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Poondru S, Yang LJ, Kundu RV. Use of complementary and alternative medicine in vitiligo: a cross-sectional survey. Arch Dermatol Res 2024; 316:126. [PMID: 38652183 DOI: 10.1007/s00403-024-02872-x] [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: 02/20/2024] [Revised: 02/20/2024] [Accepted: 04/07/2024] [Indexed: 04/25/2024]
Abstract
Vitiligo is characterized by skin depigmentation, which can lead to profound psychological effects and decreased quality of life, especially for those with skin of color. Individuals with vitiligo may utilize complementary and alternative medicine (CAM) due to limited treatment options with varying efficacy.An anonymous, multiple-choice, cross-sectional questionnaire was distributed to participants with vitiligo in the United States through online forums. Data on disease characteristics, use of prescription medications, use of topical therapies, supplements, and diets, and perceptions of CAM were collected.In total, 625 respondents completed the survey. Overall, 32.5% of participants (203/625) have tried CAM. Commonly reported CAM include supplements of vitamin D (57.7%, 116/203), vitamin B12 (46.3%, 93/203), vitamin C (27.4%, 55/203), topical Nigella sativa oil (26.4%, 53/203), oral omega-3 fatty acids (24.9%, 50/203), folic acid (22.9%, 46/203), and vitamin E (22.9%, 46/203). Frequently cited reasons for CAM use include desire to try "new" (40.4%, 82/203) or "more natural" (26.6%, 54/203) therapies, "frustration with conventional medicine" (24.6%, 50/203), and fear of "adverse side effects of conventional medicine" (23.6%, 48/203). Non-White participants were more likely than their White counterparts to report CAM use and have more positive perceptions of CAM therapies. Less than half (43.3%, 88/203) of CAM users reported that they disclosed their use of CAM with their physician.Dermatologists should be mindful of CAM and ask patients about their use. Further investigation of the role of CAM as adjuvant therapy for vitiligo is warranted to better advise patients.
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Affiliation(s)
- Sneha Poondru
- Department of Dermatology, Northwestern University Feinberg School of Medicine, 676 N St Clair Street, Suite 1600, Chicago, IL, 60611, USA
| | - Lynna J Yang
- Department of Dermatology, Northwestern University Feinberg School of Medicine, 676 N St Clair Street, Suite 1600, Chicago, IL, 60611, USA
| | - Roopal V Kundu
- Department of Dermatology, Northwestern University Feinberg School of Medicine, 676 N St Clair Street, Suite 1600, Chicago, IL, 60611, USA.
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Hamada R, Funasaka Y, Saeki H, Serizawa N, Hagino T, Yano Y, Mitsui H, Kanda N. Dietary habits in adult Japanese patients with vitiligo. J Dermatol 2024; 51:491-508. [PMID: 38421796 DOI: 10.1111/1346-8138.17163] [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: 01/23/2024] [Revised: 02/04/2024] [Accepted: 02/07/2024] [Indexed: 03/02/2024]
Abstract
Vitiligo is an autoimmune skin disease with acquired depigmentation. Dietary habits may modulate the pathogenesis of vitiligo. We evaluated dietary habits in adult Japanese patients with nonsegmental vitiligo, and compared their results with those of age- and sex-matched controls. We also examined the relationship between dietary habits and Vitiligo Area Scoring Index (VASI), or vitiligo on different anatomical sites. The intakes of energy, nutrients, and foods in the participants were analyzed using a brief-type self-administered diet history questionnaire. Patients with vitiligo showed higher body mass index (BMI) and lower intakes of manganese, vitamin D, pulses, and confection, compared with controls. Multivariate logistic regression analysis showed that vitiligo was associated with high BMI. VASI was higher in males than in females, and negatively correlated with age or intakes of potatoes and vegetables other than green/yellow vegetables. Linear multivariate regression analysis showed that high VASI was associated with younger age. Multivariate logistic regression analysis showed that moderate to severe vitiligo (VASI ≥ 4.25) was associated with male sex and longer disease duration. Multivariate logistic regression analyses showed the following association with vitiligo on respective anatomical sites: high intake of eggs and dairy products and high VASI on the head or neck, high intake of oils and fats and high VASI on the trunk, high intake of cereals and high VASI on the upper limbs, male sex and high VASI on the lower limbs, and high BMI and high VASI on the hands or feet. In conclusion, the control of obesity might have prophylactic or therapeutic effects on vitiligo.
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Affiliation(s)
- Risa Hamada
- Department of Dermatology, Nippon Medical School, Tokyo, Japan
| | - Yoko Funasaka
- Department of Dermatology, Nippon Medical School, Tokyo, Japan
| | - Hidehisa Saeki
- Department of Dermatology, Nippon Medical School, Tokyo, Japan
| | - Naotaka Serizawa
- Department of Dermatology, Nippon Medical School Chiba Hokusoh Hospital, Inzai, Japan
| | - Teppei Hagino
- Department of Dermatology, Nippon Medical School Chiba Hokusoh Hospital, Inzai, Japan
| | | | | | - Naoko Kanda
- Department of Dermatology, Nippon Medical School Chiba Hokusoh Hospital, Inzai, Japan
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Kim JC, Kim HR, Park JS, Lee SY, Kim HO, Park CW, Chung BY. Vitamin D supplementation can enhance therapeutic effects of excimer laser in patients with vitiligo. J Cosmet Dermatol 2024; 23:839-848. [PMID: 37864402 DOI: 10.1111/jocd.16043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 10/03/2023] [Accepted: 10/13/2023] [Indexed: 10/22/2023]
Abstract
PURPOSE Vitiligo is a disease of acquired depigmentation characterized by the destruction of melanocytes. A theoretical association between low level of 25-hydroxyvitamin D [25(OH)D] and vitiligo has been previously suggested. The objective of this study was to determine the efficacy of intramuscular injection of cholecalciferol with excimer laser compared with the excimer laser alone for vitiligo treatment. METHODS This study included 26 patients diagnosed with non-segmental vitiligo and low serum 25(OH)D levels (<20 ng/mL). The participants were randomly divided into two groups through randomization. The treatment using a 308-nm excimer laser was administered to both groups, and the study group additionally received cholecalciferol injection. RESULTS The Vitiligo Area Scoring Index (VASI) scores showed an 83.6% improvement over the initial score in the study group, whereas the control group showed a 54.7% improvement after 6 months of treatment. After 6 months of treatment, the study group showed a significantly higher proportion of patients who achieved VASI50 and VASI75 compared with the control group. CONCLUSION Intramuscular injection of cholecalciferol can be a supplemental option for the treatment of vitiligo patients with vitamin D deficiency with excimer laser therapy.
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Affiliation(s)
- Jin Cheol Kim
- Department of Dermatology, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea
| | - Hye Ran Kim
- Department of Dermatology, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea
| | - Jin Seo Park
- Department of Dermatology, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea
| | - So Yeon Lee
- Department of Dermatology, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea
| | - Hye One Kim
- Department of Dermatology, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea
| | - Chun Wook Park
- Department of Dermatology, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea
| | - Bo Young Chung
- Department of Dermatology, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea
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Hitesh T, Khatuja R, Agrawal P, Dhamnetiya D, Jha RP, Renjhen P. Unlocking the mystery of the role of Vitamin D in iron deficiency anemia in antenatal women: a case control study in a tertiary care hospital in New Delhi. BMC Pregnancy Childbirth 2023; 23:749. [PMID: 37875802 PMCID: PMC10594760 DOI: 10.1186/s12884-023-06047-w] [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: 07/03/2023] [Accepted: 10/03/2023] [Indexed: 10/26/2023] Open
Abstract
BACKGROUND Vitamin D deficiency and anemia are clinical conditions that coexist during pregnancy. A high prevalence of Vitamin D deficiency ranging from 50 to 94% is seen throughout the country. The aim of the study was to discover the association between Vitamin D status and iron deficiency anemia during pregnancy. Improving the vitamin D status of pregnant women is crucial to prevent iron deficiency anemia and can improve maternal and fetal outcomes. METHODS A case-control study including 94 primigravida women of age within the age group 18 to 30 years, divided into two groups: a Case Group of 48 patients with already diagnosed iron deficiency anemia (mild to moderate) and a Control Group of 46 antenatal women with normal hemoglobin levels. Data on sociodemographic, clinical characteristics, and the levels of 25(OH) Vitamin D was estimated in both the groups. The association of 25(OH)D levels and anemia was then determined using suitable statistical analysis. RESULTS Among pregnant women affected with anemia, 75% of women had serum Vitamin D concentrations < 20 ng/ml compared to 52.2% of women in the controls. Maternal serum vitamin D level was significantly lower in pregnant women affected with anemia (19.61 ± 13.12) as compared to control (29.43 ± 24.05); (p = 0.024). A positive correlation was found between hemoglobin and vitamin D levels in pregnant women (Pearson's r = 0.200, p = 0.05). CONCLUSIONS These findings provide evidence suggesting that Vitamin D deficiency or insufficiency during pregnancy may be a risk factor for anemia and correction of Vitamin D levels can improve hemoglobin levels. Educational efforts should be made to include safe vitamin D intake in antenatal care.
