1
|
Vergnaud H, Charton Z, Blumenthal D, Couturaud V, Le Fur M, Loescher E, Caisey L, Gazano G. Lip color diversity: An intricate study. Skin Res Technol 2024; 30:e13583. [PMID: 38284291 PMCID: PMC10823443 DOI: 10.1111/srt.13583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 12/04/2023] [Indexed: 01/30/2024]
Abstract
BACKGROUND Lip investigations and characterizations in the literature are less prevalent than for skin, particularly on the topic of color diversity. However, as the consumer demand increases for a nude lip makeup result, that is, shades close to the bare lip color, the identification and modification of lip color is essential for the cosmetic industry. OBJECTIVE The objective was to highlight lip color diversity among three ethnicities (Caucasian, African and Hispanic), through the use of a spectral color measurement device especially adapted to the lip area, and to consider lip color ethnic specificities and overlaps. MATERIALS AND METHODS The inferior natural lip color was measured with a full-face hyperspectral imaging system, SpectraFace (Newtone Technologies, Lyon, France), on 410 healthy women aged 19 to 68 (Caucasian French, Caucasian American, African American, and Hispanic American women). A hierarchical ascending classification, was deployed to determine clusters based on the lip colorimetric parameters along two strategies to identify the best statistical analysis to preserve the lip color diversity. RESULTS Lip color is a continuous color space, with great intra-ethnic and inter-ethnic diversity, especially for African American women in terms of chroma and lightness. Among the two strategies of data analysis, our two-step statistical clustering analysis yielded 11 groups (i.e., 11 lip tones), revealing an accurate representation of the scope of diversity, but also of the overlaps. CONCLUSION The 11 lip tones/colors could potentially serve as target shades for the development of a more diverse and inclusive range of lip cosmetics, such as nude lipsticks.
Collapse
Affiliation(s)
| | | | - David Blumenthal
- Université Paris‐SaclayINRAE, AgroParisTech, UMR SayFoodPalaiseauFrance
| | | | | | | | | | | |
Collapse
|
2
|
Vergnaud H, Cherel M, Francois G, Charton Z, Loescher E, Caisey L, Gazano G. Lip color measurement: A new hyperspectral imaging device. Skin Res Technol 2023; 29:e13418. [PMID: 37632193 PMCID: PMC10410235 DOI: 10.1111/srt.13418] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 07/12/2023] [Indexed: 08/27/2023]
Abstract
INTRODUCTION The lips are of significant interest among the facial features for self-perception and social interactions. Such perceptions could rely in part upon the contrast in color between the lips and the surrounding skin. In contrast to skin color, lip color ethnic diversity measurement provides a challenge and is less documented in the literature, most likely due primarily to challenges in measurement based upon the lip characteristics of size and contour. Accurate measurement and reproduction of lip color are essential to build strong cross-sectional knowledge about lip color. OBJECTIVE This preliminary experiment of a large-scale project on lip and skin color was designed to assess accuracy in lip color measurement and recommend instruments and protocols for good measurement practice. METHODS The study involved 19 healthy French Caucasian women. Their inferior and superior natural lip color was measured twice with three devices in order to extract the standard colorimetric parameters of lightness (L*), chroma (C*), and hue (h): the VISIA-CR® (high-resolution digital camera, Canfield Scientific Inc.); the spectrophotometer VS3200 (45°:0° spectrophotometer, MetaVue™ VS3200, X-Rite Inc.); and the SpectraFace® (new hyperspectral imaging system, Newtone Technologies). The intercomparison and color distribution between the different instruments and the measurement repeatability of each one were assessed. RESULTS Our results showed a reliable and equivalent repeatability for the three tested instruments. Moreover, the three tools led to the same conclusion regarding lip color heterogeneity (lighter, redder, less yellow and more saturated inferior lip versus superior lip). Agreement between the SpectraFace® and the spectrophotometer measurements was higher, and the SpectraFace® allowed to identify three separated lip color typologies. CONCLUSION In conclusion, the combination of imaging technology and hyperspectral measurement makes the SpectraFace® a useful tool to investigate lip color characterization and establish a large-scale cross-sectional knowledge study about lip color.
