 70 control with same sex, ages and gender matched were enrolled. All patients in both the group, we performed thyroid function test and fasting blood sugar. RESULTS Out of 70 cases, 6 (8.6%) people has impaired FBS and 6 (8.6%) people have high T3 &amp; T4 and 10 (14.3%) people have high TSH whereas 3 (4.3%) people have low T3 &amp; T4 and 4 (5.7%) people have low TSH. Association with different age group in both case and control group with fasting blood sugar and thyroid function test was seen which was statistically not significant. CONCLUSION There were impaired fasting blood sugar and abnormal thyroid dysfunction in many cases. Therefore vitiligo patient needs to undergo thyroid function test and blood sugar level to prevent the complication.

Vitiligo and surgical treatment

Objective: Initial comments on the effectiveness of surgical treatment of vitiligoResearch subjects and methods: A prospective study on 12 cases of vitiligo that were successfully treated with autologous pigment cell transplant surgery. Research period from September 2018 to October 2022 at the Center for Plastic Surgery, Surgery &amp; Regeneration - Le Huu Trac National Burn HospitalResults: 12 patients with an average age of 29, with vitiligo in several locations on the body, received pigment-containing cell transplant surgery. The graft adheres well, ensuring good coverage and assimilating the color of the vitiligo skin area with the surrounding healthy skin after about 12 months.Conclusion: Pigment graft surgery is one of the effective methods of treating vitiligo and can be applied to large areas of the diseased skin.