Survey of dermatologists′ phototherapy practices for vitiligo

AlGhamdi, Khalid M.; Khurram, Huma; Taı̈eb, Alain

doi:10.4103/0378-6323.90950

Cited by 7 publications

(7 citation statements)

References 35 publications

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“…Nevertheless, UVB rays are widely used in clinical therapy, e.g. narrow-band UVB (311-313 nm) for phototherapy [Sklar et al, 2013], for the treatment and resolution of psoriasis [Piskin et al, 2004;Kirke et al, 2007;Johnson-Huang et al, 2010;Rácz et al, 2011;Juzeniene and Moan, 2012] and vitiligo [Alghamdi et al, 2012]. UVB rays can also promote vitamin D synthesis [Wacker and Holich, 2013] and stimulate melanocytes to produce melanin [Miyamura et al, 2011].…”

Section: Introductionmentioning

confidence: 99%

Effects of UV Rays and Thymol/Thymus vulgaris L. Extract in an ex vivo Human Skin Model: Morphological and Genotoxicological Assessment

Cornaghi

Arnaboldi

Calò

et al. 2016

Cells Tissues Organs

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Ultraviolet (UV) radiation is the major environmental factor affecting functions of the skin. Compounds rich in polyphenols, such as Thymus vulgaris leaf extract and thymol, have been proposed for the prevention of UV-induced skin damage. We compared the acute effects induced by UVA and UVB rays on epidermal morphology and proliferation, cytotoxicity, and genotoxicity. Normal human skin explants were obtained from young healthy women (n = 7) after informed consent and cultured at the air-liquid interface overnight. After 24 h, the samples were divided in 2 groups: the former exposed to UVA (16 or 24 J/cm²) and the latter irradiated with UVB (0.24 or 0.72 J/cm²). One hour after the end of irradiation, supernatants were collected for evaluation of the lactate dehydrogenase activity. Twenty-four hours after UVB exposure, biopsies were processed for light and transmission electron microscopy analysis, proliferation, cytotoxicity, and genotoxicity. UVB and UVA rays induced early inhibition of cell proliferation and DNA damage compared to controls. In particular, UVB rays were always more cytotoxic and genotoxic than UVA ones. For this reason, we evaluated the effect of either T. vulgaris L. extract (1.82 µg/ml) or thymol (1 µg/ml) on all samples treated for 1 h before UVB irradiation. While Thymus had a protective action for all of the endpoints evaluated, the action of the extract was less pronounced on epidermal proliferation and morphological features. The results presented in this study could be the basis for investigating the mechanism of thymol and T. vulgaris L. extract against the damage induced by UV radiation.

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Section: Introductionmentioning

confidence: 99%

Effects of UV Rays and Thymol/Thymus vulgaris L. Extract in an ex vivo Human Skin Model: Morphological and Genotoxicological Assessment

Cornaghi

Arnaboldi

Calò

et al. 2016

Cells Tissues Organs

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“…While MED testing would account for inter‐individual variability, it requires a more significant investment of staff time that is not always feasible in small offices or very busy practices . In a self‐administered survey completed in by dermatologists in Saudi Arabia in 2008, 68% administered a fixed starting dose of NB‐UVB to all patients, whereas 31% used the minimal erythema dose as a guide .…”

Section: Question 2 With Regard To Initial Dosing Which Strategy Shmentioning

confidence: 99%

“…In response to the concern for carcinogenesis, physicians have made efforts to limit cumulative exposure. Questionnaires distributed at a national meeting in Saudi Arabia in 2008 revealed that, while no respondent reported an increased incidence of skin cancer in phototherapy‐treated vitiligo patients, forty‐seven percent (50/106) limited the number of phototherapy sessions to reduce the potential risk .…”

Section: Question 8 What Is the Maximum Number Of Exposures Allowablmentioning

confidence: 99%

Exploring the gaps in the evidence‐based application of narrowbandUVBfor the treatment of vitiligo