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Affiliation(s)
- Tanishq Hitesh
- Dr. Baba Saheb Ambedkar Medical College and Hospital, Delhi, 110085, India
| | - Ritu Khatuja
- Department of Obstetrics and Gynaecology, Dr. Baba Saheb Ambedkar Medical College and Hospital, Delhi, 110085, India.
| | - Poonam Agrawal
- Department of Biochemistry, Dr. Baba Saheb Ambedkar Medical College and Hospital, Delhi, 110085, India
| | - Deepak Dhamnetiya
- Department of Community Medicine, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, Delhi, New Delhi, 110001, India
| | - Ravi Prakash Jha
- Department of Community Medicine, Dr. Baba Saheb Ambedkar Medical College and Hospital, Delhi, 110085, India
| | - Prachi Renjhen
- Department of Obstetrics and Gynaecology, Dr. Baba Saheb Ambedkar Medical College and Hospital, Delhi, 110085, India
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Gallo D, Baci D, Kustrimovic N, Lanzo N, Patera B, Tanda ML, Piantanida E, Mortara L. How Does Vitamin D Affect Immune Cells Crosstalk in Autoimmune Diseases? Int J Mol Sci 2023; 24:ijms24054689. [PMID: 36902117 PMCID: PMC10003699 DOI: 10.3390/ijms24054689] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 02/16/2023] [Accepted: 02/25/2023] [Indexed: 03/05/2023] Open
Abstract
Vitamin D is a secosteroid hormone that is highly involved in bone health. Mounting evidence revealed that, in addition to the regulation of mineral metabolism, vitamin D is implicated in cell proliferation and differentiation, vascular and muscular functions, and metabolic health. Since the discovery of vitamin D receptors in T cells, local production of active vitamin D was demonstrated in most immune cells, addressing the interest in the clinical implications of vitamin D status in immune surveillance against infections and autoimmune/inflammatory diseases. T cells, together with B cells, are seen as the main immune cells involved in autoimmune diseases; however, growing interest is currently focused on immune cells of the innate compartment, such as monocytes, macrophages, dendritic cells, and natural killer cells in the initiation phases of autoimmunity. Here we reviewed recent advances in the onset and regulation of Graves' and Hashimoto's thyroiditis, vitiligo, and multiple sclerosis in relation to the role of innate immune cells and their crosstalk with vitamin D and acquired immune cells.
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Affiliation(s)
- Daniela Gallo
- Endocrine Unit, Department of Medicine and Surgery, University of Insubria, ASST dei Sette Laghi, 21100 Varese, Italy
| | - Denisa Baci
- Immunology and General Pathology Laboratory, Department of Biotechnology and Life Sciences, University of Insubria, 21100 Varese, Italy
- Molecular Cardiology Laboratory, IRCCS-Policlinico San Donato, San Donato Milanese, 20097 Milan, Italy
| | - Natasa Kustrimovic
- Center for Translational Research on Autoimmune and Allergic Disease—CAAD, Università del Piemonte Orientale, 28100 Novara, Italy
| | - Nicola Lanzo
- Endocrine Unit, Department of Medicine and Surgery, University of Insubria, ASST dei Sette Laghi, 21100 Varese, Italy
| | - Bohdan Patera
- Endocrine Unit, Department of Medicine and Surgery, University of Insubria, ASST dei Sette Laghi, 21100 Varese, Italy
| | - Maria Laura Tanda
- Endocrine Unit, Department of Medicine and Surgery, University of Insubria, ASST dei Sette Laghi, 21100 Varese, Italy
| | - Eliana Piantanida
- Endocrine Unit, Department of Medicine and Surgery, University of Insubria, ASST dei Sette Laghi, 21100 Varese, Italy
| | - Lorenzo Mortara
- Immunology and General Pathology Laboratory, Department of Biotechnology and Life Sciences, University of Insubria, 21100 Varese, Italy
- Correspondence:
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Fröhlich-Reiterer E, Elbarbary NS, Simmons K, Buckingham B, Humayun KN, Johannsen J, Holl RW, Betz S, Mahmud FH. ISPAD Clinical Practice Consensus Guidelines 2022: Other complications and associated conditions in children and adolescents with type 1 diabetes. Pediatr Diabetes 2022; 23:1451-1467. [PMID: 36537532 DOI: 10.1111/pedi.13445] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Affiliation(s)
- Elke Fröhlich-Reiterer
- Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria
| | | | - Kimber Simmons
- Barbara Davis Center for Diabetes, University of Colorado, Denver, Colorado, USA
| | - Bruce Buckingham
- Division of Endocrinology and Diabetes, Department of Pediatrics, Stanford University Medical Center, Stanford, California, USA
| | - Khadija N Humayun
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Jesper Johannsen
- Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital, Herlev and Steno Diabetes Center Copenhagen, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Reinhard W Holl
- Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Ulm, Germany
| | - Shana Betz
- Parent/Advocate for people with diabetes, Markham, Canada
| | - Farid H Mahmud
- Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
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Beyzaee AM, Goldust M, Patil A, Rokni GR, Beyzaee S. The role of cytokines and vitamin D in vitiligo pathogenesis. J Cosmet Dermatol 2022; 21:6314-6325. [PMID: 35871394 DOI: 10.1111/jocd.15272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 07/06/2022] [Accepted: 07/08/2022] [Indexed: 12/27/2022]
Abstract
Vitiligo is a pigment-related disease with a global prevalence of 0.2% to 1.8% associated with considerable burden on quality of life. The treatment is still a challenge because of relapses and/or incomplete re-pigmentation. Although the exact cause is still unclear, its pathogenesis seems to be justifiable with the autoimmune theory, supported by the results of clinical research. In this narrative review, we aimed to summarize the evidence related to cytokines and vitiligo development. This review is consisted of English articles published in PubMed and Google Scholar concerning levels of inflammatory mediators, especially interleukins, in vitiligo patients over the last 20 years. References of relevant articles were also considered for review. Crucial role of dysregulated levels of interleukins and their synergistic function to each other, in the onset or progression of the disease is evident. The theory of autoimmune vitiligo is reinforced by the results of the studies in the literature, due to the association of pathogenesis with increased secretion of pro-inflammatory mediators and reduction of anti-inflammatory mediators. Decreased vitamin D levels may have a considerable role in vitiligo development by affecting Th1- and Th17-related immune responses. Cytokines play an important role in the pathogenesis or progression of the disease. Moreover, we believe that decreased vitamin D level has a considerable role in vitiligo development by affecting Th1- and Th17-related immune responses.
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Affiliation(s)
| | - Mohamad Goldust
- Department of Dermatology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Anant Patil
- Department of Pharmacology, Dr. DY Patil Medical College, Navi Mumbai, India
| | - Ghasem Rahmatpour Rokni
- Department of Dermatology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Samira Beyzaee
- Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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8
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Caswell G, Eshelby B. Skin microbiome considerations for long haul space flights. Front Cell Dev Biol 2022; 10:956432. [PMID: 36158225 PMCID: PMC9493037 DOI: 10.3389/fcell.2022.956432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 08/19/2022] [Indexed: 11/13/2022] Open
Abstract
Dysbiosis of the human skin microbiome has long been associated with changes to the pH of the skin, dermal immune function and chronic skin conditions. Dermatological issues have been noted as the most prevalent medical presentation in the microgravity environment of space. The change in gravitational forces has been implicated in human immuno-suppression, also impacted by changes in the gastrointestinal-skin axis and its impact on Vitamin D metabolism, altered microbial gene expression in resident flora (leading changes in biofilm formation) and increased virulence factors in potential pathogens. There are also other stressors to the skin microbiome unique to space travel, including increased exposure to radiation, prolonged periods of dry washing technique, air quality and changes in microbe replication and growth parameters. Optimal microbiome health leads to enhanced skin barrier manufacture and maintenance, along with improved skin immune function and healing. In a microgravity environment expected to be experienced during long space flights, disruptions to the skin microbiome, coupled with increased virulence of pathological viruses and bacteria has implications for holistic skin health, astronaut cognitive function and mental health, and is coupled with slowed rates of wound healing. Scenario management for holistic skin health and restoration of microbiome homeostasis on long space flights require consideration.
