Nail abnormalities in patients with vitiligo

Abstract: Background: Vitiligo is an acquired pigmentary skin disorder affecting 0.1-4% of the general population. The nails may be affected in patients with an autoimmune disease such as psoriasis, and in those with alopecia areata. It has been suggested that nail abnormalities should be apparent in vitiligo patients. Objective: We sought to document the frequency and clinical presentation of nail abnormalities in vitiligo patients compared to healthy volunteers. We also examined the correlations between nail abnormalities and various clinical parameters. Methods: This study included 100 vitiligo patients and 100 healthy subjects. Full medical histories were collected from the subjects, who underwent thorough general and nail examinations. All nail changes were noted. In the event of clinical suspicion of a fungal infection, additional mycological investigations were performed. Results: Nail abnormalities were more prevalent in the patients (78%) than in the controls (55%) (p=0.001). Longitudinal ridging was the most common finding (42%), followed by (in descending order): leukonychia, an absent lunula, onycholysis, nail bed pallor, onychomycosis, splinter hemorrhage and nail plate thinning. The frequency of longitudinal ridging was significantly higher in patients than in controls (p<0.001). Conclusions: Nail abnormalities were more prevalent in vitiligo patients than in controls. Systematic examination of the nails in such patients is useful because nail abnormalities are frequent. However, the causes of such abnormalities require further study. Longitudinal ridging and leukonychia were the most common abnormalities observed in this study.

Prevalence of Vitiligo and Associated Comorbidities in Korea

PURPOSE: Vitiligo prevalence and its associated comorbidities rate have been reported variably among different populations. We aimed to determine the prevalence of vitiligo in Korea along with the baseline rate of comorbidities and compared the risks to the general population using hospital visit information of the total population in Korea. MATERIALS AND METHODS: We assessed demographic characteristics of vitiligo patients in Korean population from 2009 to 2011 in a nationwide data from Health Insurance Review Assessment Service. Patients who had at least one visit to Korea's primary, secondary, or tertiary referral hospitals with International Classification of Diseases, 10th Revision, Clinical Modification diagnosis code for vitiligo were identified. As a supplementary study, comorbidities associated with vitiligo were selected for further review to calculate relative risks compared to the general population. RESULTS: The annual prevalence of vitiligo determined by hospital-visiting rate in Korea was 0.12% to 0.13% over a three year period. In sync with other previous epidemiological studies, there was bimodal distribution among the age groups and no difference between genders. Also, vitiligo in Korean population was associated with various autoimmune/non-autoimmune diseases such as thyroiditis, atopic dermatitis, and psoriasis. CONCLUSION: This study was by far the most comprehensive review on prevalence of vitiligo using a data of total population in Korea. The prevalence is within a range of those reported in previous literatures, and increased risk of comorbidities such as thyroid diseases and psoriasis in vitiligo might aid clinicians in the initial work up of vitiligo patients and concurrent follow ups.

Perfil clínico e epidemiológico do vitiligo infantil: análise de 113 casos diagnosticados em um centro de referência em dermatologia de 2004 a 2014 / Clinical and epidemiological profile of childhood vitiligo: analysis of 113 cases diagnosed at a dermatology referral center from 2004 to 2014

Introdução: O vitiligo é forma adquirida autoimune de hipopigmentação ou despigmentação, iniciando-se na infância metade de seus casos. Objetivos: Traçar o perfil clínico e epidemiológico do vitiligo infantil em um centro de referência em dermatologia. Métodos: Estudo transversal e descritivo com análise dos prontuários de pacientes com menos de 13 anos diagnosticados como portadores de vitiligo entre 2004 e 2014. Resultados: Dos 113 casos identificados, 54% eram do sexo feminino e 46% do sexo masculino; a idade variou de zero a 12 anos com a maioria dos pacientes (54,8%) no subgrupo de quatro a oito anos. Em 59% dos prontuários não havia registro sobre fatores desencadeantes do vitiligo; 31% dos pacientes associaram o início da doença a estresse emocional, 3% a trauma físico, e 7% não associaram a fator desencadeante. Conclusões: A discreta prevalência no sexo feminino também foi descrita em outros estudos. O comportamento do vitiligo na criança é diferente daquele observado nos adultos. A influência dos fatores psicológicos como desencadeantes e os potenciais efeitos duradouros na autoestima devem ser levados em consideração na abordagem do paciente. Os resultados deste trabalho foram semelhantes aos relatos existentes sobre o vitiligo nessa faixa etária, que são, aliás, poucos na literatura

