Ultraviolet radiation, both UVA and UVB, influences the composition of the skin microbiome.

BACKGROUND: Studies have begun to investigate the complex relationship between host and microorganisms in non-infectious pathologies such as acne, atopic dermatitis and psoriasis. Though the skin is exposed to environmental stressors such as ultraviolet radiation (UVR), no studies exist examining the effects of both UVA and UVB on the skin microbiome. OBJECTIVE: To test the effect of UVA and UVB on human skin microbiome. METHODS: To test whether UV will alter the cutaneous microbiome, participants were exposed to doses of UVA (22-47 J/cm2 ) or UVB (100-350 mJ/cm2 ) and samples were collected. DNA was isolated and sequenced to identify the microbial composition of each sample. RESULTS: There was vast intra- and inter-subject variation at all time points, and phylum and species-level differences were identified. These included an increase in the phylum Cyanobacteria and a decrease in the family Lactobacillaceae and Pseudomonadaceae. The sensitivity of microbes to UVR and their re-colonization potential following exposure differed in UVA vs UVB samples. LIMITATIONS: The sample size was small, and the study was limited to males. CONCLUSION: The results demonstrate that UVR has profound qualitative and quantitative influences on the composition of the skin microbiome, possibly effecting skin pathology in which UVR is a factor.

The impact of oral Polypodium leucotomos extract on ultraviolet B response: A human clinical study.

BACKGROUND: There is a rationale for adding systemic photoprotective agents to the current photoprotection regimen. OBJECTIVE: This study was designed to objectively evaluate the molecular and photobiologic effects of oral administration of Polypodium leucotomos extract (PLE). METHODS: In all, 22 subjects with Fitzpatrick skin phototype I to III were enrolled. On day 1, subjects were irradiated with visible light, ultraviolet (UV) A1, and UVB (using 308-nm excimer laser). Evaluation was done immediately and 24 hours after irradiation. On days 3 and 4, irradiation and evaluation process was repeated after ingestion of PLE. RESULTS: Clinical assessments and colorimetry data showed a decrease in UVB-induced changes in 17 of 22 subjects post-PLE administration; histology findings demonstrated such a decrease in all 22 subjects. LIMITATIONS: Only 2 doses of PLE were given. Furthermore, subjects with skin phototypes I to III only were studied. CONCLUSION: The results suggest that PLE can potentially be used as an adjunctive agent to lessen the negative photobiologic effects of UVB.

Comorbid autoimmune diseases in patients with vitiligo: A cross-sectional study.

BACKGROUND: Few large-scale studies have quantified the burden of comorbid autoimmune diseases in patients with vitiligo. OBJECTIVE: We sought to determine the prevalence of comorbid autoimmune diseases in patients with vitiligo. METHODS: We conducted a manual chart review on a cohort of 1873 patients with vitiligo seen between January 2002 and October 2012 at the Henry Ford Health System in Detroit, MI. Patients were excluded if they had fewer than 2 dermatology notes (N = 595) or if they were never given a diagnosis of vitiligo by a dermatologist (N = 180). RESULTS: Of 1098 patients with vitiligo, nearly 20% had at least 1 comorbid autoimmune disease. Compared with the general US population, we found a higher prevalence of thyroid disease (12.9%, P < .001), alopecia areata (3.8%, P < .001), inflammatory bowel disease (0.9%, P = .046), pernicious anemia (0.5%, P = .007), systemic lupus erythematosus (0.3%, P = .048), Guillain-Barre syndrome (0.3%, P < .001), discoid lupus (0.2%, P = .003), linear morphea (0.2%, P < .001), myasthenia gravis (0.2%, P = .002), and Sjögren syndrome (0.2%, P = .011). LIMITATIONS: The study lacked a control group. This was a single-institution study with possible selection bias, and thus the findings may not be representative of the overall population of patients with vitiligo. CONCLUSIONS: We observed a high prevalence of comorbid autoimmune diseases in patients with vitiligo and report several new associations.

Uncommon responses of segmental vitiligo to melanocyte-keratinocyte transplantation procedure.

BACKGROUND: Patients with segmental vitiligo (SV), unlike those with nonsegmental vitiligo (NSV), have a more predictable course and are more responsive to surgery. OBJECTIVE: To report 10 patients with SV treated with the melanocyte-keratinocyte transplantation procedure (MKTP), who responded with unusual responses not previously reported in the literature. METHODS: This is a retrospective, observational study that reports 10 patients with SV who underwent the MKTP between May 2003 and May 2012. RESULTS: Two patients had successful repigmentation after split-thickness skin grafting after failure of the MKTP. Two patients developed a hypopigmented ring at a margin of the MKTP-treated area. One patient had complete repigmentation after a second MKTP. Two patients developed koebnerization of the recipient site. Three patients developed new vitiligo patches in previously unaffected areas after the MKTP. CONCLUSIONS: Uncommon and even suboptimal responses can occur following the MKTP in SV patients. There is a need for studies to provide better understanding and outcomes for SV patients undergoing the MKTP.

Polymorphous light eruption presenting as pinhead papular eruption on the face.

Polymorphic light eruption (PMLE) is the most common of the immunologically mediated photodermatoses. Onset is typically within the first three decades of life and affects females two to three times more than males. It occurs 30 minutes to 1-3 days after sun exposure and usually resolves in 7 to 10 days. Lesions present as non-scarring, erythematous and minimally pruritic papules, vesicles, papulovesicles, plaques or nodules. A pinpoint papular variant of PMLE has been reported in individuals with skin phototype IV-VI, characterized by the development of pinpoint papules, 1 to 2 mm, on sun-exposed areas after ultraviolet radiation. PMLE has a predilection for the arms, forearms, hands, head and neck region, usually with sparing of the face. We report two cases of African-American males who presented with the pinpoint papular variant of PMLE involving the face.