Stability in vitiligo: Is there a perfect way to predict it?

Sahni, Kanika; Parsad, Davinder

doi:10.4103/0974-2077.112667

Cited by 34 publications

(14 citation statements)

References 54 publications

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“…This is coupled with high oxidative stress conditions in the lesional site that alters local skin physiology. Though the clinically unaffected skin appears normal, unpredictable spread of depigmentation indicates substantial instability of peripheral skin 22 23 . Further, it remains unclear if the modified skin biology and localized immune modulation in lesional patches has any association with the resident microflora.…”

Section: Discussionmentioning

confidence: 99%

Microbial community profiling shows dysbiosis in the lesional skin of Vitiligo subjects

Ganju

Nagpal

et al. 2016

Sci Rep

106

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Healthy human skin harbours a diverse array of microbes that comprise the skin microbiome. Commensal bacteria constitute an important component of resident microbiome and are intricately linked to skin health. Recent studies describe an association between altered skin microbial community and epidemiology of diseases, like psoriasis, atopic dermatitis etc. In this study, we compare the differences in bacterial community of lesional and non-lesional skin of vitiligo subjects. Our study reveals dysbiosis in the diversity of microbial community structure in lesional skin of vitiligo subjects. Although individual specific signature is dominant over the vitiligo-specific microbiota, a clear decrease in taxonomic richness and evenness can be noted in lesional patches. Investigation of community specific correlation networks reveals distinctive pattern of interactions between resident bacterial populations of the two sites (lesional and non-lesional). While Actinobacterial species constitute the central regulatory nodes (w.r.t. degree of interaction) in non-lesional skin, species belonging to Firmicutes dominate on lesional sites. We propose that the changes in taxonomic characteristics of vitiligo lesions, as revealed by our study, could play a crucial role in altering the maintenance and severity of disease. Future studies would elucidate mechanistic relevance of these microbial dynamics that can provide new avenues for therapeutic interventions.

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Section: Discussionmentioning

confidence: 99%

Microbial community profiling shows dysbiosis in the lesional skin of Vitiligo subjects

Ganju

Nagpal

et al. 2016

Sci Rep

106

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“…Previous studies associate vitiligo to autoimmune pathologies due to its frequent association with diseases of this nature, in which melanocyte cell death by immune-mediated apoptosis is considered an important susceptibility factor for vitiligo, emphasized by the detection in serum of auto-antibodies and reactive T lymphocytes targeted against this cell type ( 29 ). In a number of case-control genetic studies of vitiligo, a genetic association of the MHC was observed by testing different MHC markers in patients with different vitiligo phenotypes versus controls ( 30 ).…”

Section: Discussionmentioning

confidence: 99%

Protein tyrosine phosphatase PTPN22 +1858C/T polymorphism is associated with active vitiligo

García-Meléndez

Salinas-Santander

Sánchez‐Domínguez

et al. 2014

Experimental and Therapeutic Medicine

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Vitiligo is characterized by a skin depigmentation disorder resulting from an autoimmune response targeting melanocytes. Within the genetic factors involved in the development of the vitiligo immune response, various genes in the major histocompatibility complex (MHC) and non-MHC loci have been considered to be risk factors. The PTPN22 gene encodes for a lymphoid protein tyrosine phosphatase, a regulator of the activation and development of T-cells. The +1858C/T polymorphism has been associated to autoimmune disease susceptibility in different populations and could be implicated in the onset of vitiligo. To assess the possible association between the presence of PTPN22 +1858C/T and vitiligo, 187 patients with vitiligo and 223 control subjects were analyzed in the study. Genomic DNA was isolated using the salting-out method and samples were subjected to polymerase chain reaction-restriction fragment length polymorphism in order to detect the PTPN22 +1858C/T polymorphism. Causal associations were determined by χ2 test and their respective odds ratio (OR) was assessed in a 2×2 contingency table. The results showed an association between active vitiligo and the allele T load [P=0.0418; OR, 2.5706; 95% confidence interval (CI), 1.0040–6.5816], and active vitiligo-CT genotype (P=0.0389, OR, 2.6548; 95% CI, 1.0191–6.9156). In conclusion, the present data indicates a possible association between the PTPN22 +1858C/T genotype and a significant susceptibility of developing an active form of vitiligo.

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“…Additionally, as far as the overall duration of disease stability is concerned, a consensus still eludes us, with different authors proposing different durations ranging from 3 months to as long as 4 years. [ 19 ] Many attempts have been made over the years to reach to certain conclusions regarding this issue. However, none of these attempts or concepts has stood the test of time.…”

Section: Discussionmentioning

confidence: 99%

“…[ 17 18 ] None of these concepts have been shown to be foolproof and accurate in predicting either disease stability or the response after vitiligo surgery. [ 19 ]…”

Section: Introductionmentioning

confidence: 99%

Is lesional stability in vitiligo more important than disease stability for performing surgical interventions? results from a multicentric study

Majid¹,

Mysore²,

Salim³

et al. 2016

J Cutan Aesthet Surg

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Background:Ensuring stability of the disease process is essential for undertaking surgical intervention in vitiligo. However, there is no consensus regarding the minimum duration of stability or the relative importance of disease and lesional stability in selecting patients for vitiligo grafting.Aim:This multicentric study aims to assess the relative importance of lesional and disease stability on selecting patients for vitiligo grafting.Materials and Methods:One hundred seventy patients were recruited into the study and divided into two groups: Group A with lesional stability of >1 year but overall disease stability of only 6-11 months and Group B with overall disease stability of >1 year. Patients underwent either tissue or cellular vitiligo grafting on the selected lesions and the repigmentation achieved was scored from 0 (no repigmentation) to 6 (100% repigmentation). Repigmentation achieved on different sites of the body was compared between the two groups. Adverse effects at both the donor and the recipient sites were also compared.Results:Of the 170 patients who were enrolled, 82 patients were placed in Group A and 88 patients in Group B. Average repigmentation achieved (on scale of 0 to 6) was 3.8 and 4.04 in Group A and Group B, respectively. In Group A, ≥90% repigmentation was achieved in 36.6% (30/82) patients, while 37.5% (33/88) achieved similar results in Group B. Additionally, 47.6% (39/82) and 53.4% (47/88) of cases achieved partial repigmentation in Group A and Group B, respectively. Perigraft halo was the commonest adverse effect observed in both groups. Statistical analysis revealed no significant differences between the two groups with respect to the repigmentation achieved or adverse effects observed. Repigmentation achieved was the best on the face and neck area, while acral areas responded the least.Conclusions:Lesional stability seems to be as relevant as the overall disease stability in selecting patients for surgical intervention in vitiligo.

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Stability in vitiligo: Is there a perfect way to predict it?

Cited by 34 publications

References 54 publications

Microbial community profiling shows dysbiosis in the lesional skin of Vitiligo subjects

Microbial community profiling shows dysbiosis in the lesional skin of Vitiligo subjects

Protein tyrosine phosphatase PTPN22 +1858C/T polymorphism is associated with active vitiligo

Is lesional stability in vitiligo more important than disease stability for performing surgical interventions? results from a multicentric study

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