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Journal of Alternative and... Apr 2021Vitiligo is an autoimmune skin condition that affects people globally anywhere, from <0.1% to more than 8% of individuals. The disease destroys skin melanocytes,...
Vitiligo is an autoimmune skin condition that affects people globally anywhere, from <0.1% to more than 8% of individuals. The disease destroys skin melanocytes, resulting in a patchy depigmentation of the skin. About 50% of all patients develop the disease before their 20s. We systematically searched the literature and reviewed the evidence for the use of nutritional supplements and diet in the management of vitiligo. Embase and Medline were searched for diet, herbal, and nutrition-based clinical studies. Additional filters were applied that looked for controlled trial or randomized controlled trial and article or article in press or letter and English and clinical study. We selected clinical studies in humans that showed how diet or natural supplements can improve the symptoms of vitiligo in all of our searches. There were 62 manuscripts that resulted from the PubMed search and 259 from the Embase search. A final of 26 studies were reviewed, and other supplemental case and case-control studies were used to introduce diet components that may influence either exacerbation or amelioration of vitiligo. Possible mechanisms of action are introduced for natural and supplemental interventions. Some of the supplements reviewed include , oral , alpha lipoic acid, vitamins B12, D, and E, folic acid, phenylalanine, canthaxanthin, oil, and other combined herbal bio-actives. Overall, the growing evidence is promising, but more studies are needed in this area to further explore the impact that supplements and diet can have on vitiligo management. The most promising therapies included oral phenylalanine as adjuvant therapy with UVA therapy, oral as monotherapy, both of which can be used with other traditional therapies, and oral with phototherapy or photochemotherapy.
Topics: Adolescent; Adult; Child; Dietary Supplements; Female; Humans; Male; Phytotherapy; Plant Preparations; Vitiligo; Young Adult
PubMed: 33337930
DOI: 10.1089/acm.2020.0292 -
Journal Der Deutschen Dermatologischen... May 2022This study aimed to investigate the association of vitiligo with metabolic syndrome (MetS) and its relevant components. (Meta-Analysis)
Meta-Analysis
BACKGROUND AND OBJECTIVES
This study aimed to investigate the association of vitiligo with metabolic syndrome (MetS) and its relevant components.
MATERIAL AND METHODS
We searched PubMed, Web of Science, Cochrane Library and Embase databases from inception to March 30, 2021, for relevant studies. Cross-sectional and case-control studies that reported either the prevalence or odds ratio [OR] of MetS or its components in vitiligo patients were included. Data were pooled using either random-effects model or fixed-effects model according to the heterogeneity.
RESULTS
Thirty studies with a total of 28,325 vitiligo patients were included. Significant associations were found between vitiligo and diabetes mellitus (pooled OR, 3.30; 95 % confidence interval [CI], 2.10-5.17) and between vitiligo and obesity (pooled OR, 2.08; 95 % CI, 1.40-3.11). The overall prevalence of hypertension in the patients with vitiligo was 19.0 % (95 % CI, 2.0 %-36.0 %).
CONCLUSIONS
Our findings suggest the association of vitiligo with diabetes mellitus, obesity, and hypertension. It is recommended for dermatologists to take these associations into account so as to identify potential comorbidities promptly in vitiligo patients. Additionally, vitiligo patients are advised to monitor the indexes including BMI, blood glucose, and blood pressure levels and the consultation with specialists is necessary upon abnormal changes of these indexes.