Madigan

Al‐Jamal

Hamzavi

2016

Photoderm Photoimm Photomed

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SUMMARYWhile narrowband ultraviolet light B (NB-UVB) has become integral to the treatment of diffuse vitiligo, evidence-based guidelines have been lacking with regard to dosing and administration. This is largely the result of heterogeneous study designs, ambiguous methodologies, disparate dosing strategies, and the use of varied, and somewhat arbitrary, outcome measures. In the absence of prospective trials to address each of these concerns, the available literature regarding the application of NB-UVB for vitiligo was reviewed and the authors now pose a set of questions to the phototherapy community in an attempt to highlight gaps within our understanding. We aim to stimulate discussion, elicit expert opinion, and identify areas for future research to move toward a unified and safe treatment guideline for patients afflicted by this disease.

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“…The absence of melanin in vitiliginous skin and prolonged phototherapy may cause concern about the development of skin cancer. However, a rarity of skin cancer, even with prolonged phototherapy, and a relative lack of sun damage have been noted in vitiliginous skin . The association of vitiligo with tumour response in patients with melanoma who undergo immunotherapy has been reported …”

Section: Introductionmentioning

confidence: 99%

“…3 The association of vitiligo with tumour response in patients with melanoma who undergo immunotherapy has been reported. 2 The negative association between vitiligo and skin cancer is still enigmatic, and genetic, environmental and immune mechanisms are involved. Avoidance of sun by patients, absence of melanocytes, 1 overexpression of p53, underexpression of p16 (senescence marker), [3][4][5] genetic variation of the HLA-A*0201 and TYR genes, 6 increased apoptosis of melanocytes and keratinocytes 7 and overproduction of reactive oxygen species (ROS) 8 may all help in reducing the risk of skin cancer in vitiligo.…”

Section: Introductionmentioning

confidence: 99%

Assessment of telomerase activity in nonsegmental vitiligo tissue: a pilot study

et al. 2019

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Summary Background Vitiligo is characterized by loss of melanocytes; therefore, an increased risk of photoageing and cancer are expected. However, a low incidence of cancer and sun damage in vitiliginous skin has been reported. Telomerase is a specialized cellular enzyme catalysing the synthesis of telomeres, and an increased level of the telomerase activity has been highlighted in most of human cancer cells and cancer cell lines. Aim To assess relative telomerase activity (RTA) among patients with nonsegmental vitiligo. Methods In this case–control study, skin biopsy specimens were taken from 20 patients (one from lesional and another from nonlesional skin) and from sun‐protected skin from 10 healthy age‐, sex‐ and skin phototype‐matched healthy controls. PCR ELISA was performed for assessment of RTA. Results RTA in lesional skin biopsies from patients with nonsegmental vitiligo was significantly decreased compared with nonlesional skin and healthy control skin samples, with no significant difference between the latter two. RTA in lesional skin was negatively correlated with Vitiligo Area Scoring Index but not correlated with Vitiligo Disease Activity score or RTA of nonlesional skin. Neither lesional nor nonlesional RTA levels showed any correlation with patient sex, age, skin phototype or with disease duration. Conclusion Low levels of RTA in vitiliginous skin may help to explain the lower chance of developing skin cancer and decreased incidence of actinic damage in vitiliginous skin.

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Survey of dermatologists′ phototherapy practices for vitiligo

Abstract: There is a need for phototherapy guidelines for the treatment of vitiligo in patients with skin of color.

Cited by 7 publications

References 35 publications

Effects of UV Rays and Thymol/<b><i>Thymus vulgaris</i></b> L. Extract in an ex vivo Human Skin Model: Morphological and Genotoxicological Assessment

Effects of UV Rays and Thymol/<b><i>Thymus vulgaris</i></b> L. Extract in an ex vivo Human Skin Model: Morphological and Genotoxicological Assessment

Exploring the gaps in the evidence‐based application of narrowbandUVBfor the treatment of vitiligo

Assessment of telomerase activity in nonsegmental vitiligo tissue: a pilot study

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