Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 5.827
Filtrar
1.
Gene ; 809: 146027, 2022 Jan 30.
Artigo em Inglês | MEDLINE | ID: mdl-34673212

RESUMO

Vitiligo is an autoimmune progressive skin depigmenting disease. Tumor necrosis factor alpha (TNF-α) is a pro-inflammatory cytokine and plays a crucial role in vitiligo development. Since there are conflicting results and consensus is lacking for the association of the TNFA gene -308 G > A polymorphism with vitiligo susceptibility; we performed a meta-analysis of all the available studies to investigate the association of TNFA -308 G > A polymorphism with vitiligo risk. 11 studies involving 2199 vitiligo patients and 3083 controls were included in the meta-analysis. The meta-analysis revealed an increased vitiligo risk with "AA", "GA" and "AA" + "GA" genotypes and 'A' allele in the overall (p = 0.006, p = 0.003, p = 0.001 & p = 0.003) and Egyptian populations (p = 0.001, p < 0.00001, p < 0.00001 & p = 0.002). Moreover, we found association for "GA" and "AA" + "GA" genotypes in Asian population (p = 0.0009 & p = 0.005) and for 'A' allele in Asian and middle eastern populations (p = 0.04 & p = 0.0002). Interestingly the disease activity based analysis revealed significant association for "GA", "AA" + "GA" genotypes and 'A' allele with active vitiligo patients in the North American population (p = 0.02). Moreover, we found significant association for "GA", "AA" + "GA" genotypes and 'A' allele with localized vitiligo in overall (p = 0.02, p = 0.02 & p = 0.04) and Asian (p = 0.004, p = 0.003 & p = 0.01) populations. Overall, our meta-analysis suggests the involvement of susceptible 'A' allele with: i) vitiligo susceptibility in overall population and specifically with Asian, Middle Eastern and Egyptian populations; ii) vitiligo disease activity in North American population and iii) localized vitiligo in overall population and specifically in Asian population.


Assuntos
Polimorfismo de Nucleotídeo Único , Fator de Necrose Tumoral alfa/genética , Vitiligo/genética , Feminino , Predisposição Genética para Doença , Humanos , Masculino , Anamnese
2.
Clin Dermatol ; 39(4): 703-706, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34809776

RESUMO

COVID-19 infection may affect the individuals with many underlying conditions including skin diseases. This cross-sectional study was conducted to provide an overview regarding the prevalence of COVID-19 disease in the patients with several skin diseases. Overall, 703 patients with several skin diseases participated in the study and completed our online-designed questionnaire. Among the total participants, only 32(4.6%) subjects reported the COVID-19 infection. The prevalence rate was equal to 0.04%. In the patients with psoriasis, 14 out of 322 people (4.3%) developed the COVID-19. Three out of 159 patients (1.9%) with alopecia areata had been affected with the COVID-19 and 4 (5.2%) patients with vitiligo had caught the disease. Only one subject (2%) with the lichen planus, and 6 (6.8%) patients with other skin diseases had developed the COVID-19 but in the patients with GVHD (Graft Versus Host Disease), 4 (80%) out of 5 patients had caught the COVID-19 disease. The frequency of COVID-19 infection was low in the studied population however; more studies with larger sample size are needed to determine the exact prevalence of the infection in the patients with skin diseases undergoing the treatment with several systemic medications.


Assuntos
COVID-19 , Dermatologia , Vitiligo , Estudos Transversais , Humanos , Irã (Geográfico)/epidemiologia , SARS-CoV-2 , Vitiligo/epidemiologia
3.
Zhonghua Yi Xue Yi Chuan Xue Za Zhi ; 38(11): 1120-1122, 2021 Nov 10.
Artigo em Chinês | MEDLINE | ID: mdl-34729756

RESUMO

OBJECTIVE: To explore the genetic basis for a patient with clinically suspected neurofibromatosis type I, alopecia areata and vitiligo. METHODS: Variant of the NF1 gene was detected by chip capture and high-throughput sequencing. Candidate variant was verified by Sanger sequencing of the family trio. RESULTS: The patient was found to harbor a novel missense c.1885G>A (p.Gly629Arg) variant of the NF1 gene, for which neither parent was carrier. The variant was not recorded in the public database. Based on the guidelines for genetic variation of the American College of Medical Genetics and Genomics, the c.1885G>A missense variant was predicted to be pathogenic (PS1+PS2+PM2+PP3+PP4). CONCLUSION: The c.1885G>A missense variant probably underlay the disease in this child. Above finding has enriched the spectrum of the NF1 gene variants.