Collapse
Affiliation(s)
| | | | | | - Zoé Charton
- MCI DepartmentLVMH RechercheNeuilly sur SeineFrance
| | | | | | | |
Collapse
|
3
|
Böhm M, Schunter JA, Fritz K, Salavastru C, Dargatz S, Augustin M, Tanew A. S1-Leitlinie: Diagnostik und Therapie der Vitiligo. J Dtsch Dermatol Ges 2022; 20:365-379. [PMID: 35304960 DOI: 10.1111/ddg.14713_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 12/01/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Markus Böhm
- Klinik für Hautkrankheiten, Universitätsklinikum Münster, Münster, Deutschland
| | - Jo Ana Schunter
- Klinik für Hautkrankheiten, Universitätsklinikum Münster, Münster, Deutschland
| | - Klaus Fritz
- Hautarztpraxis und Laserzentrum Landau, Landau, Deutschland
| | - Carmen Salavastru
- Universität Carol Davila, Pädiatrische Dermatologie, Bukarest, Rumänien
| | | | - Matthias Augustin
- Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
| | - Adrian Tanew
- Universitätsklinik für Dermatologie, Medizinische Universität Wien, Wien, Österreich
| |
Collapse
|
4
|
Böhm M, Schunter JA, Fritz K, Salavastru C, Dargatz S, Augustin M, Tanew A. S1 Guideline: Diagnosis and therapy of vitiligo. J Dtsch Dermatol Ges 2022; 20:365-378. [PMID: 35246935 DOI: 10.1111/ddg.14713] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 12/01/2021] [Indexed: 01/01/2023]
Abstract
Vitiligo is a common skin disorder characterized by immune-mediated destruction of melanocytes. Non-segmental vitiligo, the most common clinical subtype, has usually a chronic course and often results in significant psychosocial consequences for the affected patient. Early recognition, awareness of comorbidity, precise assessment of disease extent and activity, evaluation of impairment of quality of life as well as rapid initiation of treatment based on currently available evidence-based therapies are crucial cornerstones in the management of vitiligo. This S1 guideline helps German dermatologists to better diagnose and treat vitiligo.
Collapse
Affiliation(s)
- Markus Böhm
- Department of Dermatology, University Hospital Münster, Münster, Germany
| | - Jo Ana Schunter
- Department of Dermatology, University Hospital Münster, Münster, Germany
| | - Klaus Fritz
- Dermatology Office and Laser Center Landau, Landau, Germany
| | - Carmen Salavastru
- Department of Pediatric Dermatology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | | | - Matthias Augustin
- Institute for Health Services Research in Dermatology and Nursing, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Adrian Tanew
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| |
Collapse
|
5
|
Kawakami T. Surgical procedures and innovative approaches for vitiligo regenerative treatment and melanocytorrhagy. J Dermatol 2022; 49:391-401. [PMID: 35178747 DOI: 10.1111/1346-8138.16316] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 01/12/2022] [Accepted: 01/24/2022] [Indexed: 12/01/2022]
Abstract
Surgical treatments for vitiligo are a safe and effective treatment modality for select patients with vitiligo. Many techniques of vitiligo surgery exist, each with unique advantages and disadvantages. We reviewed the various surgical therapies and innovative approaches for vitiligo regenerative treatment reported in the literature. Surgical therapies can be subdivided into tissue grafting methods and cellular grafting methods. Tissue grafting methods mainly include mini punch grafts, suction blister roof grafts, and hair follicle grafts. Cellular grafting methods include cultured and non-cultured treatments. The efficacy needs to be improved largely due to the poor proliferation and quality of the autologous melanocytes. Rho-associated protein kinase inhibitor enhances primary melanocyte culture proliferation from vitiligo patients to prevent apoptosis. Innovative approaches using stem cell methods could prove invaluable in developing a novel cell therapy for patients suffering from vitiligo. We succeeded in inducing melanin pigmentation in mice skin in vivo using our human induced pluripotent stem cell-derived melanocytes. In addition, we reviewed melanocytorrhagy, detachment and transepidermal loss of melanocytes, and melanocyte-related adhesion molecules. These adhesion molecules include epithelial cadherin, discoidin domain receptor tyrosine kinase 1, glycoprotein non-metastatic melanoma protein B, macrophage migration inhibiting factor, 17β-hydroxysteroid dehydrogenase 1, and E26 transformation-specific 1.
