Does oxidative stress correlate with disease activity and severity in vitiligo? An analytical study.

BACKGROUND: Oxidative damage to melanocytes, resulting from an imbalance between the damaging oxidative pathways and the protective anti-oxidants likely plays a pathogenic role in vitiligo. AIM: To evaluate three parameters related to the oxidative stress (OS) pathway namely malondialdehyde (MDA), a marker of oxidative damage, and superoxide dismutase (SOD) and reduced glutathione (rGSH) (both antioxidants) in patients with active and stable vitiligo with either localized or generalized disease. PATIENTS/METHODS: Sixty clinically diagnosed vitiligo patients were categorized into generalized (n = 30) or localized vitiligo (n = 30) and were further sub-grouped according to their disease activity into active and stable groups. Thirty healthy volunteers were included in the control group. ELISA was used for the evaluation of MDA, SOD, and r GSH. RESULTS: The patient group demonstrated significantly raised levels of MDA and significantly decreased levels of SOD and rGSH compared with the control group. Further, the OS parameters were significantly more deranged in patients with generalized disease (all three-MDA, rGSH, and SOD) and an active disease (MDA) as compared to those with localized and stable disease, respectively. CONCLUSION: Our findings suggest an important role of OS in relation to vitiligo activity and severity. Although the OS parameters were deranged in all subsets of patients, with respect to controls, the derangement of oxidative damage marker (MDA) in generalized and active disease groups was most marked. Disease remains active when the oxidative damage becomes higher but is unmatched with the anti-oxidant reserve which does not proportionately increase.

The profile of cytokines (IL-2, IFN-γ, IL-4, IL-10, IL-17A, and IL-23) in active alopecia areata.

BACKGROUND: Alopecia areata (AA) is an autoimmune disease due to aberrant T-cell response against hair follicle self-antigens. Previous studies support the role of Th1 cytokines in pathogenesis of AA, but the role of Th2, Th17, and Treg cytokines remains to be fully elucidated. OBJECTIVES: To assess the serum levels of cytokines secreted by Th1 (IL-2, IFN-γ), Th2 (IL-4), Th17 (IL-23, IL-17A), and Treg (IL-10) pathways in patients of active AA and to correlate their levels with the severity of the disease. MATERIAL AND METHODS: Forty patients with untreated active AA of the scalp and forty age- and sex-matched healthy controls were included. Serum levels of cytokines IL-2, IFN-γ, IL-17A, IL-23, IL-4, and IL-10 were measured using enzyme-linked immunosorbent assay. RESULTS: Serum levels of cytokines IL-2, IFN-γ, IL-17A, and IL-10 were significantly raised while serum levels of IL-23 were nonsignificantly raised in AA patients as compared to controls. The levels of IL-4 were significantly lower in AA patients as compared to controls. (P < 0.05). Also, significant positive correlation was found between increase in SALT Score and serum levels of IL-2, IL-17A, and IL-23. (P < 0.05). CONCLUSION: Th1 and Th17 pathways play a central role in the initiation and progression of AA, while Th2 pathway is suppressed in active AA. Treg pathway may be opposing Th1 and Th17 pathway and causes disease localization. The instant study lays the groundwork for understanding the pathogenesis of AA and suggests the role of implicated cytokines as potential therapeutic targets and as biomarkers of disease activity.

Late onset nevus comedonicus of scalp: a rare site for an uncommon condition.

Nevus comedonicus is an uncommon hamartoma of the pilosebaceous unit characterized by keratin filled pits simulating open comedones. It may present at birth but is more commonly seen during childhood or adolescence. The most commonly affected sites are the face, neck, trunk, and arms with a few reported cases on palms, genitalia, and scalp. We report a case of a 19-year old woman with nevus comedonicus of the scalp that appeared in adolescence. This case has been presented for its sheer rarity, atypical site, and classic appearance.

Looking Beyond the Cyclosporine "Swish and Spit" Technique in a Recalcitrant Case of Erosive Lichen Planus Involving the Tongue.

Oral lichen planus is a relatively common autoimmune disease affecting the middle-aged population. Although no treatment is necessary for a benign asymptomatic case, in case of erosive lichen planus, topical corticosteroids form the mainstay of treatment. In case of failure, apart from tacrolimus, cyclosporine, using the "swish and spit" technique, is a valid therapeutic intervention. In our case, though, this therapeutic option had to be replaced by the systemic use of cyclosporine with gratifying results.

Nevoid hypertrichosis: case report with review of the literature.

Nevoid hypertrichosis is a rare entity characterized by circumscribed patches of terminal hair. It is associated with many cutaneous and extra-cutaneous abnormalities. In our case, a single circumscribed patch of terminal hair growth was present without any underlying or associated cutaneous or systemic abnormalities.