Introduction: Vitiligo is an acquired autoimmune form of hypopigmentation or depigmentation in which half of the cases begins in childhood. Objectives: To describe the clinical and epidemiological profile of childhood vitiligo in a referral center for dermatology. Methods: A cross-sectional, descriptive study was carried out based on the analysis of medical records of patients younger than 13 years diagnosed with vitiligo from 2004 to 2014. Results: Of the 113 cases identified, 54% were female and 46% male, the age ranged from 0 to 12 years, with most patients in the 4-8 years-old subgroup (54.8%). In 59% of the medical records there was no record of triggering factors of vitiligo; 31% of patients associated the onset of the illness to emotional stress, 3% to physical trauma and 7% did not associate it to any triggering factor. Conclusions: The discreet prevalence in women has also been reported in other studies. Vitiligo behavior in children is different from that observed in adults. The influence of psychological factors as triggers and potential lasting effects on self-esteem should be considered in the approach of the patient. Although studies on vitiligo in this age group are scarce in the literature, the results of the present study were similar to the reports already available in the literature

Características epidemiológicas y clínicas en pacientes con vitíligo que acuden al Servicio de Dermatología del Hospital Policia Nacional del Perú Luis Nicasio Sáenz en el periodo enero a junio del 2013 / Epidemiological and clinical characteristics of patients with vitiligo attended in the Dermatology Service at the Hospital of National Police of Peru Luis Saenz Nicasio in the period January to June 2013

Objetivos: Determinar las características epidemiológicas y clínicas en pacientes con vitíligo que acuden al Hospital Policía Nacional del Perú Luis Nicasio Sáenz en el periodo de enero a junio del 2013. Introducción: A nivel mundial el vitíligo, es uno de los trastornos pigmentarios más frecuentes, caracterizado por la aparición de manchas acrómicas secundarias a la destrucción selectiva de melanocitos funcionales Se presenta a cualquier edad, apareciendo en más del 50 por ciento de los casos en menores de 20 años; y en igual proporción en mujeres y varones, siendo las mujeres más propensas a buscar tratamiento. Existe además una historia familiar positiva en al menos el 30 por ciento de los pacientes con vitíligo y es relacionada a múltiples enfermedades autoinmunes. Materiales y Métodos: Se realizó un estudio descriptivo observacional de corte transversal. Se encuestaron 71 pacientes, 2 fichas de recolección fueron eliminadas no poseer información completa. Los 69 pacientes incluidos en el estudio tenían diagnóstico clínico de vitíligo, obteniendo información sobre género, edad actual, edad de inicio, estado civil, grado de instrucción, patrón clínico, antecedentes familiares con vitíligo, y asociación con enfermedades autoinmunes. Los datos fueron sometidos a análisis estadístico en el programa SPSS 22.0 para Windows. Resultados: Se incluyeron 69 pacientes; el 46 por ciento fueron mujeres y el 54 por ciento hombres. La edad promedio fue de ±43.52 años. En el 49.3 por ciento el tiempo transcurrido desde el inicio de la enfermedad hasta el momento del examen fue en el periodo de 1 a 10 años. En el 43.5 por ciento la localización de inicio fue la cara. El 50.7 por ciento presentaron vitíligo vulgar, el 31.9 por ciento el tipo focal. El 10.1 por ciento presentó asociación con enfermedad tiroidea, y el 1.4 por ciento presentó alopecia areata. El 15.9 por ciento presentó antecedentes familiares. Conclusiones: En la población en estudio el vitíligo predominó en...

