ABSTRACT
Background: Vitiligo is a skin disease with complex, multifactorial pathogenesis. Abnormalities in surrounding keratinocytes may cause melanocyte death due to deprivation of growth factors. Narrow band ultraviolet B (NB-UVB) is an effective therapeutic option especially in patients with generalized disease.Objective: The aim of this study was to identify histopathological changes in lesional and perilesional skin of vitiligo patients and the effect of NB-UVB therapy on them.Methods: Twenty patients were enrolled in this study. They received NB-UVB twice weekly on non-consecutive days for a total of 40 sessions. Skin biopsies from lesional and perilesional skin were obtained from each patient before and after therapy.Results: After therapy, 10% of patients showed excellent clinical response, 10% showed good response, 40% showed moderate response, 35% showed poor response and 5% showed progressive disease. Before therapy, 50% of patients showed a basal lymphocytic infiltrate with a perivascular lymphocytic infiltrate in both lesional and perilesional skin. 40% of them showed additional hydropic degeneration of lower epidermis with apoptotic keratinocytes in 20% of them. After therapy, these inflammatory changes were significantly reduced (p=0.04).Conclusion: NB-UVB is an effective method of treatment of vitiligo. This may be due to its immunosuppressive effects. Also, keratinocyte apoptosis may have a role in pathogenesis of vitiligo
Subject(s)
Apoptosis , Egypt , Keratinocytes , Ultraviolet Therapy/methods , Vitiligo/therapyABSTRACT
The Kromayer lamp is one of the most effective instruments in the production of therapeutic ultraviolet rays (Linct; 1967; Scott; 1973). Experts who recommend its technique and use say that at a distance of 4 inches it produces a First-degree erythema dose (E1) on the human skin in 10 seconds (Scott; 1973). A total of 30 blacks (Nigerians) patients were recruited at the dressing section of the out-patient department of Obafemi Awolowo University Teaching Hospital Complex; Ile-Ife; for this study; the purpose being to test whether the above parameters are applicable in our environment