Topics: Cross-Sectional Studies; Diabetes Mellitus; Humans; Hypertension; Metabolic Syndrome; Obesity; Vitiligo
PubMed: 35499212
DOI: 10.1111/ddg.14717 -
Journal of Personalized Medicine Dec 2022In most dermatological pathologies, the phenomena observed on the skin are a reflection of internal disorders. In patients with associated acral involvement on the... (Review)
Review
In most dermatological pathologies, the phenomena observed on the skin are a reflection of internal disorders. In patients with associated acral involvement on the dorsal sides of the hands, this "vitiligo phenotype" may lead to the investigation of certain associated pathologies that sometimes have no obvious clinical impact. To assess the link between skin depigmentation and autoimmune pathologies, we conducted a systematic review involving article selection from the PubMed database. Patients with coexisting thyroid pathologies were found to have a predisposition for developing acral vitiligo and depigmentation of the wrists, and autoimmune thyroid pathologies appeared to be the only coexisting autoimmune or inflammatory diseases in vitiligo patients to show a pattern of distribution. The association of concomitant thyroid dysfunction with depigmentation of the hands was found to be so strong that the absence of depigmented macules on the hands may exclude the coexistence of an autoimmune thyroid pathology. Although the frequency of acral involvement in patients with vitiligo and autoimmune pathologies is higher, the mechanism by which thyroid dysfunction influences this distribution pattern remains incompletely elucidated and requires future studies.
PubMed: 36556267
DOI: 10.3390/jpm12122048 -
Cells Sep 2023Vitamin D is one significant prohormone substance in human organ systems. It is a steroidal hormone produced in the skin upon exposure to UVB rays. This paper presents a... (Review)
Review
Vitamin D is one significant prohormone substance in human organ systems. It is a steroidal hormone produced in the skin upon exposure to UVB rays. This paper presents a systematic review of the utilization of topical vitamin D, specifically cholecalciferol, calcipotriol, and tacalcitol, in the treatment of vitiligo. It considers the role of vitamin D in stimulating the synthesis of melanin and melanogenesis, which can help with the process of repigmentation. The inclusion of calcipotriol or tacalcitol in Narrowband Ultraviolet Phototherapy (NB-UVB) has shown the potential to enhance therapeutic outcomes for vitiligo. However, their effectiveness in combination with Psoralens Long Wave Ultraviolet Radiation (PUVA) and Monochromatic Excimer Light (MEL) treatment for vitiligo is limited. In contrast, combining topical corticosteroids with vitamin D analogues has demonstrated superior efficacy in treating vitiligo compared to using vitamin D analogues alone, while also providing the added benefit of reducing corticosteroid-related adverse effects. In addition, treating stable vitiligo with topical cholecalciferol and microneedling has shown success. Future studies are needed to ascertain an efficient method of administering vitamin D topically as an anti-vitiligo agent.
Topics: Humans; Vitamin D; Vitiligo; Ultraviolet Rays; Ultraviolet Therapy; Vitamins
PubMed: 37830601
DOI: 10.3390/cells12192387 -
Journal of the European Academy of... Sep 2022Despite historical mischaracterization as a cosmetic condition, patients with the autoimmune disorder vitiligo experience substantial quality-of-life (QoL) burden. This... (Review)
Review
Despite historical mischaracterization as a cosmetic condition, patients with the autoimmune disorder vitiligo experience substantial quality-of-life (QoL) burden. This systematic literature review of peer-reviewed observational and interventional studies describes comprehensive evidence for humanistic burden in patients with vitiligo. PubMed, EMBASE, Scopus and the Cochrane databases were searched through February 10, 2021, to qualitatively assess QoL in vitiligo. Two independent reviewers assessed articles for inclusion and extracted data for qualitative synthesis. A total of 130 included studies were published between 1996 and 2021. Geographical regions with the most studies were Europe (32.3%) and the Middle East (26.9%). Dermatology-specific instruments, including the Dermatology Life Quality Index (DLQI; 80 studies) and its variants for children (CDLQI; 10 studies) and families (FDLQI; 4 studies), as well as Skindex instruments (Skindex-29, 15 studies; Skindex-16, 4 studies), were most commonly used to measure humanistic burden. Vitiligo-specific instruments, including the Vitiligo-specific QoL (VitiQoL; 11 studies) instrument and 22-item Vitiligo Impact Scale (VIS-22; 4 studies), were administered in fewer studies. Among studies that reported total scores for the overall population, a majority revealed moderate or worse effects of vitiligo on patient QoL (DLQI, 35/54 studies; Skindex, 8/8 studies; VitiQoL, 6/6 studies; VIS-22, 3/3 studies). Vitiligo also had a significant impact on the QoL of families and caregivers; 4/4 studies reporting FDLQI scores indicated moderate or worse effects on QoL. In general, treatment significantly (P < 0.05) improved QoL, but there were no trends for types or duration of treatment. Among studies that reported factors significantly (P ≤ 0.05) associated with reduced QoL, female sex and visible lesions and/or lesions in sensitive areas were most common. In summary, vitiligo has clinically meaningful effects on the QoL of patients, highlighting that greater attention should be dedicated to QoL decrement awareness and improvement in patients with vitiligo.