Assuntos
Alopecia em Áreas , Neurofibromatose 1 , Vitiligo , Alopecia em Áreas/genética , Criança , Genômica , Humanos , Mutação , Neurofibromatose 1/genética , Vitiligo/genética
4.
Saudi Med J ; 42(11): 1195-1200, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34732551

RESUMO

OBJECTIVES: To assess the quality of life (QoL) of patients with different dermatological diseases. Multiple international studies have evaluated the QoL among patients with different dermatological diseases; however, few studies of this kind have been conducted in Saudi Arabia. METHODS: This quantitative, observational, cross-sectional study was carried out in the dermatology outpatient clinics of King Saud University Medical City, Riyadh, Saudi Arabia, from September 2019 until February 2020. Data was collected using the validated Arabic version of the Dermatology of Life Quality Index (DLQI). RESULTS: A total of 391 patients ≥18 years participated in the study. The mean age of participants was 33 years (18-75 years). Most participants in this study reported that their dermatological disease had a small or no effect on their QoL (62.5%). The majority of patients who had acne vulgaris (79.7%), vitiligo (79.3%), hair disorders (76.9%), or rosacea (71.5%) reported a small to no effects on their QoL. However, diseases that reflected the largest percentages of a large to extremely large effect on QoL were urticaria (37.1%), eczema (26.6%), and psoriasis (24%). A total of 42.9% of the participants suffered from lichen planus and 66.7% of participants suffered from cutaneous neoplasms reported a moderate effect on their QoL. CONCLUSION: Understanding the impact of different dermatological diseases on QoL can help dermatologists to improve thier patients' QoL. Therefore, we recommend that further studies on this topic be conducted in multiple health centers.


Assuntos
Acne Vulgar , Psoríase , Vitiligo , Adulto , Estudos Transversais , Humanos , Qualidade de Vida
5.
Br J Dermatol ; 185(4): e158-e178, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34608618

RESUMO

Linked Article: Shourick et al. Br J Dermatol 2021; 185:787-796. Vitiligo is a persistent or chronic condition in which areas of skin lose their normal pigment and become very pale. It is common, affecting about 1% of the world's population. Vitiligo affects men and women of all races equally, but is more noticeable in people with skin of colour. Treatment of vitiligo is often challenging and patients need to persist with treatment long term. Shared decision-making tools (SDMts) are visual aids that are developed to promote joint medical decision-making between physicians and patients. They may help patients better define what they would like to achieve in terms of treatment. In dermatology, various decision support tools have been developed but none for vitiligo. In this study a SDMt was developed and tested in 30 French and 10 US adult patients with vitiligo. The patients who took part in the study reported high satisfaction rates with the use of this tool during their consultations with clinicians. In conclusion, this SDMt for vitiligo can be used routinely in daily clinical practice, and may help patients to continue with treatment for longer. It is an important step towards patient-centred care for patients with vitiligo.


Assuntos
Vitiligo , Adulto , Tomada de Decisão Clínica , Tomada de Decisão Compartilhada , Feminino , Humanos , Masculino , Assistência Centrada no Paciente , Encaminhamento e Consulta , Vitiligo/terapia
6.
Int J Mol Sci ; 22(19)2021 Sep 27.
Artigo em Inglês | MEDLINE | ID: mdl-34638746

RESUMO

A 308 nm monochromatic excimer light (MEL) is widely used to treat patients with vitiligo. However, dose optimization still needs to be clarified. This study aimed to obtain objective evidence regarding various doses of MEL irradiation, induced cell level changes in vitro, and skin level alterations in vivo. Cultured human keratinocytes were irradiated with MEL using various doses. After irradiation at low doses, stem cell factor, endothelin-1, and glycoprotein nonmetastatic melanoma protein B, factors that activate and protect melanocytes, were found to be significantly elevated in keratinocytes. After irradiation using medium and high doses, inflammatory cytokines were induced. The amount of ATP released and the level of inflammasome activation, which are known to be related to interleukin-1ß activation, were also increased. The back skin of guinea pigs and mice were irradiated with MEL at varying doses. After irradiation, an increase of epidermal melanin and epidermal melanocytes was confirmed, using the minimal erythemal dose or less. In rhododendrol-induced leukoderma guinea pigs, a much lower dose of MEL irradiation was effective, when compared with the effective dose for control guinea pigs. Our results suggest that a lower irradiation dose of MEL might be sufficient and more suitable for repigmentation in vitiligo treatment.