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Song J, Liu K, Chen W, Liu B, Yang H, Lv L, Sun X, Mao Y, Ye D. Circulating Vitamin D Levels and Risk of Vitiligo: Evidence From Meta-Analysis and Two-Sample Mendelian Randomization. Front Nutr 2022; 8:782270. [PMID: 35004812 PMCID: PMC8727691 DOI: 10.3389/fnut.2021.782270] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 11/29/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The association between circulating vitamin D levels and risk of vitiligo was inconsistent among observational studies, and whether these observed associations were causal remained unclear. Therefore, we aimed to evaluate the effect of vitamin D on the risk of vitiigo using meta-analysis and Mendelian randomization (MR). Methods: At the meta-analysis stage, literature search was performed in PubMed and Web of Science to identify eligible observational studies examining the association of circulating 25-hydroxyvitamin D [25(OH)D] or 25-hydroxyvitamin D3 [25(OH)D3] levels with risk of vitiligo up to April 30, 2021. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) of 25(OH)D and 25(OH)D3 in patients with vitiligo relative to controls were pooled. Then at the MR stage, genetic instruments for circulating 25(OH)D (N = 120,618) and 25(OH)D3 (N = 40,562) levels were selected from a meta-analysis of genome-wide association studies (GWAS) of European descent, and summary statistics of vitiligo were obtained from a meta-analysis of three GWASs including 4,680 cases and 39,586 controls. We used inverse-variance weighted (IVW) as main method, followed by weighted-median and likelihood-based methods. Pleiotropic and outlier variants were assessed by MR-Egger regression and MR Pleiotropy RESidual Sum and Outlier (MR-PRESSO) test. Results: In the meta-analysis, patients with vitiligo had a lower level of circulating 25(OH)D compared with controls [SMD = −1.40; 95% confidence interval (CI): −1.91, −0.89; P < 0.001], while no statistically significant difference of 25(OH)D3 between vitiligo cases and controls was found (SMD = −0.63; 95% CI: −1.29, 0.04; P = 0.064). However, in the MR analyses, genetically predicted 25(OH)D [odds ratio (OR) = 0.93, 95% CI = 0.66–1.31, P = 0.66] and 25(OH)D3 levels (OR = 0.95, 95% CI = 0.80–1.14, P = 0.60) had null associations with risk of vitiligo using the IVW method. Sensitivity analyses using alternative MR methods and instrumental variables (IV) sets obtained consistent results, and no evidence of pleiotropy or outliers was observed. Conclusion: Our study provided no convincing evidence for a causal effect of 25(OH)D or 25(OH)D3 levels on the risk of vitiligo. Further longitudinal and experimental studies, as well as functional studies are warranted to elucidate the role of vitamin D in the development of vitiligo.
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Affiliation(s)
- Jie Song
- Department of Epidemiology, School of Public Health, Zhejiang Chinese Medical University, Hangzhou, China
| | - Ke Liu
- Department of Epidemiology, School of Public Health, Zhejiang Chinese Medical University, Hangzhou, China
| | - Weiwei Chen
- Department of Epidemiology, School of Public Health, Zhejiang Chinese Medical University, Hangzhou, China
| | - Bin Liu
- Department of Epidemiology, School of Public Health, Zhejiang Chinese Medical University, Hangzhou, China
| | - Hong Yang
- Department of Epidemiology, School of Public Health, Zhejiang Chinese Medical University, Hangzhou, China
| | - Linshuoshuo Lv
- Department of Epidemiology, School of Public Health, Zhejiang Chinese Medical University, Hangzhou, China
| | - Xiaohui Sun
- Department of Epidemiology, School of Public Health, Zhejiang Chinese Medical University, Hangzhou, China
| | - Yingying Mao
- Department of Epidemiology, School of Public Health, Zhejiang Chinese Medical University, Hangzhou, China
| | - Ding Ye
- Department of Epidemiology, School of Public Health, Zhejiang Chinese Medical University, Hangzhou, China
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Mahmmod Z, Ismael DK. Vitamin D Deficiency in Patients With Vitiligo: A Cross-Sectional Study From Basrah, Iraq. Cureus 2021; 13:e20733. [PMID: 35111426 PMCID: PMC8790802 DOI: 10.7759/cureus.20733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/27/2021] [Indexed: 11/05/2022] Open
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Sardana K, Sachdeva S. Role of nutritional supplements in selected dermatological disorders: A review. J Cosmet Dermatol 2021; 21:85-98. [PMID: 34564936 DOI: 10.1111/jocd.14436] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 08/26/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND While a plethora of literature continues to be published on the role of nutritional agents both in lay press and indexed journals, the data is not on a firm footing and leaves the dermatologist in a quandry and the patient confused. The various agents include vitamins, minerals, amino acids, antioxidants, diets & gluten. A proper knowledge of the role of nutritional supplements in dermatological diseases can be a useful tool in advising the patients and in certain cases ameliorating the disorder. PATIENTS/METHODS Literature review of last 15 years was made using the terms "diet in dermatology," "nutrition and skin," "nutritional supplements in dermatology," "nutritional agents and acne," "nutritional agents and alopecia," and "nutritional agents and psoriasis." RESULTS While there are multiple publications on the use of nutritional supplements for amelioration of skin diseases, most of them are based on either associations or in vitro studies, but very few transcend the rigors of a clinical trial or the holey grail of a double-blinded randomized controlled trial. There seem to be some evidence in acne, psoriasis, telogen effluvium, urticaria & vitiligo. Coeliac disease and dermatitis herpetiformis have a strong link with diet. Rosacea has a strong link with certain foods, but the other disorders like melasma, aphthous stomatitis do not have any scientifically validated association with diet. CONCLUSIONS Our updated review examines the role of nutritional supplements and antioxidants in various dermatological disorders. We have found that there are varying levels of evidence with notable associations of low glycemic diet & acne, fish oil & weight loss with psoriasis, fish oils & probiotics with atopic dermatitis & vitamins & botanical extracts with vitiligo. The evidence for diet and nutrition in bullous disorders and photoageing is scarce. The role of low histamine diet in urticaria is useful in select cases of episodic urticaria. Rosacea is triggered by hot and spicy food . Apart from gluten and Dermatitis Herpetiformis, no diet can be considered disease modifying in our reveiw. The lack of comparison of nutritional or dietary modiffication with conventional validated agents, makes the data difficult to translate in real world patient management.
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Affiliation(s)
- Kabir Sardana
- Department of Dermatology, Venereology and Leprosy, Dr Ram Manohar Lohia Hospital and Post Graduate Institute of Medical Education and Research, New Delhi, India
| | - Soumya Sachdeva
- Department of Dermatology, Venereology and Leprosy, Dr Ram Manohar Lohia Hospital and Post Graduate Institute of Medical Education and Research, New Delhi, India
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Varikasuvu SR, Aloori S, Varshney S, Bhongir AV. Decreased circulatory levels of Vitamin D in Vitiligo: a meta-analysis. An Bras Dermatol 2021; 96:284-294. [PMID: 33863565 PMCID: PMC8178549 DOI: 10.1016/j.abd.2020.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 10/08/2020] [Accepted: 10/08/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The serum Vitamin D status in patients with vitiligo is ambiguous when compared to controls. A systematic review and updated meta-analysis were conducted to evaluate the association between Vitamin D and vitiligo. METHODS Relevant studies were identified by searching PubMed and other databases. The random effects model was used to obtain standardized mean differences and pooled correlation coefficients. Meta-regression and sub-group analyses were conducted to explore heterogeneity. The presence of publication bias and the study robustness were tested using funnel plot and sensitivity analyses, respectively. RESULTS This meta-analysis finally included 31 studies. Compared with controls, vitiligo patients showed significantly decreased serum Vitamin D levels (standardized mean difference = -1.03; p < 0.0001). The sub-group analysis showed that vitiligo patients with indoor/urban work had a significantly lower Vitamin D level when compared to their outdoor/rural counterparts (standardized mean differences = -0.45; p = 0.03). The sensitivity analysis indicated that no single study had a significant influence on the overall outcome, suggesting the robustness of this meta-analysis. STUDY LIMITATIONS Varied sample sizes and heterogeneous study populations from different countries are the limitations of this study. However, the between-study heterogeneity has been addressed by the random-effects model with meta-regression and sensitivity analyses. CONCLUSIONS This meta-analysis showed significantly decreased Vitamin D level in vitiligo, and its association with indoor/outdoor type of work of vitiligo patients. This study highlights the need to assess Vitamin D status for improving its level in vitiligo.
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Affiliation(s)
| | - Sowjanya Aloori
- Department of Health Education, Telangana State Residential School & College, Choutuppal, India
| | | | - Aparna Varma Bhongir
- Department of Biochemistry, All India Institute of Medical Sciences, Bibinagar, India
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Shakhbazova A, Wu H, Chambers CJ, Sivamani RK. A Systematic Review of Nutrition, Supplement, and Herbal-Based Adjunctive Therapies for Vitiligo. J Altern Complement Med 2020; 27:294-311. [PMID: 33337930 DOI: 10.1089/acm.2020.0292] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Background: Vitiligo is an autoimmune skin condition that affects people globally anywhere, from <0.1% to more than 8% of individuals. The disease destroys skin melanocytes, resulting in a patchy depigmentation of the skin. About 50% of all patients develop the disease before their 20s. Methods: We systematically searched the literature and reviewed the evidence for the use of nutritional supplements and diet in the management of vitiligo. Embase and Medline were searched for diet, herbal, and nutrition-based clinical studies. Additional filters were applied that looked for controlled trial or randomized controlled trial and article or article in press or letter and English and clinical study. We selected clinical studies in humans that showed how diet or natural supplements can improve the symptoms of vitiligo in all of our searches. Results: There were 62 manuscripts that resulted from the PubMed search and 259 from the Embase search. A final of 26 studies were reviewed, and other supplemental case and case-control studies were used to introduce diet components that may influence either exacerbation or amelioration of vitiligo. Possible mechanisms of action are introduced for natural and supplemental interventions. Conclusion: Some of the supplements reviewed include Gingko biloba, oral Polypodium leucotomos, alpha lipoic acid, vitamins B12, D, and E, folic acid, phenylalanine, canthaxanthin, Nigella sativa oil, and other combined herbal bio-actives. Overall, the growing evidence is promising, but more studies are needed in this area to further explore the impact that supplements and diet can have on vitiligo management. The most promising therapies included oral phenylalanine as adjuvant therapy with UVA therapy, oral G. biloba as monotherapy, both of which can be used with other traditional therapies, and oral P. leucotomos with phototherapy or photochemotherapy.