Objectives: To determine the epidemiological and clinical characteristics in patients with vitiligo who attend the Hospital Policia Nacional del Peru Luis Nicasio Saenz during the period from January to June 2013. Introduction: Vitiligo, is one of the most common pigmentary disorder worldwide, characterized by the appearance of amelanotic macules, secondary to a selective destruction of functional melanocytes. Vitiligo can onset at any age, appearing in more than 50 per cent of cases in people under 20 years old; it presents equally in men or women, the most likely to seek treatment being women. There is also a positive family history on at least 30 per cent of vitiligo patients and it exist an association to multiple autoimmune diseases. Materials and Methods: A descriptive cross-sectional study was carried out. We collect information from 71 patients, 2 records collection were eliminated for not possess complete information. The 69 patients included in the study had a clinical diagnosis of vitiligo, obtaining information on gender, current age, age of onset, marital status, level of education, clinical pattern, family history of vitiligo, and association with autoimmune diseases. The data were subjected to statistical analysis in SPSS 22.0 for Windows. Results: 69 patients were included; 46 per cent were women and 54 per cent men. The average age was 43.52 years ±. In 49.3 per cent the time passed since the onset of the disease until the time of examination was in the period of 1 to 10 years. In 43.5 per cent the most common site of onset of vitiligo lesion was the face. The 50.7 per cent of patients had vitiligo vulgaris, 3l.9 per cent had the focal type. The 10.1 per cent of patients had association with thyroid disease, and 1.4 per cent had alopecia are ataand 15.9 per cent had family history. Conclusions: In the study vitiligo predominated in males, and the most frequent clinical type was vulgar. Association with thyroid disease was found. Important to...

Factores pronósticos en el vitíligo / Prognostic factors for vitiligo

INTRODUCCIÓN: el vitíligo es una enfermedad cutánea benigna caracterizada por manchas despigmentadas de bordes bien definidos. Se postula que se produce por un mecanismo autoinmunitario contra los melanocitos. OBJETIVO: valorar los factores pronósticos de vitíligo asociados a la evolución de pacientes con vitíligo moderado o intenso tratados con Melagenina Plus durante un año. MÉTODO: se efectuó un estudio de tipo retrospectivo en una serie consecutiva de 62 pacientes con vitíligo con un área afectada superior al 20 % que acudieron al Centro de Histoterapia Placentaria entre agosto de 2008 y agosto de 2010. La variable respuesta consistió en la respuesta al tratamiento a los 2 años de seguimiento. Se efectuó una regresión logística para determinar factores pronósticos. RESULTADOS: el grupo etario predominante fue el de 40 a 49 años (28,6 %). La mayoría de los pacientes fueron del sexo femenino (61,4 %). El color de la piel más observado fue el blanco. La categoría de superficie corporal más frecuente fue la de 20 a 39 %, con una media de 37,6 %. El tiempo de evolución tuvo una media de ,4 años. CONCLUSIONES: el tiempo de evolución y el área de superficie corporal fueron las únicas variables estadísticamente significativas al introducir el modelo de regresión logística. Ambas tuvieron una p asociada menor de 0,05.