Assuntos
Queratinócitos/metabolismo , Melanócitos/metabolismo , Pigmentação da Pele/efeitos da radiação , Terapia Ultravioleta , Vitiligo , Animais , Linhagem Celular , Feminino , Cobaias , Humanos , Camundongos , Vitiligo/metabolismo , Vitiligo/radioterapia
9.
Niger Postgrad Med J ; 28(3): 169-174, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34708702

RESUMO

Background: Vitiligo is an acquired pigmentary disorder of the skin and mucous membranes which manifests as white macules and patches due to selective loss of melanocytes. This condition can affect the patients' psychology, leading to an impairment of quality of life (QOL). Recently, much attention is been given to the emotional and psychological issues in the affected subjects. Aim of the Study: This was to assess the QOL impairment among Nigerian patients with vitiligo using a disease-specific quality of life index questionnaire (VitiQoL). Materials and Methods: Seventy seven adults aged 18 years and above with vitiligo attending the Dermatology Clinic of a tertiary health center were included in this cross-sectional study. The QOL was assessed using the vitiligo quality of life questionnaire (VitiQoL). Disease severity was assessed using Vitiligo Area Severity Index (VASI). Results: The mean age of the study participants was 38.97 ± 13.2 years, comprising of 32 (41.6%) and 45 (58.4%) females. Almost half of the vitiligo patients belong to the lower socioeconomic class, 37 (48.1%). The mean age of first onset of vitiligo was 33.5 ± 14.84 years, with 32 (41.6%) of the participants having age of first onset between 24 and 42 years. The mean VitiQoL score was 30.51 ± 15.74 (range 3-64). There was a significant relationship between VASI score and VitiQoL (P = 0.036, r = 0.517). Other factors such as age, gender, socioeconomic status, disease activity, family history of vitiligo, duration of the disease and educational attainment were significantly associated with VitiQoL score (P < 0.05). Conclusion: QOL is impaired significantly in Nigerian patients with vitiligo. Focusing on patient's QOL is an essential aspect in the management of patients with vitiligo.


Assuntos
Qualidade de Vida , Vitiligo , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Nigéria , Inquéritos e Questionários , Vitiligo/epidemiologia , Adulto Jovem
10.
Photobiomodul Photomed Laser Surg ; 39(9): 600-606, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34546107

RESUMO

Objective: Evaluate the treatment outcome of vitiligo patients receiving a standard regimen of high-dose biweekly fractional 2940 nm erbium:yttrium aluminium garnet (YAG) laser applications as an add-on to various treatment modalities. Materials and methods: The authors extracted the study population's clinical images before treatment and 3rd-month control from their clinical archive and used the medical records. The primary outcome measure was 50% repigmentation at 3rd-month follow-up. Institutional ethical committee approved the study. Results: Of the evaluated 28 patients, 18 were eligible with 31 treatment regions. All patients received at least one topical agent [steroids, calcineurin inhibitors, or 5-fluorouracil (5-FU)] and 11 patients received either targeted ultraviolet B (UVB) or narrow-band UVB. Of the 31 study regions, 88.8% (8/9) of facial; 77.7% (7/9) of dorsal hand; 75% (3/4) of limb; and 25% (2/8) of finger lesions achieved 50% repigmentation at 3rd-month control. The facial and dorsal hand lesions' treatment responses were higher than finger lesions (p = 0.008 and 0.03, respectively). Upon evaluating adjuvant treatment modalities, all of the treatment regions receiving targeted UVB (n = 4) or topical 5-FU (n = 5) achieved the primary endpoint, whereas severe irritation limited the topical use of 5-FU. The most common adverse effects were mild oozing and crusting related to laser treatments. Conclusions: Even with high-energy settings, fractional erbium: YAG laser does not induce the Koebner phenomenon. Although controlled trials are required to make firm conclusions, fractional erbium: YAG laser was an effective and safe adjunctive option for stable vitiligo in a real-life setting.