Topics: Child; Europe; Female; Humans; Middle East; Quality of Life; Surveys and Questionnaires; Vitiligo
PubMed: 35366355
DOI: 10.1111/jdv.18129 -
Journal of Trace Elements in Medicine... Dec 2020Several studies have investigated the association between selenium levels and skin diseases, but reached inconsistent results. (Meta-Analysis)
Meta-Analysis
BACKGROUND
Several studies have investigated the association between selenium levels and skin diseases, but reached inconsistent results.
OBJECTIVE
This systematic review and meta-analysis was conducted to evaluate the association between selenium levels and skin diseases.
METHODS
A systematic search was conducted in public databases to identify all relevant studies, and study-specific standard mean differences (SMD) and 95% confidence intervals (CI) were pooled to compare the selenium levels between different groups.
RESULTS
Twenty-seven studies were identified with a total of 1315 patient and 7181 healthy controls. Compared with controls, no significant difference in selenium was found in patients with vitiligo (SMD = 0.53, 95% CI: -0.40 to 1.45), alopecia areata (SMD = 0.47, 95% CI: -2.72 and 3.65), or eczema (SMD = 0.12, 95% CI: -0.24 to 0.48). A lower selenium level was found in patients with psoriasis (SMD = -0.62, 95% CI: -1.15 to -0.10), acne vulgaris (SMD = -1.02, 95% CI: -1.45 to -0.60), chloric acne (SMD = -2.35, 95% CI: -3.15 to -1.55), and atopic dermatitis (SMD = -2.62, 95% CI: -3.00 to -2.24). As for disease severity, severe patients had a higher selenium level than mild patients in psoriasis (SMD = 0.72, 95% CI: 0.07-1.38), but no difference was found in vitiligo (SMD = -0.26, 95% CI: -2.38 to 1.85) and alopecia areata (SMD = 0.46, 95% CI: -0.34 to 1.26).
CONCLUSION
Selenium levels were associated with several skin diseases and the disease severity, and high selenium levels tended to be a protective factor in certain skin diseases.