INTRODUCTION: vitiligo is a benign skin disease characterized by depigmented patches of distinct borders. It is thought to be caused by an autoimmune reaction against melanocytes. OBJECTIVE: evaluate the prognostic factors for vitiligo associated with the evolution of patients with moderate or severe vitiligo treated with Melagenina Plus for a year. METHOD: a retrospective study was conducted of a consecutive series of 62 patients with vitiligo with an affected skin area above 20% who presented at the Placental Histotherapy Center from August 2008 to August 2010. The variable response consisted in the response to the treatment at 2 years of follow-up. A logistic regression analysis was performed to determine the prognostic factors. RESULTS: the predominant age group was 40-49 years (28.6%). Most patients were female (61.4%). The most common race was white. The most frequent body surface range was 20-39%, with a mean value of 37.6%. Average evolution time was 8.4 years. CONCLUSIONS: evolution time and body surface area were the only statistically significant variables found when the logistic regression model was applied. Both had a p value below 0.05.

Vitiligo impact scale: An instrument to assess the psychosocial burden of vitiligo.

Background : Vitiligo is a disease that significantly impairs quality of life. Previous studies have shown that vitiligo has an impact that may not correlate with the size and extent of depigmentation, indicating a need for an independent measure of the psychosocial burden. Aims : To develop a rating scale to assess the psychosocial impact of vitiligo. Methods : The study was undertaken in three broad phases: item generation, pre- and pilot testing, and test administration. Items were generated largely from a qualitative study using semi-structured interviews of patients. Face and content validity were assessed through pre- and pilot testing in 80 patients and the final version was administered to 100 patients who also received the Dermatology Life Quality Index (DLQI) and the Skindex-16. Each patient also underwent a physician global assessment (PGA) of the impact of vitiligo. Test-retest reliability was assessed in 20 patients. Results: Of 72 items initially generated for the scale, 27 were retained in the final version. Subjects were able to comprehend the items and took about 5-7 min to complete the instrument. The scale was internally consistent (Cronbach's α = 0.85). Scores on the scale correlated moderately well with the DLQI and the Skindex (Spearman rank correlation: 0.51 and 0.65, respectively). The scale was able to discriminate between patients having mild and those having moderate and severe impact as assessed by PGA. The test-retest reliability coefficient (Spearman rank correlation) was 0.80. Conclusion: The Vitiligo Impact Scale appears to be a valid measure of the psychosocial impact of vitiligo and this instrument may be useful both in the clinic and in clinical trials.

Vitiligo and autoantibodies of celiac disease

Vitiligo is an acquired, idiopathic disorder characterized by circumscribed depigmented macules and patches. The exact etiology and pathogenesis of vitiligo is not clear. Many theories have been presented regarding this subject among them aautoimmune theory is the most important one. The association of vitiligo with other autoimmune disorders has been reported, but the relationship between vitiligo and celiac disease is controversial. The aim of this study was to study the frequency of celiac autoantibodies in a group of vitiligo patients compared with control. This was a cross sectional case control study that involved 128 individuals, 64 vitiligo patients and 64 individuals as control group. The means age of participants was 30.3 +/- 14.4 years. IgA anti Endomysial antibody and IgA anti-glutaminase antibody were measured by ELISA method in the serum of all participants. Data were analyzed by SPSS software version 15. The serum of two vitiligo patients [3.1%] was positive for antibodies. All control groups were seronegative for these antibodies [P < 0.05]. There was nosignificant effect of sex and job on seropositivity. There may be a relationship between celiac disease and vitiligo. This may indicate a common basic autoimmune mechanism that is an explanation for few case reports that gluten free diets were effective in the treatment of vitiligo patients. Both T test and exact fisher test showed no effect of age, sex and job anseropositivity of these patients [p=0.56 and p=0.74, respectively]

Perfil epidemiológico dos pacientes com vitiligo e sua associação com doenças da tireoide / Vitiligo epidemiological profile and the association with thyroid disease

