RESUMEN
Pathogenesis of vitiligo is believed to be multifactorial disease with a wide variety of therapeutic modalities. The aim of this work is to assess the efficacy of oral mini-pulse steroids (OMP) plus Nb-U.V.B in comparison to OMP alone and Nb-U.V.B alone in treating stable vitiligo. A prospective randomized controlled study including 45 patients categorized into three groups receiving therapy for 3 months; Group A received Nb-U.V.B plus OMP, Group B received OMP alone while Group C received Nb-U.V.B alone. Clinical assessment and PCR evaluation of bFGF, ICAM1, and ELISA for AMA were done. Patients receiving Nb-U.V.B plus OMP and using Nb-U.V.B alone gave statistically significant clinical response than those treated with OMP alone. Statistically significant rise of BFGF was noticed after treatment with Nb-U.V.B plus OMP and with Nb-U.V.B alone. Patients treated with OMP alone and with Nb-U.V.B alone showed statistically significant drop of ICAM-1 after therapy. NB-U.V.B plus OMP and Nb-U.V.B alone were found to be clinically superior over OMP alone in treating stable vitiligo patients, hence suggesting that adding OMP to Nb-U.V.B can maintain clinical and laboratory success for a longer period of time and with less relapse.
Asunto(s)
Glucocorticoides/administración & dosificación , Prednisona/administración & dosificación , Pigmentación de la Piel/efectos de los fármacos , Pigmentación de la Piel/efectos de la radiación , Terapia Ultravioleta , Vitíligo/terapia , Administración Oral , Adolescente , Adulto , Anciano , Autoanticuerpos/sangre , Terapia Combinada , Egipto , Femenino , Factor 2 de Crecimiento de Fibroblastos/genética , Glucocorticoides/efectos adversos , Humanos , Molécula 1 de Adhesión Intercelular/genética , Masculino , Persona de Mediana Edad , Prednisona/efectos adversos , Estudios Prospectivos , Quimioterapia por Pulso , Factores de Tiempo , Resultado del Tratamiento , Terapia Ultravioleta/efectos adversos , Vitíligo/sangre , Vitíligo/genética , Vitíligo/fisiopatología , Adulto JovenRESUMEN
OBJECTIVES: To verify the role of IL-12 in the pathogenesis of psoriasis and determine its relation to IFNgamma. DESIGN AND METHODS: Skin biopsies from lesional and non-lesional skin of 30 patients and 10 healthy controls were obtained for quantitative PCR examination of IL-12 (P40) and IFNgamma mRNA as well as in situ PCR of IL-12 (P40) and IFNgamma mRNA. RESULTS: IL-12 and IFNgamma levels were higher in lesional skin than in non-lesional and control skin. A significant correlation between IL-12 and IFNgamma was found. By in situ PCR hybridization, IL-12 expression was only found in the dermis, while IFNgamma was invariably expressed in the dermis and/or epidermis. CONCLUSION: We suggest that IL-12 independently and through IFNgamma induction may have a crucial role in the development of the active psoriatic lesion itself, where it is probably produced locally in the dermis as a step in the evolution of the psoriatic lesion.