Collapse
Affiliation(s)
- Tamihiro Kawakami
- Division of Dermatology, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| |
Collapse
|
6
|
Feily A, Firoozifard A, Sokhandani T, Elosegui-Rodriguez P, Perez-Rivera E, Lange CS, Hosseinpoor M, Ramirez-Fort MK. Follicular Transplantation, Microneedling, and Adjuvant Narrow-band Ultraviolet-B Irradiation as Cost-Effective Regimens for Palmar-Plantar Vitiligo: A Pilot Study. Cureus 2020; 12:e7878. [PMID: 32489732 PMCID: PMC7255558 DOI: 10.7759/cureus.7878] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Treatment of refractory palmar-plantar vitiligo is particularly challenging because the skin in these regions has a limited supply of follicle-derived melanocytic stem cells. Autologous hair transplantation monotherapy is effective in some forms of vitiligo through the provision of melanocytic stem cells. CO2 laser followed by exposure to light (i.e., sunlight or narrow-band ultraviolet-B [nbUVB]) has independently shown to be an effective treatment strategy. Recently, it was found that the combination of hair transplantation and CO2 laser followed by nbUVB exposure had superior efficacy to either modality as monotherapy. Similar to CO2 laser, microneedling produces skin cell proliferation and releases pro-pigmentary cytokines. Given the important role of the cytokines in vitiliginous skin, microneedling may also be an effective therapeutic modality for refractory vitiligo. Herein, we conducted a pilot study to evaluate the efficacy of hair transplantation and CO2 laser or microneedling followed by nbUVB. Microneedling and fractional CO2 laser in combination with hair transplantation and nbUVB both demonstrated utility in the induction of repigmentation in refractory palmar-plantar vitiligo; however, a larger trial would be needed to determine a difference in treatment efficacy. Nonetheless, microneedling is cost-effective and requires minimal training; therefore, microneedling can be easily incorporated into standard dermatological practice.
Collapse
Affiliation(s)
- Amir Feily
- Dermatology, Jahrom University of Medical Sciences, Jahrom, IRN
| | | | | | | | | | - Christopher S Lange
- Radiation Oncology, State University of New York Downstate Health Sciences University, Brooklyn, USA
| | | | | |
Collapse
|
7
|
Abdel-Rahman AT, Mohammed SS. Clinicopathological evaluation of the donor area following autologous suction blister epithelial grafting vs Thiersch grafting in vitiligo patients: A preliminary study. Dermatol Ther 2020; 33:e13349. [PMID: 32232886 DOI: 10.1111/dth.13349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 03/03/2020] [Accepted: 03/26/2020] [Indexed: 12/01/2022]
Abstract
Surgical vitiligo treatment is suggested for recalcitrant small stable lesions. One of the limitations of this approach is the presence of large lesions. The donor site should be designed to be hidden without previous or present lesions; this limits donor sites. Aim of the study was to clinically and histopathologically evaluate donor areas 3 months and 1 year after Thiersch grafting (TG) and suction blister epithelial grafting (SBEG). Forty patients with stable vitiligo were equally divided into two groups before TG and SBEG. In each patient, the donor site was clinically and histopathologically evaluated after 3 months and 1 year. After 3 months in Group I, hyperpigmentation, mixed pigmentation with atrophic scarring, hyperpigmentation with hypertrophic scarring, erythema, and tough skin were detected in 10%, 50%, 10%, 10%, and 20% of cases, respectively. The condition improved with time leaving, leaving tough skin in all cases after 1 year. In Group II, hyperpigmentation was observed in all patients after 3 months and disappeared completely after 1 year. Histologically, biopsies taken 3 months after TG, showed increased basal pigmentation with dermal changes mimicking scar tissue in 92.5% of cases. Collagen homogenization of and fragmented elastic tissue were reported in all cases. Biopsies showed the same features after 1 year. In the SBEG group, biopsies revealed only basal hyperpigmentation that disappeared after 1 year in all patients. We concluded that SBEG is a scarless operation and regrafting from the same area can be performed. This is in contrast to TG, which is considered a scarring operation, and wherein the donor site cannot be reused for grafting.