FUNDAMENTO: O vitiligo é considerado a hipomelanose adquirida mais frequente. Apesar de sua etiopatogenia ser incerta, acredita-se que a etiologia autoimune seja a mais plausível, teoria que se fundamenta na concomitância de vitiligo com doenças autoimunes. OBJETIVOS: Traçar o perfil epidemiológico dos pacientes com vitiligo e estimar a prevalência da associação de vitiligo com doenças autoimunes da tireoide. MÉTODOS: Efetuou-se um estudo transversal, analisando-se prontuários dos pacientes com diagnóstico de vitiligo atendidos no Ambulatório de Dermatologia AME-Unisul e do HU-UFSC. Avaliaram-se as características clínicas e laboratoriais desses pacientes. RESULTADOS: Foram avaliados 85 prontuários, sendo 56 do sexo feminino, com idade média de 37,14 anos e idade média de início de 25,25 anos. O vitiligo vulgar ocorreu em 70,6 por cento dos casos. As doenças autoimunes da tireoide foram encontradas em 22,4 por cento dos casos. Outras doenças autoimunes foram identificadas em 5,9 por cento dos casos. Os pacientes com anticorpos antitireoidianos positivos revelaram uma probabilidade elevada de extensão do vitiligo maior que 25 por cento. Não houve diferença estatística quanto às características clínicas do vitiligo em portadores ou não de tireoidite autoimune com alteração hormonal. CONCLUSÃO: Os resultados deste estudo são similares aos de outros autores, mostrando que as doenças autoimunes da tireoide são mais frequentes nos pacientes com vitiligo.

BACKGROUND: Vitiligo is considered the most frequent acquired hypomelanosis. Although its pathogenesis is uncertain, it is believed that autoimmune etiology is the most plausible. This theory is based on the coexistence of vitiligo with autoimmune diseases. OBJECTIVES: To describe the epidemiological profile of vitiligo patients and to estimate the prevalence of the association of vitiligo with autoimmune thyroid diseases. METHODS: A cross-sectional study was conducted through analysis of the medical records of patients diagnosed with vitiligo in the AME-UNISUL Outpatient Clinic of Dermatology and at HU-UFSC. The clinical and laboratorial characteristics of these patients were assessed. RESULTS: 85 medical records were evaluated; 56 patients were female, with a mean age of 37.14 years and mean onset age of 25.25 years. Vitiligo vulgaris occurred in 70.6 percent. Autoimmune thyroid diseases were found in 22.4 percent. Other autoimmune diseases were identified in 5.9 percent. Patients with positive thyroid autoantibodies showed a probability of extension of vitiligo greater than 25 percent. There was no statistical difference with regard to the clinical characteristics of vitiligo in patients with or without autoimmune thyroiditis with hormonal change. CONCLUSION: The findings of this study are similar to those obtained by other authors, showing that autoimmune thyroid diseases are more common in patients with vitiligo.

Vitiligo: a Hospital-Based Study in Southern Nigeria

Background: Vitiligo is an acquired pigmentary disease characterized by loss of the pigment producing cells (melanocytes) of the skin; hair and mucous membranes (lips and genitalia); with subsequent development of white patches. The aim of this study was to evaluate the epidemiological pattern of vitiligo in Port Harcourt; south-south Nigeria. Methods: This was a prospective study of 82 cases of vitiligo seen in the dermatological clinic of the University of Port Harcourt Teaching Hospital (UPTH); Port Harcourt; Nigeria from May 2005 to April 2009. All ages were included in this study. Data was analysed using the SPSS version 15. Descriptive statistics in the form of the frequency and percentage were used. Chi square was used to test relationship between variables. P0.05 was considered statistically significant. Results: There were a total of 1;652 dermatological disorders during the study period. Eighty two patients had vitiligo giving a prevalence of 4.96. There were more females 45(54.9) than males 37(45.1) giving male: female ratio of 0.8:1. Vitiligo is commoner from the age of 20 years to 30 years (32.9). The head and neck region was the most common site of onset of the lesion and accounted for 28of cases. Generalized vitiligo [29(35.4)] was the most frequently found pattern of distribution. Positive family history was found in 6 cases (7.3). Eighteen (22.0) patients suffered from other diseases such as thyroid dysfunction [8(9.8)]; anaemia [4(4.9)]; atopic dermatitis [2(2.4)]; diabetes mellitus [1(1.2)]; anxiety disorder [1(1.2)]; collagen vascular disease [1(1.2)] and oligomenorrhoea [1(1.2)]. Conclusion: The pattern of vitiligo seen is similar to that reported from other parts of the world. There is also need to look for associated disorder in any case of vitiligo

