Analysis of interleukin-10 levels in lesions of vitiligo following treatment with topical tacrolimus.

BACKGROUND: Vitiligo is an acquired dermatological condition that is characterized by depigmentation of patches of skin. It is relatively common, occuring in about 0.38-0.50% of the general population, and can engender significant cosmetic disfigurement and psychological sequelae in the affected individual. Recent studies demonstrate that topical tacrolimus (Protopic; Astellas, Markham, ON, Canada) is efficacious in the treatment of vitiligo. We propose that the successful treatment of vitiligo with topical tacrolimus involves the unique immunosuppressive actions of the T lymphocyte T-helper (Th) 2 cytokine, interleukin (IL)-10. OBJECTIVES: We aimed to monitor clinical changes in lesions of vitiligo treated with topical tacrolimus 0.1% ointment and quantify IL-10 cytokine levels in nonvitiliginous skin, as well as lesions of vitiligo before and following topical tacrolimus therapy. METHODS: Clinical evaluation of lesions of vitiligo on the basis of surface area and follicular repigmentation under Wood's lamp was performed in 20 enrolled adult patients. Biopsy specimens were obtained from nonvitiliginous skin, as well as lesions of vitiligo before and following topical tacrolimus therapy. Specimens were processed and analysed for expression of IL-10 using the method of enzyme-linked immunosorbent assay. RESULTS: A statistically significant mean +/- SEM decrease in vitiligo lesion size of 41.0 +/- 5.2% was observed following 3 months of treatment. A pattern of follicular repigmentation was noted by the third month of treatment for all patients completing the study. In addition, there was a statistically significant difference between IL-10 expression in vitiligo lesions following treatment for 3 months with topical tacrolimus compared with untreated vitiligo lesions (P = 0.017) and normal skin (P = 0.004). CONCLUSIONS: These results confirm that topical tacrolimus is an effective treatment for vitiligo. We propose that topical tacrolimus increases IL-10 expression in vitiligo lesions, and thereby inhibits melanocyte destruction triggered by unchecked Th1 pathways in vitiligo.

Use of magnetic resonance imaging to measure facial soft tissue depth.

OBJECTIVE: To investigate the feasibility of using magnetic resonance imaging to estimate facial tissue depth at standard anthropological facial landmarks. DESIGN: Standard facial landmarks were marked with magnetic resonance imaging opaque markers on 10 normal subjects. Three observers estimated facial tissue depth at these landmarks on up to three separate occasions, and comparisons were made among the observers. SETTING: The study was conducted with volunteers at the University of Alberta Biomechanical Engineering unit. PARTICIPANTS: The volunteers were healthy individuals of both sexes between the ages of 18 and 30 years. MAIN OUTCOME MEASURES: The technical error of measurement among observers was used as the main indicator of precision of measurement. RESULTS: Measurements of tissue depth showed tolerable technical error of measurement and were precisely measured within and among observers. CONCLUSIONS: Magnetic resonance images can be used to estimate tissue depth in human faces with precision.