Collapse
|
8
|
Anbar TS, El-Ammawi TS, Mohammed SS, Abdel-Rahman AT. Noncultured epidermal suspensions obtained from partial-thickness epidermal cuts and suction blister roofs for vitiligo treatment: A prospective comparative study. J Cosmet Dermatol 2020; 19:2684-2691. [PMID: 31997482 DOI: 10.1111/jocd.13312] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 01/09/2020] [Accepted: 01/13/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND The treatment options for vitiligo are either nonsurgical, including medical treatments and phototherapy, or surgical, including autologous transplantation methods. Noncultured epidermal suspension transplantation is indicated for the treatment of stable vitiligo not responding to either medical treatment or phototherapy. Variable results have been reported for the various techniques used for the preparation of this suspension. AIM To compare the outcome between suction blister roof grafts and partial-thickness epidermal cuts for the preparation of noncultured epidermal suspensions for the treatment of stable vitiligo. PATIENTS AND METHODS Forty patients with localized stable vitiligo lesions resistant to conventional therapy were included in the study. They were randomly divided into two groups for treatment with noncultured epidermal suspension grafting. The suspensions in groups I and II were obtained from suction blister roofs and partial-thickness epidermal cuts, respectively. Repigmentation grade, color match with the surrounding skin, and any side effects were compared between the groups. RESULTS In group I, complete repigmentation was achieved in 6 cases while repigmentation was considered excellent in 8 cases; very good, 4 cases; and no response, 2 cases. In group II, complete repigmentation was achieved in 4 cases, and repigmentation was considered excellent in 16 cases. The color of the repigmented area matched the normal surrounding skin in 70% of the cases in group I and 40% of the cases in group II. CONCLUSION Both techniques yielded comparable repigmentation results with advantages and disadvantages of both techniques.
Collapse
Affiliation(s)
- Tag S Anbar
- Dermatology Department, Minia University, El-Minia, Egypt
| | | | | | | |
Collapse
|
9
|
Anbar TS, El-Fakahany HM, El-Khayyat MA, Abdel-Rahman AT, Saad EK. Factors affecting the outcome of the suction blisters using two different harvesting techniques in vitiligo patients. J Cosmet Dermatol 2019; 19:1723-1729. [PMID: 31746546 DOI: 10.1111/jocd.13222] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 10/12/2019] [Accepted: 10/29/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Suction blister grafting (SBG) technique has been used for long to treat various skin conditions. Different suction methods have been used such as syringes, Chinese cups, and suction device. There are some limitations of its use as time consumption, failure of induction or incomplete blister formation and pain. AIM The aim of this work was to evaluate the outcome of using two different suction techniques, namely the syringes and the Chinese cups in induction of suction blisters. The effect of the device diameter and preheating of the donor area on the suction blister induction time (SBIT) was studied. The effect of saline injection in the blister formation and its completion was also evaluated. METHODS The study was a left-right comparative study that included 50 patients with stable nonsegmental vitiligo. They were classified into four groups: Group 1 included 15 patients where different diameters of syringes (1.3, 1.7, and 2 cm) were compared against each other, group 2 included 15 patients where different diameters of cups (2, 3.5, and 5 cm) were compared against each other, group 3 included 20 patients subdivided into two groups; 10 patients each, where the effect of preheating the skin on blister induction was tested with use of cups (3a) and syringes (3b). Lastly, group 4 included randomly chosen 40 incomplete or multilocular blisters where the effect of saline injection on blister completion and coalescence of multilobulation was examined. SBIT was calculated in all patients. RESULTS The use of the small diameter syringes or cups gave shorter SBIT; however, the difference, which was significant between all sizes of cups, was significant between the 1.3- and 2-cm-diameter syringes only. Preheating of the donor area shorten SBIT significantly. No complications were reported at the donor site except for transient postinflammatory hyperpigmentation in all patients. CONCLUSION The small diameter syringes or cups and preheating of the donor area shorten the SBIT, while intra-blister saline injection increased the blister size and turns the multilocular blisters to unilocular ones.
