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The Journal of the Association of... May 2024Vitiligo is a dermatological condition characterized by the appearance of white spots or patches on the skin due to the loss of skin pigment called melanocytes. The...
BACKGROUND
Vitiligo is a dermatological condition characterized by the appearance of white spots or patches on the skin due to the loss of skin pigment called melanocytes. The estimated prevalence of vitiligo is about 0.5-2% of the world population, but in India, the prevalence rate varies from 2 to 8%, depending on the region. This study aimed to assess drug prescribing patterns in vitiligo patients.
MATERIALS AND METHODS
A prospective cross-sectional study was carried out in the Dermatology Department of Government General Hospital, Andhra Pradesh, India, from December 2019 to 2020. Patients aged ≥18 years, both genders, and diagnosed and receiving treatment for vitiligo were included in the study. All medicines prescribed to the patients were collected on the predesigned case report form. Ethical approval for this study was taken from the Institutional Ethics Committee of Rajiv Gandhi Institute of Medical Science (RIMS). The collected data were analyzed by using SPSS version 18.
RESULTS
The most commonly prescribed class of drugs was corticosteroids (42.9%), followed by calcineurin inhibitors (13.4%), vitamins (14.6%), basic fibroblast growth factor (BFGF) (9.5%), moisturizers (6.9%), antihistamines (6.5%), and minerals (6.2%). Among corticosteroids, betamethasone was the most commonly prescribed drug, followed by clobetasol propionate. Topical drugs were prescribed more often than orally.
CONCLUSION
The prescription pattern in vitiligo patients is as per the guidelines and recommendations. However, further studies using multiple centers are recommended to verify our findings.
Topics: Humans; Vitiligo; India; Male; Female; Adult; Cross-Sectional Studies; Practice Patterns, Physicians'; Prospective Studies; Hospitals, Teaching; Tertiary Care Centers; Middle Aged; Young Adult; Drug Prescriptions; Adolescent; Dermatologic Agents; Adrenal Cortex Hormones
PubMed: 38881111
DOI: 10.59556/japi.72.0527 -
Expert Review of Clinical Immunology Jul 2024Vitiligo is a chronic, autoimmune condition characterized by skin depigmentation caused by inflammatory-mediated melanocyte degradation. Treatment of vitiligo is... (Review)
Review
INTRODUCTION
Vitiligo is a chronic, autoimmune condition characterized by skin depigmentation caused by inflammatory-mediated melanocyte degradation. Treatment of vitiligo is challenging due to the chronic nature of the condition. Ruxolitinib cream 1.5% was recently approved by the Food and Drug Administration (FDA) as a Janus kinase 1 and 2 inhibitor for use in nonsegmental vitiligo for those 12 years and older.
AREAS COVERED
The purpose of this review is to describe the role of ruxolitinib in treating nonsegmental vitiligo.We searched PubMed using search terms nonsegmental vitiligo, jak inhibitor, and ruxolitinib. Clinicaltrials.gov was used to identify clinical trial data including efficacy, pharmacodynamics, pharmacokinetics, safety, and tolerability.
EXPERT OPINION
In both phase II and phase III (TRuE-V1 and TRuE-V2) trials, ruxolitinib cream 1.5% improved repigmentation with minimal adverse effects. Topical ruxolitinib is a much needed new vitiligo treatment option. Real life efficacy may not match that seen in clinical trials if the hurdle of poor adherence to topical treatment is not surmounted.