Assuntos
Lasers de Estado Sólido , Terapia Ultravioleta , Vitiligo , Alumínio , Terapia Combinada , Érbio , Humanos , Lasers de Estado Sólido/efeitos adversos , Vitiligo/tratamento farmacológico , Ítrio
11.
Photobiomodul Photomed Laser Surg ; 39(9): 607-611, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34546111

RESUMO

Background: Artificial ultraviolet (UV) radiation is a mainstay in the treatment of a variety of inflammatory skin disorders. Despite existence from a wealth of studies on the impact of narrow-band UVB (NBUVB) on serum levels of nutrients, clinical data on its effect on serum homocysteine (HC) level, which is thought to be a risk factor for cardiovascular disorders, dementia, and depression, are scarce. Objective: To assess serum HC status before and after treatment with at least 30 sessions of NBUVB exposure in patients with various cutaneous disorders. Methods: A prospective cohort study was conducted on 39 patients with psoriasis, vitiligo, atopic dermatitis, and mycosis fungoides who underwent at least 30 sessions of NBUVB phototherapy. Serum HC was measured and compared before and after phototherapy. This study was approved by relevant ethics committee. Results: Levels of HC decreased by 24.8% after 30 sessions of NBUVB phototherapy (10.53 ± 3.64 µmol/L vs. 7.92 ± 3.26 µmol/L, p-value <0.0001) and this decrease was more prominent in male participants and patients older than 40 years. Conclusions: Based to our findings, NBUVB phototherapy might be a modality of choice especially for older male patients not only as an effective treatment for cutaneous conditions, but also as a modality with potential protective effects against cardio-cerebro-vascular accidents.


Assuntos
Terapia Ultravioleta , Vitiligo , Homocisteína , Humanos , Masculino , Fototerapia , Estudos Prospectivos
12.
Medicina (Kaunas) ; 57(9)2021 Aug 30.
Artigo em Inglês | MEDLINE | ID: mdl-34577827

RESUMO

Background and objectives: Vitiligo is an acquired chronic and idiopathic skin disorder, characterized by selective loss of melanocytes and resulting in a cutaneous depigmentation. Treatment for vitiligo remains a challenge for dermatologists; thus, it is frustrating both for physicians and patients. The objective of this study was to evaluate a combination treatment characterized by the use of a leukocyte-rich platelet-rich plasma, which is particularly rich in monocytes (defined here as monocyte-rich PRP), in combination with a 1927 nm fraxel laser and a 308 nm excimer laser. Materials and Methods: Treatment with monocyte-rich PRP combined with 1927 nm fraxel laser and 308 nm excimer laser was performed in nine sessions in 80 days and the median follow-up of the patients was 10 months. A total of 27 Caucasian patients were included in the present study. The median age of patients was 41 years, ranging between 20 and 69 years. Results: A re-pigmentation occurred in 16 cases (59%) with a reduction of the Vitiligo Extent Score (VES) and absence of re-pigmentation in untreated areas. Performing a rank correlation between VES and re-pigmentation in the treated areas, we found that there was a significant correlation (p < 0.0001). The presence of progressive vitiligo (p = 0.1) and the anatomic areas (p = 0.1) did not influence the treatment. Untreated areas did not show any improvement of the depigmented lesions, except in one case (p < 0.0001). Conclusions: in this report, we show for the first time how PRP rich in monocytes, in combination with laser therapies, gives a long therapeutic response, which persists even after 10 months of follow-up.


