ABSTRACT
Introduction: Vitiligo is a cosmetically disfiguring,psychologically devastating disease and is resistant to therapy.Vitiligo in childhood can be associated with significantemotional trauma that may have long‑lasting effects on thepsychosocial development of these children and self esteem.Childhood vitiligo has different epidemiological, clinical,therapeutic, and prognostic profile. This study was carried outto assess the clinical and epidemiological characteristics ofvitiligo in pediatric patients.Material and methods: It was a prospective, observationalstudy carried out over a period of 1 year. All patients youngerthan 18 years of age with vitiligo attending the Dermatologyop of Osmania General hospital, hyderabad between April2017 and March 2018 were included in the study.Results: The most common pattern of vitiligo wasvulgaris (48%) followed by focal (34%), mucosal (8%)acro‑facial(6%), segmental (4%). Lower limb was the mostcommon site for vitiligo seen in 56 patients (56%), followedby face (21%), upper limbs (10%), mucosal (8%) and scalp(5%). No patients had universal presentation. 27 patients(27%) had Leukotrichia whereas Koebner’s phenomenon waspositive in 24 patients (24%).Conclusion: Childhood vitiligo is common depigmentingdisorder encountered frequently in females probably dueto higher concern about the disfiguring nature of disease infemales, with a mean age of onset being around 6.3 years.Vitiligo vulgaris was the most common pattern of presentation,followed by the focal type of vitiligo while the universalpattern was rare in childhood. Lower limbs were the mostcommon site of involvement followed by face. Patients withfamily history tend to present at an early age
ABSTRACT
Background: Vitiligo is an acquired, idiopathic, heritable depigmentary disorder of the skin and/or mucous membranes. Autoimmunity plays an important role in pathogenesis of vitiligo which is also evident by coexistence of various autoimmune disorders with vitiligo. In turn, vitamin D levels have been found to be reduced in various autoimmune disorders, thus pointing to a plausible association between vitiligo and vitamin D levels. Few reports have evaluated serum vitamin D levels in vitiligo and their results are conflicting. Aim:To study clinico-epidemiological profile and to evaluate serum vitamin D levels of vitiligo patients and compare vitamin D level with control. Methods: Total 25 patients clinically diagnosed with vitiligo were enrolled in study and 25 age and sex matched control were included. Results were carried out using STATAversion 14.2 Results:The patients had lower serum vitamin D levels than the controls, but this difference was not statistically significant. (p = 0.557) Conclusions: Significantly lower vitamin D levels were found in majority of vitiligo patients, but this was not significant.
ABSTRACT
Melanocyte loss in vitiligo vulgaris is believed to be an autoimmune process. Macrophage migration inhibitory factor (MIF) is involved in many autoimmune skin diseases. We determined the possible role of MIF in the pathogenesis of vitiligo vulgaris, and describe the relationship between MIF expressions and disease severity and activity. Serum MIF concentrations and mRNA levels in PBMCs were measured in 44 vitiligo vulgaris patients and 32 normal controls, using ELISA and real-time RT-PCR. Skin biopsies from 15 patients and 6 controls were analyzed by real-time RT-PCR. Values are reported as median (25th-75th percentile). Serum MIF concentrations were significantly increased in patients [35.81 (10.98-43.66) ng/mL] compared to controls [7.69 (6.01-9.03) ng/mL]. MIF mRNA levels were significantly higher in PBMCs from patients [7.17 (3.59-8.87)] than controls [1.67 (1.23-2.42)]. There was also a significant difference in MIF mRNA levels in PBMCs between progressive and stable patients [7.86 (5.85-9.13) vs 4.33 (2.23-8.39)] and in serum MIF concentrations [40.47 (27.71-46.79) vs 26.80 (10.55-36.07) ng/mL]. In addition, the vitiligo area severity index scores of patients correlated positively with changes of both serum MIF concentrations (r = 0.488) and MIF mRNA levels in PBMCs (r = 0.426). MIF mRNA levels were significantly higher in lesional than in normal skin [2.43 (2.13-7.59) vs 1.18 (0.94-1.83)] and in patients in the progressive stage than in the stable stage [7.52 (2.43-8.84) vs 2.13 (1.98-2.64)]. These correlations suggest that MIF participates in the pathogenesis of vitiligo vulgaris and may be useful as an index of disease severity and activity.