Collapse
Affiliation(s)
- Tag S Anbar
- Department of Dermatology, STD's and Andrology, Minia University, Minia, Egypt
| | - Hasan M El-Fakahany
- Department of Dermatology, STD's and Andrology, Minia University, Minia, Egypt
| | | | - Amal T Abdel-Rahman
- Department of Dermatology, STD's and Andrology, Minia University, Minia, Egypt
| | - Enas K Saad
- Department of Dermatology, STD's and Andrology, Matay Central Hospital, Minia, Egypt
| |
Collapse
|
10
|
Richmond JM, Strassner JP, Essien KI, Harris JE. T-cell positioning by chemokines in autoimmune skin diseases. Immunol Rev 2019; 289:186-204. [PMID: 30977191 PMCID: PMC6553463 DOI: 10.1111/imr.12762] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 03/18/2019] [Accepted: 03/21/2019] [Indexed: 12/12/2022]
Abstract
Autoimmune skin diseases are complex processes in which autoreactive cells must navigate through the skin tissue to find their targets. Regulatory T cells in the skin help to mitigate autoimmune inflammation and may in fact be responsible for the patchy nature of these conditions. In this review, we will discuss chemokines that are important for global recruitment of T cell populations to the skin during disease, as well as signals that fine-tune their localization and function. We will describe prototypical disease responses and chemokine families that mediate these responses. Lastly, we will include an overview of chemokine-targeting drugs that have been tested as new treatment strategies for autoimmune skin diseases.
Collapse
Affiliation(s)
- Jillian M Richmond
- Department of Dermatology, UMass Medical School, Worcester, Massachusetts
| | - James P Strassner
- Department of Dermatology, UMass Medical School, Worcester, Massachusetts
| | - Kingsley I Essien
- Department of Dermatology, UMass Medical School, Worcester, Massachusetts
| | - John E Harris
- Department of Dermatology, UMass Medical School, Worcester, Massachusetts
| |
Collapse
|
11
|
Efficacy of suction blister epidermal grafting with concomitant phototherapy in vitiligo treatment. Postepy Dermatol Alergol 2018; 35:592-598. [PMID: 30618527 PMCID: PMC6320492 DOI: 10.5114/pdia.2017.71257] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Accepted: 10/09/2017] [Indexed: 11/17/2022] Open
Abstract
Introduction There are many surgical methods for vitiligo treatment that have been used for over 30 years. Suction blister epidermal grafting (SBEG) is considered one of the simplest and most effective of them. Aim To determine how effective suction blister grafts with concomitant phototherapy are in vitiligo treatment. Material and methods The study was conducted on 10 patients with vitiligo that was resistant to previous treatment including phototherapy in monotherapy. Involvement of affected sites was different for every patient. We used cryotherapy for blistering at the recipient site and an automatic suction device for blistering at the donor site. The blister was separated from the donor site and fixed with dressing to the recipient site. After removing the final dressing (about 7 days after SBEG) patients started phototherapy (6 patients had UVB 311 nm and 4 had PUVA). All patients treated with UVB 311 nm were qualified for treatment in our clinic and the method was chosen according to expert recommendations from the European Dermatology Forum (EDF) Guidelines for Vitiligo where narrowband (NB) UVB is the phototherapy of choice. Three patients who had PUVA therapy were treated with this method in other clinical centers and sent to us only to undergo SBEG. One patient had previously received UVB 311 nm for 3 months, which showed no effects. Repigmentation of lesions was evaluated at 3 and 6 months after the surgical procedure. Results Ten patients (9 females with a mean age of 36.88 years and 1 man aged 39 years) were enrolled in the study. Nine patients showed progressive repigmentation at 3 and 6 months follow-up with a rate varying from 13 to 76% (mean: 44.5%) and 35 to 100% (mean: 67.5%). One patient showed 5% depigmentation at a visit after 6 months in comparison to the follow-up visit 3 months after SBEG. Conclusions With this technique, patients who did not respond to the usual treatments showed very good repigmentation over a 6-month follow-up. There were no side effects such as scarring.
