Online ISSN: 2515-8260

Keywords : Vitiligo


A Comparative Study of Clobetasol Propionate (0.05%) Cream and Tacrolimus (0.1%) Ointment in the Management of Localised Vitiligo

M. Naga Sayana Rao, S. Jareena Begum

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 2632-2638

Background: To study and compare tacrolimus ointment (0.1%) and clobetasol propionate cream (0.05%) in the management of localised vitiligo. To know the common types of vitiligo, age and sex distribution and to know the percentage of regimentation and adverse effects encountered with tacrolimus ointments (0.1%) and clobetasol propionate cream (0.05%).
Material and Methods:The present prospective study includes 50 cases of clinically diagnosed vitiligo attending the outpatient department of DVL, ACSR, Government General Hospital, Nellore from 01/06/2021 to 30/05/2022 over a period of 12 months. In this study patient with focal, local, segmental, lip-tip, mucosal and acrofacial vitiligo were included. Generalized and universal vitiligo (vitiligo vulgaris) were excluded in this study.
Results: In the present study 50 cases of vitiligo divided into two equal group treated with either tacrolimus ointment (0.1%) or clobetasol propionate cream (0.05%) were included. In this study the peak incidence of vitiligo is the age group of 21-30 years, with slight female preponderance (58%). Focal form of vitiligo in common (36%), response to clobetasol propionate cream (0.05%) 36 % whereas with tacrolimus ointment (0.1 %) it is 64 %. Adverse effects in clobetasol propionate cream (0.05%) were seen in 7 patients (28 %) and with tacrolimus in one patient (4 %).
Conclusion: In the present study clinical efficacy of tacrolimus ointment (0.1%) was almost equal to clobetasol propionate cream (0.05%) and tacrolimus ointment (0.1%) had fewer side effects than clobetasol propionate cream (0.05%) but the compliance was found to be better with clobetasol propionate cream (0.05%) due to its cost effectiveness.

Comparative study of Digital dermatoglyphics in vitiligo – A case control study

Dr. SishiraPotluru, Dr.BhanuPrakash, Dr.Geetanjali.B.S, Dr Radhika, Dr Shubha nevergi, Dr Geetharani, Dr.Mohan kumar H

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 2559-2565

Introduction: Dermatoglyphics is the scientific study of finger prints from palms, fingers, soles and toes of humans and animals. The uniqueness is it reflects DNA hence does not change & correlated with genetic abnormalities and are useful in biomedical studies. Vitiligo is the commonest heritable acquired progressive pigmentory disorder of skin. Altered dermatoglyphics pattern is well established as a early diagnostic aid in such disorder.
Material and Methods: Patients suffering from vitiligo 100 of them  (38 males and 62 females)visiting the dermatology OPD at Vydehi Institute of Medical College and Research Center, Bangalore,  were considered as cases in the study. Controls were hospital staff & medical students from the same institute. Dermatoglyphic prints were taken by the ink method & analysed with the help of magnifying hand lens.
Results: The whorl pattern in vitiligo was the commonest, mean value  was more in males than females, frequency of left hand fingers more than right in both male & female cases, Whorl pattern showed higher ratio in males in all left fingers except ring finger, in females was in left thumb, index, ring fingers. The arch pattern in vitiligo was least, mean value showed females more than males, showed in males more frequency of  left hand fingers, in females right hand fingers compared to other hand. Arch pattern showed higher frequency in males in left thumb & little finger, absent in index, ring finger, in females it was more in right fingers & absent in index finger. The loop pattern was 2nd commonest , mean value was more in males vitiligo & showed right more than left hand fingers both in males & females, Loop ratios were higher in males in all the digits except ring finger & in females showed higher ratio left hand in thumb, middle & little finger. The Total finger ridge count mean value in vitiligo showed males more than females & there was significant difference between male vitiligo & control group.
Conclusion: This concluded from our study that difference observed between vitiligo & control may be result of genetic abnormality or influence of some intrauterine environment factors. The study of dermatoglyphic pattern serves as aid to diagnose and may indicate an increasing tendency to develop the disease

A STUDY OF VITILIGO IN CHILDREN AND ADOLESCENT PATIENTS OF CENTRAL INDIA

Dr. Pritica Debnath Mathur; Dr. Vaishali H Wankhede; Dr. Rajesh Pratap Singh

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 6, Pages 1938-1947

Introduction: Vitiligo has a worldwide prevalence of 0.5-2%. Treatment of vitiligo at any age remains a challenge for clinicians, more so during childhood. Understanding the clinical profile in children paves way for early diagnosis and management of this disorder which ultimately ensures better outcomes.