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Affiliation(s)
| | - Hera Wu
- College of Medicine, California Northstate University, Elk Grove, CA, USA.,Department of Dermatology, University of California, Davis, Sacramento, CA, USA
| | - Cindy J Chambers
- College of Medicine, California Northstate University, Elk Grove, CA, USA.,Pacific Skin Institute, Sacramento, CA, USA.,Zen Dermatology, Sacramento, CA, USA
| | - Raja K Sivamani
- College of Medicine, California Northstate University, Elk Grove, CA, USA.,Department of Dermatology, University of California, Davis, Sacramento, CA, USA.,Pacific Skin Institute, Sacramento, CA, USA.,Zen Dermatology, Sacramento, CA, USA.,Department of Biological Sciences, California State University, Sacramento, Sacramento, CA, USA
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14
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Casini L, Zago D, Cavicchioli E, Tomiazzo C. Serum 25-hydroxyvitamin D concentration in Japanese Akita dogs: A survey. Vet Anim Sci 2020; 10:100139. [PMID: 32875143 PMCID: PMC7451697 DOI: 10.1016/j.vas.2020.100139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 08/14/2020] [Accepted: 08/16/2020] [Indexed: 11/23/2022] Open
Abstract
Low serum 25-hydroxyvitamin D levels are detected in Japanese Akita dogs. Healthy Akitas show a higher level of vitamin D than pathological ones. Depigmented skin areas appearance is associated with low levels of vitamin D. Sebaceous adenitis is the prevalent disease recorded among investigated Akitas.
Low serum level of vitamin D has been linked to numerous diseases. The Akita breed of dog shows a high incidence of immune-mediated diseases such as uveodermatologic (UVD) syndrome and sebaceous adenitis (SA). Furthermore, in Japanese Akita dogs, skin depigmentation often appears after birth at different ages, in healthy dogs, and without any other symptoms. In humans poliosis is associated to low vitamin D level. The aim of this survey was to evaluate serum 25-hydroxyvitamin D (25(OH)D) levels in Japanese Akita dogs. One hundred and three Akita blood samples were collected for the 25(OH)D evaluation. Age, sex, current disease, presence and location of skin depigmentation, and diet were reported on a medical record. Based on history and clinical examination, dogs were classified according their health status as healthy (HE) or pathological (PA). The overall mean of 25(OH)D concentration was 82.42 ± 26.14 ng/mL, whereas the concentrations in the healthy dogs were significantly higher (84.90 ± 3.36 ng/mL) in comparison with the dogs with diseases (72.13 ± 4.09 ng/mL) (P < 0.01). In this study, the depigmented healthy dogs showed low level of 25(OH)D and very similar to the sick group. The appearance of depigmented areas associated with low levels of vitamin D could be considered as an alert sign in Akitas as well as in humans. However, clinical trials should also be carried out to establish whether vitamin D supplementation could be an effective preventive treatment to limit the onset of immune-mediated diseases in Japanese Akita dogs.
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Affiliation(s)
- L Casini
- Department of Veterinary Science, University of Pisa, Viale delle Piagge 2, 56124 Pisa, Italy
| | - D Zago
- Veterinary Clinic San Giacomo, Via Risorgimento 42b, 35020 Albinasego, Padova, Italy
| | - E Cavicchioli
- Veterinary Clinic San Giacomo, Via Risorgimento 42b, 35020 Albinasego, Padova, Italy
| | - C Tomiazzo
- Veterinary Clinic San Giacomo, Via Risorgimento 42b, 35020 Albinasego, Padova, Italy
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15
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Association of Alopecia Areata with Vitamin D and Calcium Levels: A Systematic Review and Meta-analysis. Dermatol Ther (Heidelb) 2020; 10:967-983. [PMID: 32772238 PMCID: PMC7477029 DOI: 10.1007/s13555-020-00433-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Indexed: 12/13/2022] Open
Abstract
Introduction To investigate the associations of alopecia areata (AA) with serum vitamin D and calcium levels. Methods A systematic review of all relevant articles published up to February 2020 in PubMed, Embase, and Cochrane Library databases was conducted. Primary endpoints were serum 25-hydroxyvitamin D [25(OH)D] levels and vitamin D deficiency, and the secondary endpoint was serum calcium level. Odds ratio (OR) and standardized mean difference (SMD) with 95% CI across studies were analyzed. Results Data on 1585 patients with AA and 1114 controls from 16 case–control studies and three cross-sectional studies were included in this meta-analysis. A pooled meta-analysis was conducted using the random-effects model because of inter-study heterogeneity (vitamin D level, I2 = 87.90%; vitamin D deficiency, I2 = 81.10%; serum calcium level, I2 = 83.80%). A combined analysis revealed that patients with AA had significantly lower mean serum 25(OH)D level compared with control (WMD − 9.08, 95% CI − 11.65, − 6.50, p < 0.001), and were more likely to have vitamin D deficiency (OR 4.14, 95% CI 2.34, 7.35, p < 0.001). However, the pooled analysis revealed that patients with AA did not have significantly lower serum calcium levels compared with control (WMD − 0.17, 95% CI − 0.40, 0.06, p = 0.143). Subgroup analysis suggested that matched control, mean age, and country might contribute to the heterogeneity of serum vitamin D level, while study design, matched control, and country might contribute to the heterogeneity of vitamin D deficiency. Conclusion Deficiency of serum 25(OH)D level, rather than calcium level, was present in patients with AA. Screening for vitamin D deficiency and vitamin D supplementation may be beneficial in the treatment of patients with AA. Electronic supplementary material The online version of this article (10.1007/s13555-020-00433-4) contains supplementary material, which is available to authorized users.
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16
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Saudi WM, Swelam MM, El-Barbary RAH, Zakaria L, Gaber DA. Vitamin D receptor (VDR) gene polymorphism in Egyptian vitiligo patients. J Cosmet Dermatol 2020; 20:980-986. [PMID: 32648639 DOI: 10.1111/jocd.13606] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 07/01/2020] [Accepted: 07/06/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND Vitiligo is an autoimmune dermatological disorder, precipitated by genetic and nongenetic factors leading to destruction of epidermal melanocytes. In Egypt, it has a prevalence rate of 1.2%. Vitamin D has stimulatory and protective effects on melanocytes and acts through its nuclear vitamin D receptor (VDR) on target cells. The consequences of polymorphisms in VDR have been previously studied for mapping their link with various disorders of autoimmune etiology. AIM OF THIS WORK To study Apa-I and Taq-I VDR single-nucleotide polymorphisms (SNPs) and the risk to develop vitiligo. METHODS Extracted genomic DNA from the venous blood of 60 patients and controls was amplified and analyzed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) for analysis of VDR gene polymorphisms. Serum 25-hydroxyvitamin D3 (25-OH-D3) level was measured using ELISA technique. RESULTS The most common VDR genotypes were AA and TT among both groups with no significant difference. Analysis of the frequency of combinations of genotypes revealed AATT as the most common among patients (36.7%) while in the control group, AATt is the most common (33.3%) but no significant difference was noted on comparison of both groups. The genotype allele tt appeared to be more expressed in patients with marginal significance value (P 0.053). Serum 25-OH-D3 showed a relatively decreased level among patients and controls with no statistically significant difference. CONCLUSION Although VDR SNPs are not correlated with vitiligo, the elevated frequency of tt genotype among vitiligo patients may suggest the risk to develop the disease.