Collapse
|
12
|
Kar BR, Raj C. Suction Blister Epidermal Grafting for Vitiligo Involving Angles of Lip: Experience of 112 Patients. J Cutan Aesthet Surg 2018; 11:13-19. [PMID: 29731587 PMCID: PMC5921444 DOI: 10.4103/jcas.jcas_111_15] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background: Lip vitiligo is usually resistant to medical modalities of treatment, and in all these cases, surgery offers a hope. Suction blister grafting (SBG) has been tried since long for lip vitiligo with high rate of success. There have been no long-term follow-up studies of patients with SBG at a difficult-to-treat site like angles of lip, which prompted us to conduct this study. Aims and Objectives: To assess the pigmentation rate and patient satisfaction of SBG on vitiligo involving angles of lip. Materials and Methods: This is a prospective study conducted on 112 patients with stable vitiligo involving angles of lip. SBG was carried out in all the patients using the standard procedure. Patients were advised to apply topical psoralen followed by sun exposure (PUVASOL) for 8–12 weeks after operation. The patients were followed up at 3, 6, 12, 18, and 24 months for assessment of pigmentation and overall satisfaction. Results: We found a pigmentation success rate of 83.7%, 84.9%, 85.7%, 78.3%, and 77.8% in the patients who were followed up at 3, 6, 12, 18, and 24 months, respectively. A total of 77.8% of patients who came for follow-up at the end of 24 months were very happy with the treatment. Discussion: Our data show clearance of vitiligo and persistence of pigmentation gained through SBG in 77.8% of cases at the end of 2 years as well as excellent patient satisfaction in the cohort of patients who followed up with us. Conclusion: SBG is an easy and cost-effective way of repigmentation of vitiligo involving angles of lip.
Collapse
Affiliation(s)
- Bikash R Kar
- Department of Dermatology, Venereology and Leprosy (DVL), Institute of Medical Sciences and SUM Hospital, Siksha 'O'Anusandhan University, Bhubaneswar, Odisha, India
| | - Chinmoy Raj
- Department of Dermatology, Venereology and Leprosy (DVL), Institute of Medical Sciences and SUM Hospital, Siksha 'O'Anusandhan University, Bhubaneswar, Odisha, India
| |
Collapse
|
13
|
Strassner JP, Rashighi M, Ahmed Refat M, Richmond JM, Harris JE. Suction blistering the lesional skin of vitiligo patients reveals useful biomarkers of disease activity. J Am Acad Dermatol 2017; 76:847-855.e5. [PMID: 28259440 PMCID: PMC5392432 DOI: 10.1016/j.jaad.2016.12.021] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Revised: 12/12/2016] [Accepted: 12/14/2016] [Indexed: 12/21/2022]
Abstract
BACKGROUND Vitiligo is an autoimmune disease of the skin with limited treatment options; there is an urgent need to identify and validate biomarkers of disease activity to support vitiligo clinical studies. OBJECTIVE To investigate potential biomarkers of disease activity directly in the skin of vitiligo subjects and healthy subjects. METHODS Patient skin was sampled via a modified suction-blister technique, allowing for minimally invasive, objective assessment of cytokines and T-cell infiltrates in the interstitial skin fluid. Potential biomarkers were first defined and later validated in separate study groups. RESULTS In screening and validation, CD8+ T-cell number and C-X-C motif chemokine ligand (CXCL) 9 protein concentration were significantly elevated in active lesional compared to nonlesional skin. CXCL9 protein concentration achieved greater sensitivity and specificity by receiver operating characteristic analysis. Suction blistering also allowed for phenotyping of the T-cell infiltrate, which overwhelmingly expresses C-X-C motif chemokine receptor 3. LIMITATIONS A small number of patients were enrolled for the study, and only a single patient was used to define the treatment response. CONCLUSION Measuring CXCL9 directly in the skin might be effective in clinical trials as an early marker of treatment response. Additionally, use of the modified suction-blister technique supports investigation of inflammatory skin diseases using powerful tools like flow cytometry and protein quantification.