Evaluation of serum levels of Vitamin D and contrast effects and controls in vitiligo patients

Dr.Niti Gaur, Dr.Parmil Kumar

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 4716-4720

Aim: Evaluation of serum levels of Vitamin D and contrast effects and controls in vitiligo
patients.
Methods: After receiving ethical approval from management, this case control research was
conducted in the department of dermatology. This study comprised 100 clinically diagnosed
instances of dermatological vitiligo (group A) and 100 control (group B) participants. The
control group (Group B) was made up of age and gender matched healthy volunteers. A
history of thyroid dysfunction, atopy, and diabetes was also suggested. Participants in the
research were all subjected to a complete general physical examination. A full systematic
study for associated disorders was also performed, and the results were recorded. A full
cutaneous investigation, including mucosa, was performed to diagnose the disease, determine
the type of the vitiligo, and investigate specific features such as trichrome, quadrichrome, and
leukotrichia.
Results: In our study, 200 patients who satisfied the inclusion criteria were enrolled, with
100 in Group A and 100 in Group B. The majority of patients (35.5 percent) were between
the ages of 30 and 40, with 34.5 percent between the ages of 40 and 50. 16.5 percent of the
patients were above the age of 30. Around 13.5 percent of those polled were above the age of
50. Males made up 54 percent of our research subjects, while females made up 46 percent.
Vulgaris was the most common kind of vitiligo observed in 50 percent of the cases. Mucosal
Vitiligo was seen in 13% of the patients. Both segmental and focal vitiligo were observed in
10% of the patients. AcrofacialVitiligo was seen in 11% of the patients, whereas Universalis
was seen in 7% of the cases. The duration of Vitiligo was less than 6 years in 70% of the
patients. In 21% of instances, the duration of vitiligo ranged from 6 to 12 years. In 7% of
instances, the duration of vitiligo ranged from 12 to 18 years and from 18 to 24 years. In 5%
of individuals, the vitiligo had been present for more than 24 years.
Conclusion: This analysis is closely linked to serum cholecalciferol and vitiligo.
Cholecalciferol is also strongly linked to the clinical type, duration, and severity of vitiligo.
Our research highlights the importance of low vitamin D levels in the aetiology of vitiligo, as
well as the function of vitamin D supplementation in the therapy of vitiligo.

Efficacy of fractional CO2 laser, NB-UVB and .05% clobetasol propionate vs NB-UVB and .05% clobetasol propionate in patients with vitiligo: A comparative study

Dr Manish Choudhary, Dr Rajkumar Kothiwala

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 1027-1031

Background: Conventional vitiligo treatment on the hands and feet frequently yields
disappointing results. In the face, neck, and truncal areas, various ablative therapy
approaches were tested with positive results.
Material and methods: On 44 individual patients in each group with 44 pair-lesions of
non-segmental vitiligo on both hands, a prospective randomized study was done. In
(Group A) treatment with fractional CO2 laser, NB-UVB phototherapy, and 0.05 %
clobetasol propionate cream and NB-UVB phototherapy and 0.05 % clobetasol
propionate cream was given (Group B). For ten sessions, fractional CO2 laser was used
at four week intervals. NBUVB phototherapy was given twice a week for a total of 20
sessions. Twelve weeks following the last therapy, the patients were assessed. Standard
digital pictures, patient satisfaction, and adverse events were used to assess the
outcomes.
Results: Patients' satisfaction with lesions in group A was much higher than that of
group B. Lesions on dorsal surfaces of hands responded more quickly than those on
ventral surfaces.
Conclusion: In some individuals, combining fractional CO2 laser treatment with NBUVB
phototherapy and topical steroids enhances repigmentation in vitiliginous lesions
on the hands. Patients with vitiligo who have not responded to conventional therapies
may be offered this procedure.

Stress, Anxiety and Depression among vitiligo patients visiting dermatology clinic.

Malak Abdullah Alshilli, Aref Salem Zaban Alzeyadi, Turki Ali Hamed Almaliki

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 3195-3209

Background: Vitiligo has a significant effect on patients’ quality of life; they feel stigmatized and disturbed by their condition. A lot of vitiligo patients, according to reports, suffer from psychological disturbances. The aim of the study is to find the relation between vitiligo and stress, anxiety, and depression and to measure how vitiligo affects the quality-of-life index. Methods of study is a case-control involving fifty patients of both sexes with the diagnosis of vitiligo and fifty healthy volunteers as a control group matched in age, gender, and academic level. Patients were selected from patients who visiting dermatology clinic at King Abdul-Aziz hospital in Makkah Al-Mokarramah. All patients were assessed by the Depression Anxiety Stress Scale (DASS) to determine the severity of anxiety, depression, and stress symptoms and the Dermatology Life Quality Index (DLQI) scale to evaluate their quality of life while the control group underwent only the Depression Anxiety Stress Scale. Results: The prevalence of stress was 76%, anxiety was 78%, and depression was 80%; the difference was statistically significant between patient group and control group regarding stress, anxiety, and depression. Gender had a significant relationship with stress, anxiety, and depression (p < 0.05) (female affected more than male). Also, there was a statistically significant relation between the degree of vitiligo and anxiety (p < 0.05). Vitiligo has a moderate to very severe effect on the quality of life index. There was a statistically significant positive correlation between stress and feeling of embarrassment from vitiligo and clothes choice. Conclusion: Vitiligo is a psych cutaneous disease that does not only affect the patient’s physical status, but also his mental and psychological status.