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Affiliation(s)
- Wael M Saudi
- Dermatology and Venerology Department, Faculty of Medicine, Misr University for Science and Technology, Cairo, Egypt
| | - Mervat M Swelam
- Dermatology and Venerology Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | - Rasha A H El-Barbary
- Dermatology and Venerology Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | - Lola Zakaria
- Dermatology and Venerology Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | - Dalia A Gaber
- Medical Biochemistry and Molecular Biology Department, Faculty of Medicine, Helwan University, Cairo, Egypt
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17
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Murdaca G, Tonacci A, Negrini S, Greco M, Borro M, Puppo F, Gangemi S. Emerging role of vitamin D in autoimmune diseases: An update on evidence and therapeutic implications. Autoimmun Rev 2019; 18:102350. [PMID: 31323357 DOI: 10.1016/j.autrev.2019.102350] [Citation(s) in RCA: 153] [Impact Index Per Article: 30.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 03/08/2019] [Indexed: 12/24/2022]
Abstract
Vitamin D plays a key role in in calcium homeostasis and, thus, provides an important support in bone growth by aiding in the mineralization of the collagen matrix. However, vitamin D performs various immunomodulatory, anti-inflammatory, antioxidant and anti-fibrotic actions. Autoimmune diseases result from an aberrant activation of the immune system, whereby the immune response is directed against harmless self-antigens. Does vitamin D play a role in the pathophysiology of autoimmune diseases? And, if so, what is its role? In the last decade, researchers' interest in vitamin D and its correlations with autoimmune diseases has considerably increased. We conducted a literature review, covering the period January 1, 2009 through March 30, 2019, in PubMed. We analyzed more than 130 studies in order to find a correlation between vitamin D levels and its effect upon several autoimmune diseases. The analysis demonstrated an inverse association between vitamin D and the development of several autoimmune diseases, such as SLE, thyrotoxicosis, type 1 DM, MS, iridocyclitis, Crohn's disease, ulcerative colitis, psoriasis vulgaris, seropositive RA, polymyalgia rheumatica. International multicenter study could allow us to confirm the data already present in the literature in the single clinical studies and to evaluate when to effectively supplement vitamin D in patients who do not take corticosteroids.
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Affiliation(s)
- Giuseppe Murdaca
- Clinical Immunology Unit, Department of Internal Medicine, University of Genoa and Ospedale Policlinico San Martino,Genoa, Italy.
| | - Alessandro Tonacci
- Clinical Physiology Institute, National Research Council of Italy (IFC-CNR), Pisa, Italy
| | - Simone Negrini
- Clinical Immunology Unit, Department of Internal Medicine, University of Genoa and Ospedale Policlinico San Martino,Genoa, Italy
| | - Monica Greco
- Clinical Immunology Unit, Department of Internal Medicine, University of Genoa and Ospedale Policlinico San Martino,Genoa, Italy
| | - Matteo Borro
- Clinical Immunology Unit, Department of Internal Medicine, University of Genoa and Ospedale Policlinico San Martino,Genoa, Italy
| | - Francesco Puppo
- Clinical Immunology Unit, Department of Internal Medicine, University of Genoa and Ospedale Policlinico San Martino,Genoa, Italy
| | - Sebastiano Gangemi
- School and Operative Unit of Allergy and Clinical Immunology, Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy
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18
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Ochoa-Ramírez LA, Díaz-Camacho SP, Becerra-Loaiza DS, Verdugo-Nieto L, Muñoz-Estrada VF, Servín-Vázquez LA, Osuna-Ramírez I, Rodríguez-Millán J, Velarde-Félix JS. Catalase but not vitamin D receptor gene polymorphisms are associated with nonsegmental vitiligo in Northwestern Mexicans. Int J Dermatol 2019; 58:1264-1269. [PMID: 31120146 DOI: 10.1111/ijd.14508] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 03/19/2019] [Accepted: 04/29/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Vitiligo is an acquired pigmentation disorder characterized by melanocyte loss via autoimmune mechanisms triggered by oxidative stress. Gene polymorphisms in antioxidant enzymes and immunomodulators such as catalase (CAT) and vitamin D receptor (VDR), respectively, have been linked to vitiligo in European and Asian populations. Our aim was to evaluate the role of CAT and VDR gene polymorphisms as well as CAT and vitamin D in nonsegmental vitiligo in Northwestern Mexicans. METHODS A total of 357 subjects, 173 nonsegmental vitiligo patients and 184 age-gender matched healthy controls, were genotyped by PCR-restriction fragment length polymorphism. CAT activity was determined in 39 patients and in 39 controls and vitamin D (VitD) levels in 35 individuals per group. RESULTS CAT 419 C/T gene polymorphism was not informative, -89 A/T was associated with risk (P = 0.02), and 389 C/T conferred protection against vitiligo along with AT haplotype (P < 0.01 in both cases). VDR BsmI, ApaI, and TaqI gene polymorphisms were not associated with vitiligo, but BsmI was more prevalent in patients with Koebner phenomenon (P = 0.02). Serum CAT activity and VitD levels were lower in patients than in controls, but they showed no association with any vitiligo clinical characteristics neither with their gene polymorphisms. CONCLUSIONS Our results suggest a role for CAT gene polymorphisms in vitiligo susceptibility in the Mexican population and a lack of association with VDR gene polymorphisms.
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Affiliation(s)
- Luis A Ochoa-Ramírez
- Facultad en Ciencias Químico Biológicas, Universidad Autónoma de Sinaloa (UAS), Culiacán, Sinaloa, México
| | - Sylvia P Díaz-Camacho
- Unidad de Investigaciones en Ambiente y Salud, Universidad Autónoma de Occidente, Culiacán, Sinaloa, México
| | - Denisse S Becerra-Loaiza
- Facultad en Ciencias Químico Biológicas, Universidad Autónoma de Sinaloa (UAS), Culiacán, Sinaloa, México
| | - Lucía Verdugo-Nieto
- Servicios de Salud Sinaloa, Hospital General de Culiacán, Culiacán, Sinaloa, México
| | - Víctor F Muñoz-Estrada
- Centro de Investigación y Docencia en Ciencias de la Salud, UAS, Culiacán, Sinaloa, México
| | | | - Ignacio Osuna-Ramírez
- Facultad en Ciencias Químico Biológicas, Universidad Autónoma de Sinaloa (UAS), Culiacán, Sinaloa, México
| | | | - Jesús S Velarde-Félix
- Facultad en Ciencias Químico Biológicas, Universidad Autónoma de Sinaloa (UAS), Culiacán, Sinaloa, México.,Servicios de Salud Sinaloa, Hospital General de Culiacán, Culiacán, Sinaloa, México.,Facultad de Biología, UAS, Culiacán, Sinaloa, México
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19
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Siddappa H, Kumar YHK, Vivekananda N. Evaluation of Association of Vitamin D in Alopecia Areata: A Case-control Study of 100 Patients in a Tertiary Rural Hospital of Southern India. Indian Dermatol Online J 2019; 10:45-49. [PMID: 30775298 PMCID: PMC6362755 DOI: 10.4103/idoj.idoj_84_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: Alopecia areata is a common autoimmune disorder which is characterized by non-scarring hair loss. Vitamin D plays an important role in immune regulation, cell growth, differentiation, and maintenance of hair cycle. Aims and Objectives: (1) To evaluate serum vitamin D levels in alopecia areata. (2) To compare serum vitamin D levels in new versus old cases and with respect to severity of alopecia areata. Materials and Methods: A retrospective case–control study with 100 cases of alopecia areata and 100 age- and sex-matched healthy controls was conducted from December 2014 to November 2015. All subjects underwent complete clinical evaluation and serum vitamin D levels. Results: The mean serum vitamin D level was significantly lower in patients with alopecia areata (18.90 ± 8.32 ng/mL) (64%) as compared to healthy controls (28.21 ± 18.32 ng/mL) (38%) (P < 0.001). The mean serum vitamin D levels was significantly lower in old cases (15.11 ± 4.75 ng/mL) as compared to new cases (20.85 ± 9.09 ng/mL) (P < 0.001). The proportion of subects with vitamin D deficiency was significantly higher among old cases (84.3%) as compared to new cases (53.1%) (P < 0.05). There was a significant inverse correlation between Severity of Alopecia Tool scores and serum vitamin D levels (r = −0.298, P < 0.05). Conclusion: Decreased vitamin D levels were observed in patients with alopecia areata and significant inverse correlation exists between vitamin D levels and duration/severity of the disease. These findings may suggest a causal role of vitamin D deficiency in the pathogenesis and therapeutic role of vitamin D supplementation in the management of alopecia areata.
