Practical guidelines for the treatment of vitiligo with the melanocyte-keratinocyte transplantation procedure.

Vitiligo manifests as depigmented macules and patches on the skin and can significantly impact a patient's quality of life. Despite the availability of several treatment modalities, rates of repigmentation can vary widely among individuals and disease subtypes. For patients with stable vitiligo who have not achieved satisfactory results with medical treatments, the melanocyte-keratinocyte transplantation procedure (MKTP) is a viable option. While variations of this autologous non-cultured cellular grafting procedure are performed by dermatologic surgeons worldwide and has shown good tolerability and effectiveness, it remains under utilized in the United States. We present a comprehensive overview of MKTP, highlighting evidence-based and practical techniques to enhance patient outcomes. By serving as a valuable resource, this review aims to support dermatologic surgeons seeking to incorporate MKTP into their practice and promote awareness regarding its benefits, ultimately fostering a more comprehensive approach to vitiligo care.

The development of non-scarring alopecia in women who wear the hijab.

Little is known about hair loss associated with wearing the hijab, a religious head covering worn by Muslim women. We performed a single-center analysis to investigate the association between various forms of non-scarring alopecia and wearing the hijab. This study included 125 patients who wore the hijab and 40 race/ethnicity-matched women who did not wear the hijab. Among the 165 total patients diagnosed between January 2015 and March 2022, 71 had telogen effluvium, 78 had female pattern hair loss, and 16 had traction alopecia. We found patients who wore the hijab had a younger mean age of alopecia onset than patients who did not wear the hijab (31.5 vs. 37.3 years; P = 0.02). Our study suggests that vitamin D deficiency (OR 4.1; 95% CI 1.2-14.1; P = 0.02) and seborrheic dermatitis (OR 2.9; 95% CI 1.1-8.1; P = 0.03) may significantly impact the development of telogen effluvium in patients who wear the hijab. Targeting these risk factors among patients who wear the hijab may be considered to prevent hair loss.

Diagnosing Disorders of Hypopigmentation and Depigmentation in Patients with Skin of Color.

Skin hypopigmentation and depigmentation disorders are a top concern for patients with skin of color seeking care from a dermatologist. The visual contrast between involved and uninvolved skin in these disorders makes them particularly burdensome for patients with skin of color. These disorders may have a wide differential of diagnosis, as patients with skin of color may present differently or more frequently than White patients for certain conditions. Clues from a comprehensive history and physical examination with standard lighting and a Wood's light are essential for clinching the diagnosis, although a biopsy may be warranted in special cases.

Implementation of the vitiligo area scoring index in clinical studies of patients with vitiligo: a scoping review.

The vitiligo area scoring index (VASI) is a validated, reliable clinician-reported outcome measure widely used to assess the extent of skin depigmentation seen in patients with vitiligo and to measure patient responses to therapies for vitiligo in clinical trials. However, its implementation in studies is inconsistent and makes comparing results across different studies difficult. The aim of this scoping review is to summarize interventional clinical studies that applied the VASI to measure vitiligo and identify variability in VASI implementation. A systematic search of Ovid Medline, Embase, Web of Science, Cochrane, and ClinicalTrials.gov was performed. Interventional studies published between January 1946 and October 2020 that used the VASI as an outcome measure for assessing vitiligo response were reviewed for methodological approach. Great heterogeneity was found within the 55 included interventional studies that used VASI as an outcome measure. A total of 9 VASI subtypes were described by the authors within 10 intervention categories. VASI determined study eligibility in one study. Body surface area was most frequently established using inconsistent methods. We found unclear or ambiguously scaled assessments of depigmentation. Most VASI outcomes were reported as mean absolute difference, percentage VASI improvement, and percentage of patients who achieved the VASI endpoint. The VASI score was over 100 in one study. Our scoping review revealed many VASI methodology variations in interventional clinical studies of vitiligo. While VASI is a standard method to measure vitiligo changes, substantial heterogeneity in methodology limits reliable comparison and interpretation of findings from different clinical trials. Our findings may be used as a foundation to standardize the VASI outcome measure methodology, allowing for improved clinician training and rigorous data analysis across vitiligo research groups worldwide.

The cutaneous effects of blue light from electronic devices: a systematic review with health hazard identification.

The biologic effects of visible light, particularly blue light, on the skin at doses and irradiances representative of sunlight have been established. Recent research studies investigated the effects of blue light (BL) from electronic screen devices; however, it is unclear if the evidence can be generalized to real life. The aim of this systematic review was to evaluate available evidence regarding clinical effects of BL emitted from electronic devices on human skin using the framework established by the Office of Health Assessment and Translation (OHAT). A systematic literature search was conducted by two librarians in Ovid MEDLINE, Embase.com, and Web of Science for relevant articles published from 1946 to March 2022. In vitro and in vivo studies that investigated the effects of BL from electronic devices on skin were included. From the 87 articles gathered from database searches and 1 article identified from citation search, only 9 met the inclusion criteria (6 in vitro and 3 in vivo studies). Human and animal literature with the highest level of evidence ratings were considered with mechanistic data to form one of five human hazard identifications for each outcome category using the OHAT protocol: (1) known, (2) presumed, (3) suspected, (4) not classifiable, or (5) not identified to be a hazard to humans. Literature-based evidence integration did not identify exposure to BL from electronic devices as a hazard to skin pigmentation, redness, yellowness, or melasma exacerbation. Exposure to BL from electronic devices was not classified as a skin photoaging hazard. Low confidence in representative exposure characterization drove high OHAT risk-of-bias ratings for the majority of included studies. While these conclusions hold true for the limited existing data, a larger number of future studies with high-confidence evidence are needed to verify and strengthen hazard identification conclusions.