Topics: Alopecia Areata; Dermatitis, Atopic; Humans; Psoriasis; Selenium; Severity of Illness Index; Skin Diseases; Vitiligo
PubMed: 32497930
DOI: 10.1016/j.jtemb.2020.126548 -
The Journal of International Advanced... Jul 2023Autoimmune diseases may cause various kinds of conflicts in and outside the target organ, and some evidence brings forward the suggestion that autoimmune diseases may... (Meta-Analysis)
Meta-Analysis
Autoimmune diseases may cause various kinds of conflicts in and outside the target organ, and some evidence brings forward the suggestion that autoimmune diseases may damage the auditory nerve and cause sensorineural hearing loss. However, this relationship is not clearly defined yet. Therefore, the aim of this study was to assess sensorineural hearing loss in autoimmune diseases through systematic review and metaanalysis. The literature databases of PubMed, Google Scholar, Scopus, Web of knowledge, and Cochrane library were thoroughly searched, and a meta-analysis study was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. Eighteen articles were included, involving 27 859 cases affected by autoimmune diseases. The prevalence of sensorineural hearing loss in systemic lupus erythematosus cases was 21.26 [3.80, 38.71]%, which was significant, and pooled analysis of odds ratio observed in individual studies showed that the odds of sensorineural hearing loss prevalence was 12.11 [7.4, 24.12] (P < .001). The prevalence of sensorineural hearing loss in rheumatoid arthritis cases was 16.14 [-9.03, 41.31]%, which was significant, and pooled analysis of odds ratio observed in individual studies showed that the odds of sensorineural hearing loss prevalence was 2.23 [1.84, 2.32] (P < .001). In vitiligo cases, the prevalence of sensorineural hearing loss was 38.80 [22.36, 55.25]%, which was significant, and pooled analysis of odds ratio observed in individual studies showed that the odds of sensorineural hearing loss prevalence was 5.82 [3.74, 9.68] (P < .001). The present study showed that sensorineural hearing loss is significantly related to the autoimmune diseases of systemic lupus erythematosus, rheumatoid arthritis, and vitiligo. Therefore, these cases need a routine evaluation of sensorineural hearing loss.
Topics: Humans; Vitiligo; Autoimmune Diseases; Hearing Loss, Sensorineural; Lupus Erythematosus, Systemic; Arthritis, Rheumatoid
PubMed: 37528591
DOI: 10.5152/iao.2023.22991 -
Journal of Cosmetic Dermatology Mar 2023Vitiligo was an autoimmune disease and some guidelines for the management of vitiligo encouraged the use of NB-UVB combination therapies to enhance repigmentation. (Meta-Analysis)
Meta-Analysis
BACKGROUND
Vitiligo was an autoimmune disease and some guidelines for the management of vitiligo encouraged the use of NB-UVB combination therapies to enhance repigmentation.
OBJECTIVES
To compare the effectiveness of current NB-UVB combination regimen at the improvement in repigmentation through a systematic review and network meta-analysis.
METHODS
We searched the electronic databases for randomized controlled trials related to NB-UVB combination therapy for vitiligo till October 2022. STATA15.0 software was applied to carrying out data analysis.
RESULTS
A total of 28 eligible studies involving 1194 participants were enrolled in the analysis. The NMA results revealed that compared with NB-UVB, carboxytherapy [OR = 32.35, 95% CI (1.79, 586.05)], Er: YAG laser+ topical 5% 5-FU [OR = 10.74, 95% CI (4.05, 28.49)], needling/micro-needling [OR = 3.42, 95% CI (1.18, 9.88)], betamethasone intramuscular injection [OR = 3.08, 95% CI (1.17, 8.13)], topical tacrolimus [OR = 2.54, 95% CI (1.30, 4.94)], and oral Chinese herbal medicine compound [OR = 2.51, 95% CI (1.40, 4.50)] integrated with NB-UVB were more efficacious in excellent to complete repigmentation response rate (≥75%). Besides, NB-UVB+ Er: YAG laser+ topical 5% 5-FU [OR = 0.17, 95% CI (0.04, 0.67)] and NB-UVB+ needling/micro-needling [OR = 0.24, 95% CI (0.06, 0.88)] were less likely evaluated as ineffective repigmentation response (≤25%).
CONCLUSIONS
All combination therapies ranked higher than NB-UVB monotherapy in inducing successful repigmentation and avoiding failed treatment in patients with vitiligo. Comprehensive consideration, NB-UVB+ Er: YAG laser+ topical 5% 5-FU and NB-UVB+ needling/microneedling would be the preferred therapeutic approaches.