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Affiliation(s)
- Harsha Siddappa
- Department of Dermatology, Raja Rajeswari Medical College and Hospital, Kambipura, Mysore Road, Bangalore, Karnataka, India
| | - Y Hari Kishan Kumar
- Department of Dermatology, Raja Rajeswari Medical College and Hospital, Kambipura, Mysore Road, Bangalore, Karnataka, India
| | - N Vivekananda
- Department of Dermatology, Raja Rajeswari Medical College and Hospital, Kambipura, Mysore Road, Bangalore, Karnataka, India
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20
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Rehman F, Dogra N, Wani MA. Serum Vitamin D Levels and Alopecia Areata- A Hospital Based Case-Control Study from North-India. Int J Trichology 2019; 11:49-57. [PMID: 31007473 PMCID: PMC6463459 DOI: 10.4103/ijt.ijt_3_19] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Background: Alopecia areata (AA) is an autoimmune disease which is characterized by hair loss and affects any hair-bearing area. Low levels of Vitamin D have been implicated in a variety of autoimmune diseases. This study was conducted to assess the levels of Vitamin D in patients with AA and its correlation with severity, pattern, and extent of the disease. Materials and Methods: This hospital-based study included 135 cases with AA and 135 age- and sex-matched controls. AA cases were grouped according to the severity, pattern, and extent of the disease. The levels of Vitamin D were assessed and compared between cases and controls and among different groups of cases. The data were analyzed, and the correlation was derived. Results: The more number of patients from the case group had deficient and insufficient levels of Vitamin D as compared to controls, the difference being statistically significant (P = 0.01). A highly significant difference was found in mean Vitamin D levels between cases and controls (P = 0.0004). A negative correlation was found between Vitamin D levels and severity of AA as accessed by SALT score. A negative correlation was also found between Vitamin D levels with pattern and extent of the disease. Conclusion: Vitamin D deficiency may be one of the factors having a role either in etiopathogenesis or exacerbation of AA. Supplementation of Vitamin D as a treatment modality may improve the clinical outcome of AA.
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Affiliation(s)
- Fozia Rehman
- Department of Dermatology, Venereology and Leprosy, Government Medical College Jammu, SMGS Hospital, Jammu, Jammu and Kashmir, India
| | - Naina Dogra
- Department of Dermatology, Venereology and Leprosy, Government Medical College Jammu, SMGS Hospital, Jammu, Jammu and Kashmir, India
| | - Mashkoor A Wani
- Department of Dermatology, Venereology and Leprosy, Government Medical College Jammu, SMGS Hospital, Jammu, Jammu and Kashmir, India
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21
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Tang L, Fang W, Lin J, Li J, Wu W, Xu J. Vitamin D protects human melanocytes against oxidative damage by activation of Wnt/β-catenin signaling. J Transl Med 2018; 98:1527-1537. [PMID: 30206310 DOI: 10.1038/s41374-018-0126-4] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2018] [Revised: 07/06/2018] [Accepted: 08/09/2018] [Indexed: 12/23/2022] Open
Abstract
Vitamin D analogs have been widely utilized for the treatment of vitiligo, but the molecular mechanism underlying their pharmacological effects (especially their antioxidant properties) has not yet been investigated. We evaluated the relationship between serum vitamin D level and oxidative damage severity in vitiligo patients, and investigated the molecular mechanism of vitamin D in protecting melanocytes against oxidative stress. Serum levels of 25-hydroxyvitamin D and malondialdehyde (MDA) were first measured in patients. A variety of in vitro experiments such as intracellular reactive oxygen species (ROS), cellular viability, migration, and apoptotic assays were then performed to detect the effects of vitamin D or β-catenin silencing on H2O2-treated melanocytes. Expression of Wnt/β-catenin, Nrf2, apoptotic, and MITF pathways was finally examined using quantitative real-time PCR and western blot. In this study, we initially found that vitamin D insufficiency was closely associated with the severity of oxidative stress in vitiligo patients. Using ex vivo cell models, we further showed that vitamin D positively modulated β-catenin signaling at both translational and posttranslational levels in melanocytes under oxidative stress. Like WNT agonists, vitamin D significantly inhibited ROS accumulation and cell apoptosis in H2O2-treated melanocytes and promoted their proliferative and migratory activity, while the protective effects of vitamin D against oxidative stress were abolished by β-catenin silencing in melanocytes. Furthermore, β-catenin deficiency also blocked the activation of Nrf2 and MITF as well as the inhibition of apoptosis induced by vitamin D. Taken together, vitamin D insufficiency was associated with severity of oxidative stress in vitiligo patients. Our work also provides new insights into the mechanism of vitamin D against vitiligo, in which vitamin D protects melanocytes against oxidative stress by activating Wnt/β-catenin signaling.
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Affiliation(s)
- Luyan Tang
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China.,The Shanghai Institute of Dermatology, Shanghai, China
| | - Wei Fang
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China.,Shanghai Key Laboratory of Molecular Medical Mycology, Department of Dermatology and Venereology, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Jinran Lin
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China.,The Shanghai Institute of Dermatology, Shanghai, China
| | - Jian Li
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China.,The Shanghai Institute of Dermatology, Shanghai, China
| | - Wenyu Wu
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China. .,The Shanghai Institute of Dermatology, Shanghai, China.
| | - Jinhua Xu
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China. .,The Shanghai Institute of Dermatology, Shanghai, China.
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22
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Mahmud FH, Elbarbary NS, Fröhlich-Reiterer E, Holl RW, Kordonouri O, Knip M, Simmons K, Craig ME. ISPAD Clinical Practice Consensus Guidelines 2018: Other complications and associated conditions in children and adolescents with type 1 diabetes. Pediatr Diabetes 2018; 19 Suppl 27:275-286. [PMID: 30066458 PMCID: PMC6748835 DOI: 10.1111/pedi.12740] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Accepted: 07/27/2018] [Indexed: 02/06/2023] Open
Affiliation(s)
- Farid H. Mahmud
- Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | | | | | - Reinhard W. Holl
- Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Ulm, Germany
| | | | - Mikael Knip
- Children’s Hospital, University of Helsinki, Helsinki, Finland
| | - Kimber Simmons
- Barbara Davis Center for Diabetes, University of Colorado, Denver, Colorado
| | - Maria E. Craig
- The Children’s Hospital at Westmead, Westmead, NSW, Australia,Discipline of Child and Adolescent Health, University of Sydney, Sydney, NSW, Australia,School of Women’s and Children’s Health, University of New South Wales, Sydney, NSW, Australia
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23
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Çerman AA, Karabay EA, Altunay IK, Cesur SK. Vitamin D levels in actinic keratosis: a preliminary study. An Bras Dermatol 2018; 93:535-538. [PMID: 30066760 PMCID: PMC6063125 DOI: 10.1590/abd1806-4841.20186999] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 06/23/2017] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Recent studies that investigated the effect of vitamin D on skin cancer risk have exhibited inconsistent results. OBJECTIVE The aim of the study was to evaluate vitamin D status in patients with actinic keratosis. METHODS A cross-sectional study was conducted on 31 patients with actinic keratosis and 29 healthy controls. Serum vitamin D levels in the study group were determined by liquid chromatography/tandem mass spectrometry. RESULTS Serum 25(OH)D levels in patients with actinic keratosis were significantly higher than those of the healthy controls (P=0.04). Prevalence of 25(OH)D deficiency was significantly higher in the healthy controls (75.9%) compared to the patients with actinic keratosis (54.8%), but the difference was not statistically significant (P= 0.09). STUDY LIMITATIONS The cross-sectional design of the study, data on smoking based on patient self-report, and subjects' different dietary habits, which can influence 25(OH)D levels, are the study's limitations. CONCLUSION Serum vitamin D level can be used as a marker for ultraviolet B radiation from sun exposure; therefore, it can be used in individuals at risk of actinic keratosis. Oral intake of vitamin D through diet or supplements is proposed instead of prolonged ultraviolet exposure to maintain adequate vitamin D serum levels. Further research is needed to elucidate the role of vitamin D in skin carcinogenesis.