Vitiligo appearing in striae distensae as a Koebner phenomenon

Koebner phenomenon, the appearance of preexisting skin lesions following trauma to previously uninvolved skin, has been seen frequently with vitiligo. The type of trauma leading to Koebner phenomenon can vary from scratching, surgical scars, radiotherapy, burns, irritation from drug use and laser therapy. Striae distensae are a form of injury to the skin and in this particular case resulted from rapid increase in body size at puberty and possibly the use of systemic steroids for the treatment of vitiligo. The appearance of vitiligo in striae distensae as a form of Koebner phenomenon has been reported rarely. We describe a 14-year-old boy with vitiligo for the past 2 years, which Koebnerized in the striae distensae

Vitíligo en niños: estudio epidemiológico / Vitiligo in children: Epidemiologic study

Introducción: El vitíligo es una discromía, que refleja ausencia de melanocitos, de causa aún desconocida, relacionada a fenómenosautoinmunes y genéticos. Objetivos: Determinar las características clínico-epidemiológicas del vitíligo infantil en la consulta externa, en el Hospital Nacional EsSalud Chiclayo. Material y Métodos: Estudio descriptivo, retrospectivo, transversal, entre julio 2003 y julio 2006. Revisión de datos clínico-epidemiológicos de historias clínicas de pacientes pediátricos con vitíligo enConsultorio de Dermatología Pediátrica. Resultados: De 1082 niños, 5,5% tuvieron vitíligo. La edad media fue 8,8 años, en edad escolar 45,8% y de sexo femenino 67,8%. Presentaron vitíligo generalizado 64,4%, localizado 35,6% y universal, ninguno. El tiempo de enfermedad media fue 24,8 meses. Fue enfermedad asociada la pitiriasis alba, en 18,6%. Hubo antecedente familiar dela misma enfermedad en 11,9%. Presentaron repigmentación 80,4% y no hubo respuesta en 19,6%. Conclusiones: El vitíligo infantil en Chiclayo es un problema común. Las características clínicas son similares a otras poblaciones, con buen pronóstico al tratamiento.

Introduction: Vitiligo is a disease due to lack of melanocytes. Its etiology is unknown, possibly linked to autoimmune and genetic events. Objectives: To determine the clinical-epidemiological characteristics of vitiligo in children at Chiclayo EsSalud National Hospitaloutpatient department. Materials and Methods: Descriptive, retrospective and transversal trial, from July 2003 through July 2006. Review of the clinical-epidemiological data of pediatricpatients with vitiligo medical records at the pediatric dermatology outpatient department. Results: Of 1082 children 5,5% had vitiligo. Mean age was 8,8 year-old. It was more common in thescholar age, 45,8%, and in the female gender, 67,8%. Generalized vitiligo was present in 64,4%, localized in 35,6% and none had the universal type. The mean disease time was 24,8 months. Associated disease was pityriasis alba in 18,6%. There was family history of vitiligo in 11,9%; 80,4% obtained repigmentation and there was no response in 19,6%. Conclusions: Vitiligo in Chiclayo is a common problem in childhood. Clinical characteristics are similar to those observed on other populations, with good prognosis to treatment.