Topics: Humans; Vitiligo; Ultraviolet Therapy; Network Meta-Analysis; Combined Modality Therapy; Fluorouracil; Treatment Outcome
PubMed: 36456176
DOI: 10.1111/jocd.15534 -
Journal of Cosmetic Dermatology Aug 2020Atopic dermatitis (AD) is a chronic inflammatory skin disease associated with multiple immune-mediated disorders. A comprehensive meta-analysis assessing the prevalence... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Atopic dermatitis (AD) is a chronic inflammatory skin disease associated with multiple immune-mediated disorders. A comprehensive meta-analysis assessing the prevalence or risk of vitiligo in AD patients is lacking.
OBJECTIVE
To compare the prevalence and assess the risk of vitiligo in patients with AD by performing a meta-analysis of observational studies.
METHODS
PubMed, Scopus, and Cochrane databases were systematically searched until August 25, 2019, following the PRISMA guidelines. Published English-language articles including case-control, cross-sectional, or cohort studies that reported either odds or risk of vitiligo in AD patients were included. Full-text review and study assessment were performed by the two authors independently. Random-effects meta-analysis model was used to calculate the odds ratio (OR) and risk ratio (RR) with the corresponding 95% confidence interval (CI). The risk of bias was assessed using the Newcastle-Ottawa Scale.
RESULTS
Seven studies with a total of 1 540 688 unique AD patients were included. The random-effects meta-analysis of case-control and cross-sectional studies showed a significant association of AD with vitiligo (OR, 3.21; 95% CI, 1.90-5.43). Subgroup analyses also showed a significant association for both adult AD (OR, 4.46; 95% CI, 1.65-12.07) and childhood AD (OR, 2.83; 95% CI, 1.53-5.25). Pooling of the results of 2 cohort studies showed an increased risk of vitiligo in patients with AD (RR, 1.64; 95% CI, 1.27-2.13).
CONCLUSIONS
Results from this study support an association of AD with vitiligo. Exploration of possible mechanisms responsible for this association could be important to develop proper treatment approaches for the affected patients.
Topics: Adult; Child; Cohort Studies; Cross-Sectional Studies; Dermatitis, Atopic; Eczema; Humans; Vitiligo
PubMed: 31872933
DOI: 10.1111/jocd.13263 -
Journal of Cosmetic Dermatology Jul 2024Vitiligo, an autoimmune skin disorder linked to hormonal and genetic factors, results in reduced pigmentation due to a gradual decline in melanocyte activity. This... (Review)
Review
BACKGROUND
Vitiligo, an autoimmune skin disorder linked to hormonal and genetic factors, results in reduced pigmentation due to a gradual decline in melanocyte activity. This systematic review delves into the role of dietary intervention and nutrition in managing vitiligo.
METHODS
A comprehensive search on PubMed, Google Scholar, and European PMC identified 214 studies, with 14 meeting inclusion criteria post-screening. The selected studies primarily explored the impact of dietary supplements on disease activity.
RESULTS
Heavy metal exposure, specifically Cd, Pb, and Hg, indicated potential links to heightened reactive oxygen species and vitiligo development. Conflicting evidence emerged regarding the role of trace minerals (Zn and Cu), with some studies suggesting deficiencies and others proposing excesses in vitiligo patients. Vitamins with anti-inflammatory properties like vitamin C, D, and B12, along with antioxidants, were investigated for their potential in repigmentation strategies. Additionally, polyunsaturated fatty acids (PUFAs), especially in varying types of fat consumption, were implicated. Emphasizing the need to reduce reliance on pharmacological and phototherapy interventions, the review uncovers novel roles for dietary supplements as adjuncts or flare reducers.
CONCLUSION
While dietary interventions cannot be thought of as a standalone therapy, they still make a case for being used as adjuncts. Large scale clinical trials are warranted to establish strong evidence and protocols, and might also help reduce the dependency on pharmacological methods, which come with their adverse effect profiles.
Topics: Humans; Vitiligo; Dietary Supplements; Diet; Antioxidants; Vitamins; Nutritional Status; Skin Pigmentation; Trace Elements; Fatty Acids, Unsaturated
PubMed: 38465786
DOI: 10.1111/jocd.16277