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Affiliation(s)
- Aslı Aksu Çerman
- Department of Dermatology and Venereology, Şişli
Hamidiye Etfal Training and Research Hospital, Health Science University, Istanbul,
Turkey
| | - Ezgi Aktaş Karabay
- Department of Dermatology and Venereology, Faculty of Medicine,
Bahçeşehir University, Istanbul, Turkey
| | - Ilknur Kivanc Altunay
- Department of Dermatology and Venereology, Şişli
Hamidiye Etfal Training and Research Hospital, Health Science University, Istanbul,
Turkey
| | - Seher Küçükoğlu Cesur
- Department of Dermatology and Venereology, Medicalpark
Bahçelievler Hospital, Istanbul, Turkey
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24
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Zhang JZ, Wang M, Ding Y, Gao F, Feng YY, Yakeya B, Wang P, Wu XJ, Hu FX, Xian J, Kang XJ. Vitamin D receptor gene polymorphism, serum 25-hydroxyvitamin D levels, and risk of vitiligo: A meta-analysis. Medicine (Baltimore) 2018; 97:e11506. [PMID: 30024533 PMCID: PMC6086540 DOI: 10.1097/md.0000000000011506] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES To explore the relationship among the vitamin D receptor (VDR) gene polymorphisms, serum 25-hydroxyvitamin D levels, and vitiligo. METHODS Databases including PubMed, Cochrane Library, Ovid, Web of Science, CNKI, SinoMed, and Wanfang Data were systematically searched. The association was assessed using odds ratios (ORs), standard mean difference (SMD), and 95% confidence intervals (CIs). The statistical tests were performed using Review Manager 5.3.3. RESULTS We identified a total of 17 studies. The relationship between VDR gene polymorphisms (BsmI, ApaI, TaqI, and FokI), serum 25 (OH)D levels, and incidence of vitiligo was investigated. The results of this meta-analysis showed that the dominant genetic model (CC+AC vs AA, P = .007, OR = 1.41, 95% CI = 1.10-1.80), recessive genetic model (CC vs AC+AA, P = .01, OR = 4.10, 95% CI = 1.36-12.35), and allelic contrast model (C vs A, P = .005, OR = 1.87, 95% CI = 1.21-2.90) of VDR Apal locus increased the risk of vitiligo, and BsmI, TaqI, and FokI loci and the risk of vitiligo have no obvious correlation. Serum 25 (OH)D deficiency was positively associated with the incidence of vitiligo (P < .0001, SMD = -0.94, 95% CI = -1.39, -0.48). CONCLUSION This meta-analysis revealed that VDR Apal polymorphism increased the susceptibility risk of vitiligo, and there is a positive correlation between serum 25 (OH)D deficiency and the incidence of vitiligo.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Jun Xian
- Department of Gynecology, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, China
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Gade VKV, Mony A, Munisamy M, Chandrashekar L, Rajappa M. An investigation of vitamin D status in alopecia areata. Clin Exp Med 2018; 18:577-584. [PMID: 29869122 DOI: 10.1007/s10238-018-0511-8] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 05/29/2018] [Indexed: 11/29/2022]
Abstract
Alopecia areata (AA) is a type of non-scarring, recurrent patchy loss of hair in hair-bearing areas and is mostly of autoimmune origin. Previous studies have suggested that some autoimmune diseases were found to be associated with vitamin D deficiency. The current study was designed to assess the levels of serum 25-hydroxy vitamin D and C-reactive protein in AA, as compared with controls and to further identify the association between vitamin D levels and disease severity in patients with AA. This cross-sectional study included 45 patients with AA and 45 healthy volunteers. Clinical and anthropometric parameters were recorded, according to a pre-designed proforma. Serum 25-hydroxy vitamin D and high-sensitivity C-reactive protein were estimated using ELISA kits. The severity of AA was determined using Severity of Alopecia Tool (SALT) score. We observed a significant rise in systemic inflammation as seen by elevated high-sensitive C-reactive protein levels and lowered 25-hydroxy vitamin D levels in patients with alopecia areata, compared to controls (p = 0.001). The levels of 25-hydroxy vitamin D showed a significant negative correlation with disease severity, while hs-CRP levels showed a significant positive correlation with disease severity (ρ = - 0.714, p = 0.001 and ρ = 0.818, p = 0.001). Our results suggest significant systemic inflammation and vitamin D deficiency in alopecia areata, more so with increasing disease severity. This gains particular importance in the treatment of alopecia areata in future, as supplementing vitamin D to AA patients would result in reducing the disease severity and inducing remission.
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Affiliation(s)
| | - Archana Mony
- Department of Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, 605006, India
| | - Malathi Munisamy
- Department of Dermatology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Laxmisha Chandrashekar
- Department of Dermatology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Medha Rajappa
- Department of Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, 605006, India.
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Ibrahim H, El Taieb M, El Gamel Z, El Saied AR. Effect of narrow-band ultraviolet B on the serum of 25-hydroxyvitamin D in vitiligo patients. J Cosmet Dermatol 2018. [PMID: 29524288 DOI: 10.1111/jocd.12515] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Narrow-band ultraviolet B (NB-UVB) is the gold standard in the treatment of vitiligo. 25-hydroxyvitamin D (25-OH- vitamin D) might play a physiological role in photo-induced melanogenesis in human skin so the association between vitamin D levels and vitiligo still needs to be investigated more thoroughly. OBJECTIVE we aim to investigate the influence of cumulative doses of NB-UVB phototherapy on vitamin D in patients with vitiligo and their correlation with NB-UVB-induced pigmentation. METHODS Eighty patients of vitiligo and twenty number of age and sex matched controls were recruited in a case-control study. Patients with vitiligo were treated with NB-UVB twice weekly for 24 weeks. 25-hydroxy vitamin D levels were measured at 0, 12, and 24 weeks in the cases and at 0 only in control by enzyme-linked immunosorbent assay (ELISA) and Vitiligo Area Severity Index (VASI) were calculated at 0 (baseline) and 24 weeks. RESULTS The mean baseline level of 25-hydroxyvitamin D (at 0 week) was significantly lower in patients than the control group. Levels of 25(OH) vitamin D at 12 and 24 weeks showed significant improvement and Patients show significant reduction in VASI score after 24 weeks of therapy. CONCLUSIONS Cumulative doses of NB-UVB therapy improve low vitamin D levels in patients with vitiligo, which might have a significant role in NB-UVB-induced repigmentation and may contribute to its therapeutic efficacy but further studies with larger sample size are needed to prove the complete mechanisms of NB-UVB-induced pigmentations and vitamin D in vitiligo.
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Affiliation(s)
- Hassan Ibrahim
- Department of Dermatology, Venereology and Andrology, Qena Faculty of Medicine, South Valley University, Qena, Egypt
| | - Moustafa El Taieb
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Aswan University, Aswan, Egypt
| | - Zeinab El Gamel
- Department of Dermatology, Qena General Hospital, South Valley University, Qena, Egypt
| | - Abdel Rahman El Saied
- Department of Clinical Pathology, Faculty of Medicine, South Valley University, Qena, Egypt
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Watabe A, Yamasaki K, Asano M, Kanbayashi Y, Nasu-Tamabuchi M, Terui H, Furudate S, Kakizaki A, Tsuchiyama K, Kimura Y, Ito Y, Kikuchi K, Aiba S. Efficacy of oral cholecalciferol on rhododendrol-induced vitiligo: A blinded randomized clinical trial. J Dermatol 2018; 45:456-462. [DOI: 10.1111/1346-8138.14244] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2017] [Accepted: 01/03/2018] [Indexed: 12/13/2022]
Affiliation(s)
- Akiko Watabe
- Department of Dermatology; Tohoku University Graduate School of Medicine; Sendai Japan
| | - Kenshi Yamasaki
- Department of Dermatology; Tohoku University Graduate School of Medicine; Sendai Japan
| | - Masayuki Asano
- Department of Dermatology; Tohoku University Graduate School of Medicine; Sendai Japan
| | - Yumi Kanbayashi
- Department of Dermatology; Tohoku University Graduate School of Medicine; Sendai Japan
| | - Mei Nasu-Tamabuchi
- Department of Dermatology; Tohoku University Graduate School of Medicine; Sendai Japan
| | - Hitoshi Terui
- Department of Dermatology; Tohoku University Graduate School of Medicine; Sendai Japan
| | - Sadanori Furudate
- Department of Dermatology; Tohoku University Graduate School of Medicine; Sendai Japan
| | - Aya Kakizaki
- Department of Dermatology; Tohoku University Graduate School of Medicine; Sendai Japan
| | - Kenichiro Tsuchiyama
- Department of Dermatology; Tohoku University Graduate School of Medicine; Sendai Japan
| | - Yutaka Kimura
- Department of Dermatology; Tohoku University Graduate School of Medicine; Sendai Japan
| | - Yumiko Ito
- Department of Dermatology; Tohoku University Graduate School of Medicine; Sendai Japan
| | - Katsuko Kikuchi
- Department of Dermatology; Tohoku University Graduate School of Medicine; Sendai Japan
| | - Setsuya Aiba
- Department of Dermatology; Tohoku University Graduate School of Medicine; Sendai Japan
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28
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El-hanbuli HM, Dawoud NM, Mahmoud RH. Narrow-band UVB effects on cutaneous vitamin D receptor expression and serum 25-hydroxyvitamin D in generalized vitiligo. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2017; 34:175-183. [DOI: 10.1111/phpp.12362] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/18/2017] [Indexed: 12/12/2022]
Affiliation(s)
- Hala M. El-hanbuli
- Department of Pathology; Faculty of Medicine; Fayoum University; Fayoum Egypt
| | - Noha M. Dawoud
- Department of Dermatology, Andrology and STDs; Menoufia University; Shebin Elkoom Egypt
| | - Rania H. Mahmoud
- Department of Biochemistry and molecular biology; Faculty of Medicine; Fayoum University; Fayoum Egypt
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30
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Thompson JM, Li T, Park MK, Qureshi AA, Cho E. Estimated serum vitamin D status, vitamin D intake, and risk of incident alopecia areata among US women. Arch Dermatol Res 2016; 308:671-676. [PMID: 27664090 DOI: 10.1007/s00403-016-1687-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 09/08/2016] [Accepted: 09/13/2016] [Indexed: 01/08/2023]
Abstract
Studies have identified increased prevalence of vitamin D deficiency in patients with alopecia areata (AA), an autoimmune disease characterized by hair loss, but none have prospectively examined vitamin D status and incident AA. In 55,929 women in the Nurses' Health Study (NHS), we prospectively evaluated the association between estimated vitamin D status, derived from a prediction model incorporating lifestyle determinants of serum vitamin D, and self-reported incident AA. We evaluated dietary, supplemental, and total vitamin D intake as additional exposures. Using Cox proportional hazards models, we calculated age-adjusted and multivariate hazard ratios (HR) to evaluate risk of AA. We identified 133 cases of AA over a follow-up of 12 years. The age-adjusted HR between top vs. bottom quartiles for serum vitamin D score was 0.94 (95 % CI 0.60-1.48) and the corresponding multivariate HR was 1.08 (95 % CI 0.68-1.73). There was no significant association between dietary, supplemental, or total vitamin D intake and incident AA. This study does not support a preventive role for vitamin D in the risk of developing AA.