Collapse
Affiliation(s)
- James P Strassner
- Department of Medicine, Division of Dermatology, University of Massachusetts Medical School, Worcester, Massachusetts
| | - Mehdi Rashighi
- Department of Medicine, Division of Dermatology, University of Massachusetts Medical School, Worcester, Massachusetts
| | - Maggi Ahmed Refat
- Department of Medicine, Division of Dermatology, University of Massachusetts Medical School, Worcester, Massachusetts; Department of Dermatology, Sohag University, Sohag, Egypt
| | - Jillian M Richmond
- Department of Medicine, Division of Dermatology, University of Massachusetts Medical School, Worcester, Massachusetts
| | - John E Harris
- Department of Medicine, Division of Dermatology, University of Massachusetts Medical School, Worcester, Massachusetts.
| |
Collapse
|
14
|
Shilpa K, Sacchidanand S, Savitha S, Ranjitha R, Lakshmi DV, Divya G. A Study of the Outcome of Primary Excision and Closure Technique in the Management of Lip Leukoderma in 30 Patients. J Cutan Aesthet Surg 2016; 9:20-6. [PMID: 27081245 PMCID: PMC4812883 DOI: 10.4103/0974-2077.178539] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Context: Lips being one of the graceful cosmetic units of the face, any disfigurement, including depigmentation, can be embarrassing, psychologically distressing, and socially stigmatizing. Even with the evolution of various surgical modalities, none of the techniques ensure 100% pigmentation with a good cosmetic appearance. With this background, this study was undertaken to study the efficacy of the technique—primary excision and closure in treatment of lip leukoderma (LL). Aims: To study the efficacy, cosmetic outcome, and recurrence following primary excision and closure technique in the management of LL. Settings and Design: A prospective single-center open-label uncontrolled study. Materials and Methods: Thirty patients with LL involving inner margin of the lower lip and those who fulfilled inclusion and exclusion criteria were included in the study. After obtaining consent and physician fitness, patients were posted for primary excision and closure of the vitiliginous area of the lip. Patients were followed up at the immediate postoperative period and 6 months later. Patient satisfaction scale was done by asking the patient to grade the response between one and ten. Statistical Analysis Used: Mean and percentiles. Results: Out of 30 patients, 29 patients achieved complete clearance that was cosmetically acceptable. Only one patient showed recurrence at the end of 6 months. Average patient satisfaction scale showed an average of 9.66. Conclusions: Primary excision and closure technique is one of the safe, inexpensive modality in the management of LL involving the inner margin of the lip with immediate result.
Collapse
Affiliation(s)
- Kanathur Shilpa
- Department of Dermatology, Venereology, Leprology, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India
| | - S Sacchidanand
- Department of Dermatology, Venereology, Leprology, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India
| | - Somaiah Savitha
- Department of Dermatology, Venereology, Leprology, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India
| | - Ramamurthy Ranjitha
- Department of Dermatology, Venereology, Leprology, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India
| | - D V Lakshmi
- Department of Dermatology, Venereology, Leprology, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India
| | - Gorur Divya
- Department of Dermatology, Venereology, Leprology, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India
| |
Collapse
|
15
|
Abstract
The range of treatment options for vitiligo has significantly expanded in the last 10 years and we can offer our patients more effective treatment strategies supported by European guidelines and consensus findings. Topical and UV therapy are-often in combination-the main components of vitiligo treatment. The main outcome parameters include extent and maintenance of gained repigmentation, cessation of spreading, avoidance of side effects and the influence of the treatment on the quality of life. The efficacy of the currently available treatments is often limited. New options include antioxidative or melanocyte-stimulating adjuvant therapies in combination with UV or laser light as well as a topical maintenance treatment to reduce the risk of recurrences. In many cases, psychological support is indicated.
