Association of singlenucleotide NR3C1 gene polymorphisms with glucocorticosteroid responsiveness in patients with pemphigus vulgaris.

The glucocorticosteroid (GC) is crucial when managing patients with pemphigus vulgaris (PV). Polymorphisms in the gene encoding the nuclear receptor subfamily 3, group C, member 1 (NR3C1) protein (the GC receptor) may explain the variations in treatment efficacy. We evaluated the effects of 10 single nucleotide polymorphisms (SNPs) in the NR3C1 gene and the correlations with the GC responsiveness in patients with PV. The accumulative GC doses were recorded, and patients were assessed for the Pemphigus Disease Activity Index (PDAI) scores until the GC doses would be tapered. Whole blood samples at the initial visit were genotyped using TaqMan SNP Genotyping. In the NR3C1 gene, SNPs were detected in 6 (rs17209237, rs11745958, rs7701443, rs41423247, rs33388, and rs6196); the genotypes rs17209237 AA, rs11745958 CC, and rs6196 AG may be associated with a need for a lower accumulative GC dose; rs17209237 AA and rs6196 AG with shorter times to commencement of tapering; and rs17209237 AA and rs11745958 CC with shorter times to attainment of 50 and 25% PDAI scores. Thus, NR3C1 gene variations may predict GC responsiveness in PV patients.

Moisturizing effectiveness of immediate compared with delayed moisturization.

INTRODUCTION: Moisturizers play an essential role in maintaining the integrity of the skin barrier by increasing stratum corneum hydration (SCH) and reducing transepidermal water loss (TEWL). According to dermatology and allergy guidelines, moisturizers should be applied on the skin within 3 min after bathing or showering. However, there is very little evidence supporting this recommendation. This study aimed to investigate the effectiveness of immediate and delayed moisturizing after bathing/washing on the improvement of SCH and TEWL. METHODS: This was a crossover study of 60 healthy Vietnamese volunteers aged 18-25 years. In each subject, SCH and TEWL levels were measured at three areas: non-moisturized, immediate moisturizing after washing, and delayed moisturizing at 30 min after washing. RESULTS: In non-moisturized skin, SCH and TEWL levels were significantly different from the baseline at 60 min after washing, while significantly decreased TEWL levels were observed immediately after moisturizing. In addition, moisturized skin had significantly higher SCH and lower TEWL levels compared with non-moisturized areas at every time point (p < 0.05). Interestingly, the percentage changes of SCH and TEWL levels from baseline did not differ between immediately and delayed moisturized areas. CONCLUSIONS: Tested moisturizer helped increase SCH and decrease TEWL; however, there was no difference in moisturizing effectiveness between immediate and delayed moisturizing in healthy skin. The recommendation of immediate application of moisturizers after bathing/washing should be reconsidered, and more studies are needed to establish a stronger recommendation.

Increased Circulatory Interleukin-17A Levels in Patients with Progressive and Leukotrichial Vitiligo.

BACKGROUND: Vitiligo is a chronic condition characterized by skin depigmentation. Although not life-threatening, it significantly impacts quality of life. The pathophysiology of vitiligo remains poorly understood, and treatment options are limited. Mounting evidence supports the importance of autoreactive T cells and, particularly interleukin-17A- (IL-17A-) secreting Th17 cells, in vitiligo. IL-17A targeting has been proven successful in various inflammatory dermatological conditions, including psoriasis and lupus erythematosus. OBJECTIVE: We evaluated the relationship between serum levels of IL-17A and the clinicopathological characteristics of Vietnamese vitiligo patients. METHODS: In this cross-sectional study, we analyzed data from 52 nonsegmental vitiligo patients and 50 age- and sex-matched healthy individuals. Serum levels of IL-17A were measured using an enzyme-linked immunosorbent assay. We evaluated the correlation between IL-17A levels and clinical characteristics including leukotrichia, disease duration, vitiligo activity, and body surface area involvement. RESULTS: Patients with progressive vitiligo had significantly higher IL-17A levels than patients with stable vitiligo (P = 0.014) or healthy individuals (P = 0.002). In addition, serum IL-17A levels were higher in vitiligo patients with leukotrichia than in patients without it (P = 0.04). Furthermore, serum IL-17A levels were negatively correlated with age (r = -0.39, P = 0.004) and age of onset (r = -0.33, P = 0.016) in vitiligo patients. CONCLUSIONS: Higher serum levels of IL-17A in patients with progressive vitiligo and leukotrichia suggest a potential role of IL-17A in melanocyte destruction in the epidermis and the follicular matrix.