Serum cytokine and chemokine profiles in patients with alopecia areata.

BACKGROUND: Most evidence supports the role of altered T cell-mediated immunity in the pathogenesis of alopecia areata (AA). Tough cytokines and chemokines play an important role in the immune process of AA, their expressions have been examined in limited studies. OBJECTIVE: To determine serum cytokine levels of TNF-α, IL-6, and IL-23, and some of the Th1-(CXCL9), Th2-(CCL17), and Th17-associated (CCL20 and CCL27) chemokines in patients with AA. METHODS: Forty patients with AA and 40 healthy controls were enrolled in the study. Serum concentrations of cytokines and chemokines were measured using enzyme-linked immunoassay techniques. RESULTS: The mean serum levels of TNF-α, IL-6, IL-23, CXCL9, CCL17, CCL20, and CCL27 in AA patients were significantly higher than in the controls. However, with logistic regression analyses, only CCL17 and CCL27 levels showed a positive relationship, and IL-23 levels showed a negative relationship, with the presence of AA. Furthermore, serum CCL27 levels were positively correlated with AA severity. CONCLUSION: This study suggests that CCL17 and CCL27 may have an aggravating effect, whereas IL-23 may have a protective effect for the development of AA. Additionally, serum CCL27 levels may be useful as marker of disease severity.

Psychiatric symptomatology and health-related quality of life in children and adolescents with alopecia areata.

BACKGROUND: There is a very limited amount of data available regarding the relationship between alopecia areata (AA) and psychiatric morbidity and quality of life (QoL) in children and adolescents. OBJECTIVES: The aim of this study was to determine the psychiatric state and health-related quality of life (HRQL) of children and adolescents with AA, as well as their relationships with clinical parameters. METHODS: The sample consisted of 74 children with AA aged 8-18 years. Questionnaires were used to evaluate the psychiatric status and HRQL of the patients. The study and control groups were divided into child and adolescent groups to exclude the effect of puberty on psychological condition. RESULTS: In the child group, patients had higher state anxiety and trait anxiety scores; they also had lower parent-rated psychosocial and total area HRQL scores than the controls did. In addition, the depression score was prone to show a positive relationship with having AA in the children. In the adolescent group, however, only the state anxiety score had a significant association with AA. All of the parent-rated HRQL scores were also prone to being lower compared with controls in this age group. Regarding determinants of HRQL, prolonged disease duration and later disease onset had positive effects, whereas severity of scalp involvement, trait anxiety and depression had negative effects, for the sample as a whole. CONCLUSIONS: Alopecia areata is associated with poor psychiatric status and QoL, especially in childhood. The impact of the disease on QoL occurs through both clinical and psychiatric parameters.

The relationship between the second to fourth digit ratio and acne vulgaris.

BACKGROUND: Although the pathophysiology of acne vulgaris (AV) is not clear, androgens are thought to play an important role in its development through either an increased level of circulating androgens or end-organ sensitivity. The ratio of the length of the second and fourth digit (2D : 4D) has been hypothesized to reflect prenatal androgen exposure and/or an individual's sensitivity to androgens, with a low 2D : 4D ratio suggesting high prenatal androgen exposure. Interestingly, the prenatal androgen peak time period coincides with both the development of the sebaceous gland and digits. OBJECTIVES: To determine the relationship between digit ratio and AV. METHODS: Vernier caliper was used to take digit measurements of both patients and controls. Acne severity was assessed by using the International Consensus Conference on Acne Classification System. RESULTS: Data of 251 patients with AV (67.7% female) and 120 healthy controls (72.5% female), aged 16-40 years, were analysed. The 2D : 4D ratios of female patients with AV were significantly lower than healthy females in both hands. However, there was no significant difference between male acne cases and controls. Acne severity was positively correlated with the left 2D : 4D ratios and mean 2D : 4D ratio, whereas the duration of acne was negatively correlated with the right 2D : 4D ratios in females. CONCLUSION: Our results support the anatomical evidence of in utero androgen exposure and/or an individual's sensitivity to androgens in patients with AV and suggest that the 2D : 4D ratio might be a predictor of acne development, duration, and severity grade, at least in female patients.

Depression, anxiety and health-related quality of life in children and adolescents with vitiligo.

BACKGROUND: Only a limited number of studies have studied the relationship between vitiligo and psychiatric morbidity and quality of life (QOL) in children and adolescents. AIM: To determine levels of depression, anxiety and QOL in children and adolescents with vitiligo. METHODS: In total, 41 outpatients with vitiligo aged 8-18 years and a control group were assessed using the Child Depression Inventory (CDI), State-Trait Anxiety Inventories for Children (STAI-C) and Pediatric Quality of Life Inventory, Parent and Child versions (PedsQL-P and PedsQL-C). Both study and control groups were divided into child (8-12 years old) and adolescent (13-18 years old) groups to exclude the effect of puberty on psychological condition. RESULTS: Children with vitiligo scored higher on the CDI compared with controls; no other significant differences were found between the groups. Vitiligo severity correlated negatively with psychosocial score on PedsQL-P in the adolescent group. Duration of the illness was positively related to physical health score on PedsQL-P in the child group. Involvement of the face, head or neck in boys and involvement of the genital area and legs in girls were related to impaired QOL. CONCLUSIONS: Vitiligo relates to the severity of depression in children, but a similar effect was not observed in adolescents. We suggest that the location of the lesions is a significant factor that leads to QOL impairment, possibly because of its effects on identity development.