Vitíligo: aspectos clínicos y epidemiológicos / Vitiligo: clinical and epidemiological aspects

El vitíligo es una enfermedad adquirida de la piel, caracterizada por ausencia de melanocitos funcionales provocando máculas despigmentadasy afecta aproximadamente al 1% de la población. La causa no se conoce y los tratamientos actuales no son del todo satisfactorios.Objetivo: Describir algunas características clínicas y epidemiológicas en pacientes con vitíligo diagnosticados en el Hospital Regional Docentede Trujillo entre enero de 1994 y diciembre de 2003. Material y métodos: Estudio descriptivo retrospectivo. Se evaluaron la frecuencia, sexo, edad de inicio, edad en que se hizo el diagnóstico,duración, localización de las lesiones iniciales, sitios comprometidos, modo de inicio y procedencia.Resultados: Se encontró una frecuencia de 1.5%. El 47.9% fueron hombres y 52.1% mujeres con una relación hombre/mujer de 0.92. La edadde inicio promedio fue de 23.9 años. La edad promedio en que se hizo el diagnóstico fue 26.1 años. La duración promedio de la enfermedadfue de 2.4 años. El modo de inicio fue unicéntrico en el 60.6% siendo el sitio más frecuente la cara (31.2% de las lesiones iniciales). El 22.9% de las lesiones totales se encontraron en las extremidades superiores. Al momento de la consulta el 46.7% de los pacientes presentaba al menosuna lesión en la cara. El 42.6% de pacientes procedía de Trujillo. Conclusiones: Los datos encontrados son similares a los de otras poblaciones; se proporcionan las bases para futuros trabajos.

Vitiligo is an acquired disorder of the skin represented by the absence of functional melanocytes causing depigmented maculae and affect sapproximately 1% of the general population. Cause is unknown and actual treatments are not enough satisfactories. Objective: To analyze some clinical and epidemiological features of patients with vitiligo diagnosed at Regional Hospital of Trujillo betweenJanuary 1994 and December 2003. Methods: This is a descriptive and retrospective study. It was evaluated frequency, sex, age at onset, age at initial visit, duration, site of theinitial lesion, involved sites, mode of onset and procedence.Results: The frequency was 1.5%. 47.9% were male and 52.1% female. The mean age of onset was 23.9 years old. The mean age at the first visit was 26.1 years old. Duration of disease was 2.4 years. Onset mode was unicentric in 60.6% and the most common site was face (31.2% of initial lesions). 22.9% of the total lesions were found in upper limbs. At moment of visit, 46.7% of patients had al least one lesion in face. 42.6% of patients were from Trujillo.

Pattern of skin disorders in Muzaffarabad: a comparison of pre- and post-earthquake scenario

Psyche and skin are closely related. The anatomical and physiological integrity is maintained when they are congruent in their functioning. Natural calamities and disasters affect this harmony adversely by causing psychological as well as physical trauma, which leads to a number of immediate as well as long term skin ailments. The study was aimed to observe any change in pattern of skin diseases in Muzaffarabad after devastating earthquake of October 8th, 2005. Patients and methods The study was carried out in CMH, Muzaffarabad from March, 2006 to August 2006. Patient's record of same six months of last year was retrieved and was compared with present record. Patients of all ages, with any cutaneous disease, attending the outpatient departments or admitted to the skin ward of Combined Military Hospital Muzaffarabad, from 1St March 2006 to 31St August 2006, were included in the study. A detailed dermatological evaluation was carried out in all patients. Relevant investigations like o scraping for fungus and biopsy were done when required. Indoor as well as outpatients' record for the same period of last year [2005] was retrieved. The information were duly documented and compiled. Prevalence of various common skin disorders was compared in pre and post earthquake scenario and statistical evaluation was done by calculating p-value after applying z-test. In post-earthquake period, overall proportion of skin patients increased when compared with similar per-earthquake period. Infections remained at the top in both scenarios but their proportion increased significantly after earthquake period. Psychocutaneous disorders like, trichotillothania and dermatitis artifacta were also frequently seen in post- earthquake period. Hair, nail, pigmentary disorders, sexually transmitted infections were statistically less frequent in post earthquake period. Eczemas, psoriasis and vitiligo were also less frequently reported. A significant increase in overall proportion of skin patients and prevalence of bacterial infections, viral infections, scabies and certain psychocutaneous disorders was probably related to compromised hygiene and sanitation and psychological trauma as consequence of devastating earthquake of October 8th, 2005