Topics: Nitriles; Humans; Vitiligo; Pyrimidines; Pyrazoles; Skin Pigmentation; Janus Kinase 1; Skin Cream; Janus Kinase 2; Janus Kinase Inhibitors
PubMed: 38879876
DOI: 10.1080/1744666X.2024.2326858 -
Archives of Dermatological Research Jun 2024
Topics: Humans; Hyperpigmentation; Lasers, Solid-State; Lip; Treatment Outcome; Low-Level Light Therapy
PubMed: 38878254
DOI: 10.1007/s00403-024-03152-4 -
Archives of Dermatological Research Jun 2024Vitiligo is considered an autoimmune disease, and its treatment is challenging. We assessed and compared the effect of fractional erbium:yttrium-aluminum-garnet (Er:YAG)... (Randomized Controlled Trial)
Randomized Controlled Trial
Vitiligo is considered an autoimmune disease, and its treatment is challenging. We assessed and compared the effect of fractional erbium:yttrium-aluminum-garnet (Er:YAG) laser-assisted delivery of platelet-rich plasma versus microneedling (Mn) with platelet-rich plasma (PRP) in enhancing skin repigmentation in localized stable vitiligo patients. In total, 40 patients with localized stable vitiligo were selected in a random manner into two similar groups (20 each). Group (A) was subjected to fractional Er:YAG laser combined with platelet-rich plasma and Group (B) was subjected to microneedling combined with platelet-rich plasma. The procedure was repeated every 2 weeks for up to 6 months. Each individual was assessed clinically utilizing Vitiligo Area Scoring Index (VASI). Fractional Er:YAG + PRP group achieved better pigmentation100% (excellent 30%, very good 15%, good 30% and satisfactory 25%) which is comparable to Mn + PRP where 80% of cases demonstrate repigmentation (20% very good, 10% good and 50% mild). When comparing the VASI scores for both groups after therapy to the baseline VASI, there was a statistically significant decrease [p = 0.001 for group(A) and 0.003 for group(B)]. Regarding the treatment side effects, there was significantly (p = 0.048) side effects among cases treated with microneedling group(B) (25%) than those fractional Er:Yag laser therapy group(A) (5%). Both forms of therapy demonstrated induction of repigmentation of vitiligo, but fractional Er:YAG laser efficacy is greater when combined with platelet-rich plasma.Clinical trials.gov identifier: NCT05511493.
Topics: Humans; Vitiligo; Platelet-Rich Plasma; Lasers, Solid-State; Female; Male; Adult; Treatment Outcome; Skin Pigmentation; Needles; Young Adult; Middle Aged; Adolescent; Dry Needling; Combined Modality Therapy; Percutaneous Collagen Induction
PubMed: 38878236
DOI: 10.1007/s00403-024-03035-8 -
Archives of Dermatological Research Jun 2024
Topics: Humans; Vitiligo; Metabolic Syndrome; Female; Male; Middle Aged; Adult; Aged; Risk Factors
PubMed: 38878093
DOI: 10.1007/s00403-024-03117-7 -
Sleep Jun 2024To isolate melanopsin contributions to retinal sensitivity measured by the post-illumination pupil response (PIPR), controlling for individual differences in...
The role of retinal irradiance estimates in melanopsin-driven retinal responsivity: A reanalysis of the post-illumination pupil response (PIPR) in seasonal affective disorder.
To isolate melanopsin contributions to retinal sensitivity measured by the post-illumination pupil response (PIPR), controlling for individual differences in non-melanopsin contributions including retinal irradiance is required. When methodologies to negate such differences present barriers, statistical controls have included age, baseline diameter, iris pigmentation, and circadian time of testing. Alternatively, the pupil light reflex (PLR) and calculations estimating retinal irradiance both reflect retinal irradiance, while the PLR also reflects downstream pathways. We reanalyzed data from an observational, correlational study comparing the PIPR across seasons in seasonal affective disorder (SAD) and controls. The PIPR was measured in 47 adults in Pittsburgh, Pennsylvania (25 SAD) over 50 s after 1 s red and blue stimuli of 15.3 log photons/cm2/s. The PLR was within 1 s while PIPR was averaged over 10-40 seconds post-stimulus. Two raters ranked iris pigmentation using a published scale. We evaluated model fit using Akaike's Information Criterion (AIC) across different covariate sets. The best fitting models included either estimated retinal irradiance or PLR, and circadian time of testing. The PLR is collected contemporaneously in PIPR studies and is an individually specific measure of nonspecific effects, while being minimally burdensome. This work extends the prior publication by introducing theoretically grounded covariates that improved analytic model fits based on AIC specific to the present methods and sample. Such quantitative methods could be helpful in studies which must balance participant and researcher burden against tighter methodological controls of individual differences in retinal irradiance.