Study of the Enhanced Role of Latanoprost Combined with Narrow Band Ultraviolet B Rays in Vitiligo Repigmentation

Heba Gamal Elsheikh,Al_Mokadem S, Abdulla Esawy

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 3423-3433

Background:Vitiligo is an acquired, autoimmune disease characterized by depigmented macules and
patches on the skin, which occur secondary to melanocyte destruction. Focal and segmental vitiligo
patterns involve ≤10% body surface area (BSA) and are considered stable patterns. Generalized
vitiligo typically involves ≥10% BSA, appears bilaterally in a symmetric distribution, and generally
follows a relapsing and remitting disease course. The pathogenesis is complex and involves the
interplay of multiple factors; however, the exact pathogenesis is not well known. In particular, the
autoimmune mechanism is clearly established. Vitiligo may appear at any age and affect both
sexes.Treatment can be challenging, though available modalities of therapy include pharmacologic,
surgical, and phototherapy. Appropriate characterization of vitiligo type, consideration of disease
extent and duration, and efficacy of prior therapies can guide management and maximize treatment
efficacy.Latanoprost was documented to stimulate prostaglandin E2(PGE2) formation, and
repigmentation is likely to be induced in part by endogenous PGE2 which acts as a melanogenic
stimulator.Narrow band UVB rays are one of the safest and most effective therapeutic modalities of
vitiligo. It emits wavelengths between 310 and 315 nm. This specific wavelength is very effective in
vitiligo because it can stimulate the dormant skin melanocytes and also modulate the cutaneous
immune system.

NEED OF VITAMIN D BEYOND BONE: A CONSISE REVIEW.

Roshan Kumar Jha; Deepika Kanyal; Dr. Archana Dhok; Lata Kanyal Butola

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 1096-1109

Vitamin D is also known as calciferol because of its role in calcium metabolism and antirachitic factor because it prevents rickets. It is a modified steroid, synthesised in the skin under the influence of sunlight and is necessary for metabolism of calcium and phosphorus. Its RDA is 400 IU or 10 mg, it binds to the receptor of target cells and regulate through gene expression. Vitamin D undergoes hydroxylation in the liver to form 25 hydroxy vitamin D [25(OH) vitamin D]. The two main forms are vitamin D2 (ergocalciferol) and vitamin D3 (cholecalciferol). The main source of vitamin D in humans is in the form of vitamin D3, which is derived from synthesis in the skin via exposure of 7- dehydrocholesterol, concentrated in the stratum basale and stratum spinosum, to ultraviolet B (UV-B) radiation. Vitamin D2 is obtained from the diet, and is derived from ultraviolet irradiation of ergosterol, found in fungi. Both metabolites are transported in the blood bound to vitamin D binding protein (DBP). These inactive vitamin D metabolites must undergo a two-step hydroxylation process to become biologically active. Initially, vitamin D2 and D3 undergo hydroxylation in the maternal liver, via the action of vitamin D 25-hydroxylase enzyme (CYP27A1), to form the inactive steroid precursor 25-hydroxyvitamin D (25[OH]D). 25[OH]D is the major circulating and stored form of vitamin D. In this present review we have focused on need of vitamin D beyond bone.

Modern Approaches To Vitiligo Treatment

Mukhabbatkhon Yokubova

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 8, Pages 1005-1007

This article discusses modern approaches to treating vitiligo and lists the methods of treating vitiligo.It was used to treat vitiligo in 28 patients. Most of them enjoyed of clinical condition. The preparation was well tolerated and produced no adverse effects.

A STUDY ON THE QUALITY OF LIFE IN PATIENTS OF VITILIGO, PSORIASIS AND PEMPHIGUS VULGARIS.

Dr. Sneha Deshmukh; Dr. Adarshlata Singh

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 7, Pages 2158-2165

Background/Rationale: Skin is the most visible organ that defines our appearance and plays a significant social communication role to a great extent. Human beings are often concerned with their external physical appearance, which is directly related to the health of the skin, and if any disease triggers a change in the skin's natural appearance, it causes distress to the individual. Chronic diseases such as Vitiligo, Psoriasis, and Pemphigus severely dagrades the quality of life ( QOL) of affected individuals. ,Psychiatric morbidity was shown by Indian patients as stress ,anxiety depression, lower self-esteem, adjustment disorders, and sleep disturbance, and are vulnerable to various psychiatric disorders such as severe depression and suicidal ideations. The involvement of a chronic illness is typically associated with lower health-related quality of life ( HRQOL), and severity of the disorder often affects HRQOL. Objectives: To evaluate the quality of life of patients having Psoriasis, Vitiligo and Pemphigus Vulgaris and To explore the correlation between disease severity and quality of life. Methods: Prospective Cross sectional Study will be carried out in 65 patients with chronic skin diseases, attending Out Patient Department of Dermatology, AVBRH, JNMC, Sawangi, Wardha, will be Registered after having considered different conditions for inclusion and exclusion. A detailed history will be taken, severity index will be calculated and questionnaire, DLQI, HRQOL will be given to the patients. Results: The result would be undertaken in SPSS software. Conclusion: The conclusion will be based on findings for study protocol.