Experience of Iranian women with vitiligo: a phenomenological study

Vitiligo is a progressive condition and relatively common depigmentary disorder that affects about 1-4% of general population. There is no effective treatment for it so far. In Iran, no exact estimation of vitiligo prevalence is available, but it has been estimated that 0.9 to 1.2% of the total population are suffering from vitiligo. As vitiligo does not result from a traumatic event or significantly impair physical health and it causes no pain, it represents an ideal model for examining the psychological phenomena of living with an appearance altering disease. Sixteen women who suffered from vitiligo were recruited into this hermeneutic phenomenological study. Data were analyzed using Dickelman and Allen method. Four subordinate themes were identified: perceptions of self, perceptions of disease, adaptation to the disease [acceptance or non acceptance of the disease], others and disease [significant others, supportive behavior and threatening behavior]. Women affected with vitiligo during their marriage-ready years, in addition to their mental problems resulting from a skin disease and marred beauty; face various other social problems such as rejection by associates, isolation, divorce and an obligatory choice of a single life. Since stress is a known exacerebating factor for vitiligo, social support and psychotherapy, increasing awareness level of general population about this disease, revision of social law, may help to break the visicious cycle of disease exacerbation

[Prevalence of depression in vitiligo patients]

Vitiligo is a acquired skin disease with prevalence of 1% in the community. In spite of existing different options in its treatment, commonly the course is progressive and the prognosis is unpredictable. In our community with a negative attitude of people to the disease, great burdens of social and familial problems are caused to the patient and these may bring about Psychological disorders. The object of this study is to evaluate the prevalence and severity of depression in vitiligo patients and comparison with normal population according to Hamilton Rating Score for Depression. This is a cross-sectional descriptive Analytical study. 52 vitiligo patients presenting to dermatology clinic of Imam Reza Hospital agreed to participate in this study. The dissemination and extent of their skin disease was determined and their demographic identification recorded. Then, the 24 item questionnaire of HRSD completed. The same was performed for the control group, which were healthy in general and dermatology examination and the same as examination group in demographic identification. In the vitiligo patient group 24 patients [46.2%] and in the control group 3 [5.8%] were depressed. Mean depression score in the vitiligo patients was 17.48 and in the control 5.6. 7.6% of vitiligo patients had a history of suicidal attempt. Also, in vitiligo patients no significant statistical relationship was found between depression score and age, sex, marital state, extent of skin involvement with vitiligo, expose or non-expose skin lesions, and history of consullation with psychiatrist [P> 0.05]. High prevalence of depression in these patients is indicator of an insistent need to collaboration of psychiatrists with dermatologists in the management of this disease

Clinical presentation of vitiligo.

Clinical patterns and manner of presentation of vitiligo in 200 cases have been studied. Females have a slightly higher preponderance. Majority (66%) of the patients had generalized vitiligo. Lower extremity was the most common (30%) site of involvement. Family history was positive in 24% of cases. Leukotrichia (44%) and Koebner phenomenon (30%) were the associated cutaneous findings.

Vitiligo en pacientes pediátricos: asociación con otras enfermedades / Vitiligio in pediatric patient: association with other diseases

Se estudió la asociación de otras patologías en 1117 pacientes pediátricos con vitiligo. Las asociaciones encontradas fueron: morfea en 12 (1,07 por ciento), alopecia areata en 5 (0,45 por ciento), enfermedades tiroideas en 4 (0,34 por ciento), lupus eritematoso en 2 (0,18 por ciento), dermatomiositis, diabetes mellitus y liquen estriado en un paciente cada una (0,09 por ciento)