Assuntos
Plasma Rico em Plaquetas , Vitiligo , Adulto , Humanos , Lasers de Excimer , Monócitos , Projetos Piloto , Resultado do Tratamento , Vitiligo/terapia
13.
Artigo em Inglês | MEDLINE | ID: mdl-34565123

RESUMO

INTRODUCTION: Vitiligo is a disease with a high prevalence and burden that has a negative impact on various aspects of life. Because most cases of vitiligo are not responsive to medical treatment, we performed simplified autologous melanocyte and keratinocyte grafting to treat refractory stable vitiligo. METHODS: This interventional study was carried out on 32 patients (16 females and 16 males). After local anesthesia at the donor site, we shaved the donor sites to harvest autologous melanocyte material. The harvested paste-like non-trypsinized material was spread over the abraded recipient area. Patient follow-up was performed to track the treatment outcome and possible complications. RESULTS: Out of 32 patients with 99 lesions, the generalized type accounted for 28 (87.5%) patients, and 46 (46.5%) lesions were seen in the upper extremity as the most common clinical type and site of involvement. Eighteen (18.2%) and 26 (26.3%) patches showed excellent and good re-pigmentation, respectively, and face areas showed significantly better re-pigmentation (p < 0.001). CONCLUSIONS: Simplified autologous melanocyte and keratinocyte grafting is a safe, simple, office-based, and low-cost procedure with a modest re-pigmentation outcome in refractory stable vitiligo. Moreover, the face area had a satisfactory outcome with this procedure.


Assuntos
Vitiligo , Feminino , Humanos , Queratinócitos , Masculino , Melanócitos , Pigmentação da Pele , Resultado do Tratamento , Vitiligo/cirurgia
14.
Immunity ; 54(9): 2117-2132.e7, 2021 09 14.
Artigo em Inglês | MEDLINE | ID: mdl-34525340

RESUMO

The nature of the anti-tumor immune response changes as primary tumors progress and metastasize. We investigated the role of resident memory (Trm) and circulating memory (Tcirm) cells in anti-tumor responses at metastatic locations using a mouse model of melanoma-associated vitiligo. We found that the transcriptional characteristics of tumor-specific CD8+ T cells were defined by the tissue of occupancy. Parabiosis revealed that tumor-specific Trm and Tcirm compartments persisted throughout visceral organs, but Trm cells dominated lymph nodes (LNs). Single-cell RNA-sequencing profiles of Trm cells in LN and skin were distinct, and T cell clonotypes that occupied both tissues were overwhelmingly maintained as Trm in LNs. Whereas Tcirm cells prevented melanoma growth in the lungs, Trm afforded long-lived protection against melanoma seeding in LNs. Expanded Trm populations were also present in melanoma-involved LNs from patients, and their transcriptional signature predicted better survival. Thus, tumor-specific Trm cells persist in LNs, restricting metastatic cancer.


Assuntos
Linfócitos T CD8-Positivos/imunologia , Memória Imunológica/imunologia , Linfonodos/imunologia , Melanoma Experimental/imunologia , Melanoma/imunologia , Neoplasias Cutâneas/imunologia , Animais , Humanos , Camundongos , Vitiligo
15.
J Vis Exp ; (174)2021 08 27.
Artigo em Inglês | MEDLINE | ID: mdl-34515686

RESUMO

The loss of function of melanocytes leads to vitiligo, which seriously affects the physical and mental health of the affected individuals. Presently, there is no effective long-term treatment for vitiligo. Therefore, it is imperative to develop a convenient and effective treatment for vitiligo. Regenerative medicine technology for direct reprogramming of skin cells into melanocytes seems to be a promising novel treatment of vitiligo. This involves the direct reprogramming of the patient's skin cells into functional melanocytes to help ameliorate the loss of melanocytes in patients with vitiligo. However, this method needs to be first tested on mice. Although direct reprogramming is widely used, there is no clear protocol for direct reprogramming into melanocytes. Moreover, the number of available transcription factors is overwhelming. Here, a concentrated lentivirus packaging system protocol is presented to produce transcription factors selected for reprogramming skin cells to melanocytes, including Sox10, Mitf, Pax3, Sox2, Sox9, and Snai2. Mouse embryonic fibroblasts (MEFs) were infected with the concentrated lentivirus for all these transcription factors for the direct reprogramming of the MEFs into induced melanocytes (iMels) in vitro. Furthermore, these transcription factors were screened, and the system was optimized for direct reprogramming to melanocytes. The expression of the characteristic markers of melanin in iMels at the gene or protein level was significantly increased. These results suggest that direct reprogramming of fibroblasts to melanocytes could be a successful new therapeutic strategy for vitiligo and confirm the mechanism of melanocyte development, which will provide the basis for further direct reprogramming of fibroblasts into melanocytes in vivo.