Collapse
Affiliation(s)
- M Meurer
- Stiftung zur Förderung der Hochschulmedizin in Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland.
| | - M Schild
- Klinik und Poliklinik für Dermatologie, Universitätsklinikum Carl Gustav Carus, Dresden, Deutschland
| |
Collapse
|
16
|
Tsuchiyama K, Watabe A, Sadayasu A, Onodera N, Kimura Y, Aiba S. Successful Treatment of Segmental Vitiligo in Children with the Combination of 1-mm Minigrafts and Phototherapy. Dermatology 2016; 232:237-41. [PMID: 26836583 DOI: 10.1159/000442666] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Accepted: 11/23/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Minigrafts using a 1-mm biopsy punch (1-mm minigrafts) are being increasingly used to treat vitiligo. However, there have been few reports of the use of 1-mm minigrafts in pediatric patients. OBJECTIVE To examine the effectiveness of combination therapy with 1-mm minigrafts and phototherapy in children with segmental vitiligo. METHODS Minigrafts were placed in 13 patients aged ≤16 years with segmental vitiligo. Following surgery, 11 patients underwent irradiation with excimer laser light and 2 with narrow-band ultraviolet B light. RESULTS A mean repigmentation of 81.6% was obtained. A particularly high mean repigmentation of 87.9% was seen in patients aged ≤12 years, indicating greater efficacy in these patients than in patients aged ≥13 years (mean, 67.5%). Although a transient cobblestone appearance occurred as an adverse effect, it improved over time. CONCLUSIONS Combined treatment of segmental vitiligo with 1-mm minigrafts and phototherapy can be performed safely and is highly effective in young patients.
Collapse
Affiliation(s)
- Kenichiro Tsuchiyama
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | | | | | | | | | | |
Collapse
|
17
|
Maleki M, Banihashemi M, Sanjari V. Efficacy of suction blister epidermal graft without phototherapy for locally stable and resistant vitiligo. Indian J Dermatol 2012; 57:282-4. [PMID: 22837562 PMCID: PMC3401843 DOI: 10.4103/0019-5154.97669] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Surgical methods for treatment of vitiligo include punch grafts, blister grafts, follicular grafts and cultured melanocyte grafts. The aim of this study was to determine the efficacy of suction blister grafts for treatment of vitiligo, without the use of phototherapy. MATERIALS AND METHODS This clinical trial study was conducted on 10 patients with vitiligo that was resistant to usual treatments and with limited involvement in the affected sites. We used cryotherapy and a manual suction device for blistering at the recipient and donor sites, respectively. The blister was separated and fixed with sutures and a dressing to the recipient site. Repigmentation of lesions was evaluated monthly for 6 months after treatment. Repigmentation rates higher than 90%, between 71%-90%, from 51%-70%, and less than 50% were graded as complete, good, moderate, and poor, respectively. RESULTS Ten patients (five females with a mean age of 23.2±3.96 years and five males with a mean age of 30.60±4.15 years) were enrolled in the study. Reponses to treatment after a 6-month follow-up were 'complete,' 'good,' and 'moderate' in 7 (70%), 1 (10%), and 2 (20%) patients, respectively. CONCLUSION With this technique, patients with restricted sites of involvement, that did not respond to the usual treatments showed very good repigmentation without any additional phototherapy over a 6-month follow-up; moreover, there were no side effects such as scarring.
Collapse
Affiliation(s)
- Masoud Maleki
- Research Center for Skin Disease and Cutaneous Leishmaniasis, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | | |
Collapse
|
18
|
Khunger N, Kathuria SD, Ramesh V. Tissue grafts in vitiligo surgery - past, present, and future. Indian J Dermatol 2010; 54:150-8. [PMID: 20101311 PMCID: PMC2807155 DOI: 10.4103/0019-5154.53196] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Vitiligo, characterized by depigmented macules is a common disorder with a high psychosocial impact, particularly in darker skins. Surgical methods become important in cases where medical therapy fails to cause repigmentation or in cases of segmental vitiligo where the response to surgery is excellent. The basic principle of surgical treatment is autologous grafting of viable melanocytes from pigmented donor skin to recipient vitiliginous areas. Various grafting methods have been described including tissue grafts and cellular grafts. Stability of the disease is the most important criterion to obtain a successful outcome. Counseling of the patient regarding the outcome is vital before surgery. The technique and followup management of the tissue grafts has been described in detail in this review.
Collapse
Affiliation(s)
- Niti Khunger
- Department of Dermatology and STD, V.M. Medical College and Safdarjang Hospital, New Delhi, India.
| | | | | |
Collapse
|