PubMed: 38877879
DOI: 10.1093/sleep/zsae109 -
International Journal of Dermatology Jun 2024
PubMed: 38876469
DOI: 10.1111/ijd.17316 -
Experimental Dermatology Jun 2024
Topics: Female; Humans; Male; Middle Aged; Biomarkers; Lentigo; MicroRNAs
PubMed: 38874433
DOI: 10.1111/exd.15118 -
G3 (Bethesda, Md.) Jun 2024This study investigated the dominant blue eyes (DBE) trait linked to hearing impairment and variable white spotting in Maine Coon cats. Fifty-eight animals descending...
This study investigated the dominant blue eyes (DBE) trait linked to hearing impairment and variable white spotting in Maine Coon cats. Fifty-eight animals descending from two different DBE lineages, the Dutch and the Topaz lines, were sampled. They comprised 48 cats from the Dutch bloodline, including 9 green-eyed and 31 blue-eyed cats, with some individuals exhibiting signs of deafness, and 8 stillborn kittens. Samples from the Topaz lineage included ten blue-eyed animals. A brainstem auditory evoked potential test (BAER) revealed a reduced to absent response to auditory stimuli and absent physiological waveforms in all of the eight examined DBE animals. We sequenced the genome of two affected cats from the Dutch line and searched for variants in 19 candidate genes for the human Waardenburg syndrome and pigmentary disorders. This search yielded nine private protein-changing candidate variants in the genes PAX3, EDN3, KIT, OCA2, SLC24A5, HERC2 and TYRP1. The genotype-phenotype co-segregation was observed for the PAX3 variant within all animals from the Dutch lineage. The mutant allele was absent from 461 control genomes and 241 additionally genotyped green-eyed Maine Coons. We considered the PAX3 variant as the most plausible candidate -a heterozygous nonsense single basepair substitution in exon 6 of PAX3 (NC_051841.1: g.205,787,310G>A, XM_019838731.3:c.937C>T, XP_019694290.1:p.Gln313*), predicted to result in a premature stop codon. PAX3 variants cause auditory-pigmentary syndrome in humans, horses, and mice. Together with the comparative data from other species, our findings strongly suggest PAX3:c.937C>T (OMIA:001688-9685) as the most likely candidate variant for the DBE, deafness and minimal white spotting in the Maine Coon Dutch line. Finally, we propose the designation of DBERE (Rociri Elvis Dominant Blue Eyes) allele in the domestic cat.
PubMed: 38869246
DOI: 10.1093/g3journal/jkae131 -
Frontiers in Immunology 2024Chronic inflammatory skin diseases are multifactorial diseases that combine genetic predisposition, environmental triggers, and metabolic disturbances associated with... (Review)
Review
Chronic inflammatory skin diseases are multifactorial diseases that combine genetic predisposition, environmental triggers, and metabolic disturbances associated with abnormal immune responses. From an immunological perspective, the better understanding of their physiopathology has demonstrated a large complex network of immune cell subsets and related cytokines that interact with both epidermal and dermal cells. For example, in type-1-associated diseases such as alopecia areata, vitiligo, and localized scleroderma, recent evidence suggests the presence of a type-2 inflammation that is well known in atopic dermatitis. Whether this type-2 immune response has a protective or detrimental impact on the development and chronicity of these diseases remains to be fully elucidated, highlighting the need to better understand its involvement for the management of patients. This mini-review explores recent insights regarding the potential role of type-2-related immunity in alopecia areata, vitiligo, and localized scleroderma.
Topics: Humans; Vitiligo; Animals; Alopecia Areata; Th2 Cells; Cytokines; Dermatitis, Atopic; Scleroderma, Localized; Inflammation; Skin
PubMed: 38868763
DOI: 10.3389/fimmu.2024.1405215