Assuntos
Fibroblastos , Vitiligo , Animais , Humanos , Melaninas , Melanócitos , Camundongos , Pele , Vitiligo/terapia
17.
Clin Dermatol ; 39(3): 517-520, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34518013

RESUMO

COVID-19 infection may affect the individuals with many underlying conditions including skin diseases. This cross-sectional study was conducted to provide an overview regarding the prevalence of COVID-19 disease in the patients with several skin diseases. Overall, 703 patients with several skin diseases participated in the study and completed our online-designed questionnaire. Among the total participants, only 32(4.6%) subjects reported the COVID-19 infection. The prevalence rate was equal to 0.04%. In the patients with psoriasis, 14 out of 322 people (4.3%) developed the COVID-19. Three out of 159 patients (1.9%) with alopecia areata had been affected with the COVID-19 and 4 (5.2%) patients with vitiligo had caught the disease. Only one subject (2%) with the lichen planus, and 6 (6.8%) patients with other skin diseases had developed the COVID-19 but in the patients with GVHD (Graft Versus Host Disease), 4 (80%) out of 5 patients had caught the COVID-19 disease. The frequency of COVID-19 infection was low in the studied population however; more studies with larger sample size are needed to determine the exact prevalence of the infection in the patients with skin diseases undergoing the treatment with several systemic medications.


Assuntos
COVID-19 , Dermatologia , Vitiligo , Estudos Transversais , Humanos , Imunomodulação , SARS-CoV-2
18.
Acta Dermatovenerol Croat ; 291(1): 54-55, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-34477066

RESUMO

Dear Editor, Nivolumab is a fully human monoclonal antibody that targets the programmed cell death 1 (PD-1) immune checkpoint. It has been approved for its use in several types of advanced solid tumors, including melanoma, lung cancer, and renal cell carcinoma (RCC). The inhibition of PD-1 leads to an enhanced adaptive immune response against tumor cells through the activation of T-cells. Vitiligo-like depigmentation (VLD) is a well-known side-effect in patients with melanoma that are being treated with anti PD-1 therapies (1). However, its development in patients undergoing treatment with nivolumab for cancers other than melanomas has been described very rarely. To our knowledge, herein we report the second case of nivolumab-induced VLD in a patient with metastatic RCC (2). The patient was a 63-year-old man who had a medical history of advanced RCC. He had initially undergone nephrectomy, and three months later he presented with local relapse and lung metastases. He had then received different treatment regimes, presenting with progression each time, until he finally started treatment with nivolumab. Five months after its introduction, the patient developed a disseminated hypochromic eruption. No other drugs were started over that period. He had no personal or family history of vitiligo or other autoimmune disorders. Dermatological examination revealed multiple, symmetrical, well-demarcated, depigmented macules involving his face, neck, torso, hands, and forearms. (Figure 1, a). Preservation of pigment in hair follicles could be seen on the dorsal aspect of his hands (Figure 1, b). Two 4-mm punch biopsies were taken, one from one from a depigmented patch and another from normally pigmented skin. In the first one, immunohistochemical analysis with Melan-A immunostaining demonstrated the absence of melanocytes, whereas melanocytes were present in the second one. A CD-8+ positive infiltrate was present in both biopsies, especially in the first one (Figure 2). The patient was diagnosed with VLD associated with nivolumab therapy. Since the patient was asymptomatic, no treatment was prescribed. He was advised to protect the achromic areas from sun exposure. In our patient, a causal association between the onset of VLD and the treatment with nivolumab cannot be completely ruled out. However, the clinical presentation with flecked macules in sun-exposed areas was consistent with what has been described in other patients presenting with VLD after starting treatment with this chemotherapeutic agent. The time to onset in our case was also within the limits which have been previously reported for this side-effect (16-52 weeks) (3). Therefore, we believe that a causal association is very probable. In patients with advanced melanoma who are treated with PD-1 inhibitors, the development of vitiligo-like lesions has been proved to be associated with improved progression-free and overall survival rates (4,5). This mechanism is not fully understood, but it has been suggested that inhibition of PD-1 could cause a loss of tolerance to melanocytic antigens, thus leading to a CD-8 T-cell dependent destruction of melanocytes present in the melanoma as well as in healthy skin (3,5). The presence of CD8 T-lymphocytes in our patient's biopsies supports this theory. However, the development of this condition in patients suffering from non-melanoma cancers suggests that different mechanisms, independent from melanoma, could also be involved. Larger studies are needed in order to determine if VLD also correlates with better survival rates in patients treated with nivolumab for non-melanoma malignancies. In conclusion, new checkpoint inhibitors can cause VLD not only in patients suffering from melanoma but also in those affected by other tumors. We believe dermatologists should play a key role in the management of this side-effect. Therefore, we ought to be familiar with it in order to be able to identify and treat it appropriately without discontinuation of anticancer treatment.


