ABSTRACT
Background: Vitiligo is an idiopathic skin disease manifested by depigmented macules. It is characterised by melanocyte destruction, and redox imbalance is proposed to play a contributory role. Aim: The aim of this study was to analyze the effects of an ethanolic extract of Piper betle leaves on the generation of reactive oxygen species in erythrocytes sourced from vitiligo patients. Methods: The effect of Piper betle on the generation of reactive oxygen species in erythrocytes was measured by fl ow cytometry in patients with active and stable vitiligo versus healthy controls, using 5-(and-6)-chloromethyl-2’-7’-dichlorodihydrofl uorescein diacetate. Results: The generation of reactive oxygen species in erythrocytes was higher in patients with vitiligo (n = 23) compared to healthy controls (n = 18). The geometrical mean fl uorescence channel was 23.05 ± 2.11 in patients versus 17.77 ± 1.79 in controls, P = 0.039. The levels of reactive oxygen species were higher in patients with active vitiligo. Treatment of erythrocytes with Piper betle in concentrations of 0.5 and 1.0 μg/ml signifi cantly decreased the baseline levels of reactive oxygen species by 31.7% in healthy controls, and 47.6% and 44.3% in patients with active vitiligo, respectively. Piper betle effectively scavenged hydrogen peroxide, which was evident by a decrease in the geometrical mean fl uorescence channel by 52.4% and 62.9% in healthy controls, and 45.0% and 57.0% in patients with active vitiligo. Limitations: The study had a small sample size. Future studies should focus on evaluation of the antioxidant role of Piper betle at the lesional site. Conclusion: This pilot study indicates that patients with active vitiligo demonstrate enhanced generation of reactive oxygen species in erythrocytes, which was signifi cantly reduced following ex vivo treatment with Piper betle.
ABSTRACT
Background: Estimation of facial aging has assumed growing importance due to the advent of several antiaging therapies. Evidence-based estimation of global facial aging is often necessary, especially for validation of these treatment modalities. Most available methods are expensive and have been used in fair skinned individuals. Aim: We attempted to develop a clinical rating scale for the estimation of global facial aging applied on an Indian population which has brown to black skin. We have also measured the association of this rating scale score with the chronological age. Methods: Initially, a 14- item summated rating scale was developed with inputs from fi ve dermatologists and a clinical pharmacologist. The rating scale was applied to 105 consenting subjects with healthy facial skin between 30 to 90 years of age. Intra- and inter-rater reliability was assessed. Results: The summated rating score showed a signifi cant positive correlation with the chronological age (Pearson’s correlation coeffi cient 0.834, P < 0.001). We omitted one item from the scale due to a low inter-rater agreement. The resulting 13-item rating scale was internally consistent (Cronbach’s alpha: 0.905), with substantial inter- and intra-rater reliability (intraclass correlation coeffi cient: 0.973 and 0.788, respectively). Principal components and predictive equation for perceptible age were identifi ed on further computation. Limitations: Participants of this study were limited to a particular ethnic group from West Bengal and other neighboring states of Eastern India. Conclusions: We have developed and validated a 13-item rating scale for the quantifi cation of global facial aging suitable for Indian (brown to black) skin type. This scale can be utilized effectively for clinical estimation of global facial aging.
ABSTRACT
Granuloma annulare is an idiopathic, palisaded, granulomatous disorder. There are four main clinical varieties of GA of which the subcutaneous type is less commonly encountered. Here, we report a case of generalized subcutaneous granuloma annulare in a 10-year-old boy. This variety is common in children but its generalized form is a rare presentation.