Investigation of factors associated with health-related quality of life and psychological distress in vitiligo.

BACKGROUND AND OBJECTIVES: Skin diseases distort the body image with possible negative effects on the quality of life and psychosocial health of patients. While vitiligo does not affect the physical well-being, it may be psychologically distressing. The present study was based on the hypothesis that particular factors might be critical regarding the adjustment to the disease. PATIENTS AND METHODS: We investigated the vitiligo-related quality of life and psychological distress of 216 patients diagnosed with the disease in relation to demographic factors, disease components, and personality traits. For this purpose, we administered the self-completed questionnaires Dermatological Quality of Life Index, General Health Questionnaire, Eysenck Personality Inventory, and Rosenberg Self-Esteem Scale. RESULTS: Statistical analysis revealed a significant positive correlation between patients' distress and health-related quality of life. Moreover, the impact of vitiligo on the quality of life was significantly associated with disease variables as well as personality traits and gender. On the other hand, psychological distress was significantly associated with personality traits and gender, but not with disease components. CONCLUSIONS: Our results indicate that the psychosocial adjustment to the disease is mainly influenced by subjective factors. This observation could imply the need for targeted support interventions in the treatment of vitiligo.

Increased frequency of self-reported parasomnias in patients suffering from vitiligo.

Vitiligo is a skin disorder of unknown aetiology, affecting 0.1-2% of the general population. The aim of the present study was to investigate its relationship with sleep disorders, especially parasomnias. Two hundred and sixteen individuals were examined. Among them, 116 were suffering from vitiligo, 52 from other dermatological diseases and 48 were healthy subjects, serving as a control group. An inventory including items related to sleep disorders from childhood and adolescence was used. The study was focused specifically on parasomnias. Patients suffering from vitiligo reported a significantly higher occurrence of sleepwalking, nocturnal enuresis, night illusions, sleep terrors and nightmares than that of the control group, prior to the manifestation of the disease. Patients suffering from other dermatological diseases only reported significantly more often nightmares and nocturnal enuresis compared to the control group. A relationship between parasomnias during early life and later development of vitiligo was detected. This finding supports the hypothesis that neural mechanisms involving monoaminergic systems (especially the serotoninergic one) may potentially be involved in the aetiopathology of vitiligo.

Matrix metalloproteinases of epithelial origin in facial sebum of patients with acne and their regulation by isotretinoin.

Acne vulgaris is a skin disorder of the sebaceous follicles, involving hyperkeratinization and perifollicular inflammation. Matrix metalloproteinases (MMP) have a predominant role in inflammatory matrix remodeling and hyperproliferative skin disorders. We investigated the expression of MMP and tissue inhibitors of MMP (TIMP) in facial sebum specimens from acne patients, before and after treatment with isotretinoin. Gelatin zymography and Western-blot analysis revealed that sebum contains proMMP-9, which was decreased following per os or topical treatment with isotretinoin and in parallel to the clinical improvement of acne. Sebum also contains MMP-1, MMP-13, TIMP-1, and TIMP-2, as assessed by ELISA and western blot, but only MMP-13 was decreased following treatment with isotretinoin. The origin of MMP and TIMP in sebum is attributed to keratinocytes and sebocytes, since we found that HaCaT keratinocytes in culture secrete proMMP-2, proMMP-9, MMP-1, MMP-13, TIMP-1, and TIMP-2. SZ95 sebocytes in culture secreted proMMP-2 and proMMP-9, which was also confirmed by microarray analysis. Isotretinoin inhibited the arachidonic acid-induced secretion and mRNA expression of proMMP-2 and -9 in both cell types and of MMP-13 in HaCaT keratinocytes. These data indicate that MMP and TIMP of epithelial origin may be involved in acne pathogenesis, and that isotretinoin-induced reduction in MMP-9 and -13 may contribute to the therapeutic effects of the agent in acne.