Assuntos
Carcinoma de Células Renais , Neoplasias Renais , Vitiligo , Carcinoma de Células Renais/tratamento farmacológico , Humanos , Neoplasias Renais/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Nivolumabe/efeitos adversos , Vitiligo/induzido quimicamente
19.
Pediatr Dermatol ; 38(5): 1012-1019, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34561885

RESUMO

Vulvar vitiligo (VV) and vulvar lichen sclerosus (VLS), both feature skin and mucosal hypo-/depigmentation. The aim of this study was to describe the clinical and dermoscopic features of VV and VLS in the pediatric population, providing diagnostic clues, and to define their association. We performed a systematic literature review of the clinical and dermoscopic features of pediatric VV and VLS. An observational study was conducted on children affected by VLS associated with VV, referred to the Dermatology Unit of the Sant'Orsola Polyclinic in Bologna, Italy. Medical history, age at diagnosis, ethnicity, clinical and dermoscopic features, and symptoms were recorded for all patients. 124 cases of VLS and 10 cases of VV were reviewed. Clinical manifestations included hypo-/depigmented patches in both conditions, while ecchymosis/purpura and fissures/erosion were observed in VLS. Symptoms including pruritus, pain, or burning were reported only by VLS patients. In our study five patients with VLS associated with VV were retrieved. Clinical features included well-demarcated depigmented patches in VV and translucent areas, erythema, ecchymoses/purpura, and labial fusion in VLS. Dermoscopy showed white structureless areas with a whipped cream-like appearance, linear or dotted vessels, white chrysalis-like structures, erosion and red-purpuric blotches in VLS and reduced pigment network or pigment absence, intralesional spots of residual pigmentation and telangiectasias in VV. Symptoms were present in all patients. Both VV and VLS show hypo-/depigmented patches. In the presence of associated symptoms, possible VLS should be investigated with clinical and dermoscopic examination to achieve a prompt diagnosis.


Assuntos
Líquen Escleroso e Atrófico , Vitiligo , Líquen Escleroso Vulvar , Criança , Feminino , Humanos , Líquen Escleroso e Atrófico/complicações , Líquen Escleroso e Atrófico/diagnóstico , Estudos Observacionais como Assunto , Pele , Vitiligo/diagnóstico , Líquen Escleroso Vulvar/diagnóstico
20.
Int J Mol Sci ; 22(16)2021 Aug 17.
Artigo em Inglês | MEDLINE | ID: mdl-34445526

RESUMO

Among disorders of pigmentation, vitiligo is the most common, with an estimated prevalence between 0.5% and 1%. The disease has gathered increased attention in the most recent years, leading to a better understanding of the disease's pathophysiology and its implications and to the development of newer therapeutic strategies. A better, more integrated approach is already in use for other chronic inflammatory dermatological diseases such as psoriasis, for which metabolic comorbidities are well-established and part of the routine clinical evaluation. The pathogenesis of these might be linked to cytokines which also play a role in vitiligo pathogenesis, such as IL-1, IL-6, TNF-α, and possibly IL-17. Following the reports of intrinsic metabolic alterations reported by our group, in this brief review, we analyze the available data on metabolic comorbidities in vitiligo, accompanied by our single-center experience. Increased awareness of the metabolic aspects of vitiligo is crucial to improving patient care.


Assuntos
Doenças Metabólicas/epidemiologia , Vitiligo/epidemiologia , Ensaios Clínicos como Assunto , Comorbidade , Humanos , Doenças Metabólicas/patologia , Vitiligo/patologia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...