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Affiliation(s)
- Jordan M Thompson
- Warren Alpert Medical School, Brown University, Providence, RI, 02903, USA
| | - Tricia Li
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, 02115, USA
| | - Min Kyung Park
- Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, RI, 02903, USA
| | - Abrar A Qureshi
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, 02115, USA
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI, 02903, USA
- Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, RI, 02903, USA
| | - Eunyoung Cho
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, 02115, USA.
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI, 02903, USA.
- Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, RI, 02903, USA.
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The role of serum vitamin D levels in vitiligo. Postepy Dermatol Alergol 2016; 33:300-2. [PMID: 27605903 PMCID: PMC5004211 DOI: 10.5114/pdia.2016.59507] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Accepted: 09/18/2015] [Indexed: 12/14/2022] Open
Abstract
Introduction Vitiligo is a common acquired pigmentary skin disorder. Vitamin D is responsible for skin pigmentation, increases tyrosinase activity and melanogenesis, and exhibits immunoregulatory functions. Low levels of vitamin D are associated with many autoimmune diseases, including systemic lupus, diabetes mellitus, rheumatoid arthritis, multiple sclerosis and alopecia areata. Few reports have evaluated serum vitamin D levels in vitiligo patients, and their results are conflicting. Aim To evaluate serum vitamin D levels of vitiligo patients and compare the results with controls. Material and methods In total, 50 vitiligo patients and 47 controls were enrolled in the study. Vitamin D levels were measured from blood samples. Group comparisons were performed using appropriate statistical methods. Results The patients had lower serum vitamin D levels than the controls, but this difference was not significant (p = 0.570). Conclusions It remains unknown whether vitamin D deficiency causes vitiligo. Larger controlled studies are required to prove whether low circulating vitamin D is a causative factor in vitiligo.
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Sobeih S, Mashaly HM, Gawdat H, Amr K, Hamid MFA, Shaalan E. Evaluation of the correlation between serum levels of vitamin D and vitamin D receptor gene polymorphisms in an Egyptian population. Int J Dermatol 2016; 55:1329-1335. [PMID: 27420410 DOI: 10.1111/ijd.13363] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Revised: 03/29/2016] [Accepted: 04/07/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND Vitiligo is an autoimmune depigmentation disorder. Polymorphisms in the vitamin D receptor (VDR) have been found to be associated with vitiligo. OBJECTIVES To evaluate the potential association between VDR gene polymorphisms (ApaI, TaqI, and FokI) and vitiligo susceptibility, and to detect if there is correlation between serum 25-hydroxyvitamin D [25(OH)D] levels and vitiligo and between VDR gene polymorphisms and 25(OH)D levels in vitiligo. MATERIALS AND METHODS Seventy-five patients with vitiligo and 75 age and sex-matched controls were subjected to detailed history taking and dermatological examination to determine the extent and clinical type of vitiligo. A blood sample (5 ml) was retrieved to investigate VDR gene polymorphisms and serum 25(OH)D level. RESULTS Our results showed that the serum level of vitamin D is statistically significantly lower in patients than controls. The frequency of the ApaI variant a allele, the variant genotype (aa), and the variant genotype (tt) were significantly higher among the vitiligo cases than among controls. Our study also showed that the serum 25(OH)D levels were not significantly different among the different ApaI, TaqI, and FokI genotypes. CONCLUSION The present study showed that serum level of 25(OH)D is statistically significantly lower in patients than controls, so screening for vitamin D deficiency seems of value in patients with vitiligo for the possibility of vitamin D supplementation. We also report that VDR gene polymorphisms may be a risk for the development of vitiligo in an Egyptian population.
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Affiliation(s)
- Shereen Sobeih
- Dermatology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Heba M Mashaly
- Dermatology, Faculty of Medicine, Cairo University, Cairo, Egypt.
| | - Heba Gawdat
- Dermatology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Khalda Amr
- Molecular Genetics, National Research Centre, Cairo, Egypt
| | | | - Eman Shaalan
- Dermatology, National Research Centre, Cairo, Egypt
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Stringer E, Han S, Larsen RS. Cutaneous vitiligo associated with hypovitaminosis D in Malayan flying foxes (
Pteropus vampyrus
) and Island flying foxes (
Pteropus hypomelanus
). VETERINARY RECORD CASE REPORTS 2016. [DOI: 10.1136/vetreccr-2016-000297] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
| | - Sushan Han
- Department of MicrobiologyDiagnostic Medicine CenterColorado State UniversityFort CollinsColoradoUSA
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Upala S, Sanguankeo A. Low 25-hydroxyvitamin D levels are associated with vitiligo: a systematic review and meta-analysis. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2016; 32:181-90. [DOI: 10.1111/phpp.12241] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/18/2016] [Indexed: 01/11/2023]
Affiliation(s)
- Sikarin Upala
- Department of Internal Medicine; Bassett Medical Center and Columbia University College of Physicians and Surgeons; Cooperstown NY USA
- Department of Preventive and Social Medicine; Faculty of Medicine Siriraj Hospital; Mahidol University; Bangkok Thailand
| | - Anawin Sanguankeo
- Department of Internal Medicine; Bassett Medical Center and Columbia University College of Physicians and Surgeons; Cooperstown NY USA
- Department of Preventive and Social Medicine; Faculty of Medicine Siriraj Hospital; Mahidol University; Bangkok Thailand
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Aksu Cerman A, Sarikaya Solak S, Kivanc Altunay I. Vitamin D deficiency in alopecia areata. Br J Dermatol 2016; 170:1299-304. [PMID: 24655364 DOI: 10.1111/bjd.12980] [Citation(s) in RCA: 83] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/15/2014] [Indexed: 12/14/2022]
Abstract
BACKGROUND Alopecia areata (AA) is a T cell-mediated autoimmune disease that causes inflammation around anagen-stage hair follicles. Insufficient levels of vitamin D have been implicated in a variety of autoimmune diseases. Previous reports have described the effects of vitamin D on hair follicles. OBJECTIVES To evaluate the status of vitamin D in patients with AA, and the relationship between vitamin D levels and disease severity. METHODS A cross-sectional study of 86 patients with AA, 44 patients with vitiligo and 58 healthy controls was conducted. The serum vitamin D levels of the study group were determined by liquid chromatography/tandem mass spectrometry. RESULTS Serum 25-hydroxyvitamin D [25(OH)D] levels in patients with AA were significantly lower than those of the patients with vitiligo and the healthy controls (P = 0·001 and P < 0·001, respectively). The prevalence of 25(OH)D deficiency was significantly higher in patients with AA (91%) compared with patients with vitiligo (71%) and healthy controls (33%) (P = 0·003 and P < 0·001, respectively). Furthermore, a significant inverse correlation was found between disease severity and serum 25(OH)D level in patients with AA (r = -0·409; P < 0·001). CONCLUSIONS Deficient serum 25(OH)D levels are present in patients with AA and inversely correlate with disease severity. Accordingly, screening patients with AA for vitamin D deficiencies seems to be of value for the possibility of supplementing these patients with vitamin D.
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Affiliation(s)
- A Aksu Cerman
- Dermatology Department, Şişli Etfal Training and Research Hospital, Halaskargazi Cad., 34371, Şişli-Istanbul, Turkey
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Toossi P, Azizian Z, Yavari H, Fakhim TH, Amini SHS, Enamzade R. Serum 25-hydroxy vitamin D levels in patients with acne vulgaris and its association with disease severity. CLINICAL CASES IN MINERAL AND BONE METABOLISM 2016; 12:238-42. [PMID: 26811702 DOI: 10.11138/ccmbm/2015.12.3.238] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Since vitamin D is a recent known immunoregulatory factor in some diseases which are addressed in immune system disorders such as SLE, [psoriasis] and others. OBJECTIVE To determine the serum levels of 25-hydroxy vitamin D3 [25(OH)D] in patients with acne vulgaris and its association with clinical features. METHODS This cross-sectional study was conducted over months. This study included 39 patients with acne vulgaris and 40 healthy controls. Subjects who did not use alcohol, vitamin D supplements, oral steroids or PUVA and/or NBUVB for more than three months were included. Serum 25(OH)D levels were measured. Baseline demographics, family history and comorbidities like PCO were recorded. Statistical analyses were performed using SPSS 16.0.0. RESULTS The median concentration of 25(OH)D was 8.4 ng/mL (range: 1.4-99) in patients and 10.4 ng/mL (range: 3.1-56.7) in controls, with no statistical significant difference. PCOS was a significant predictor of the occurrence of acne vulgaris (OR=6.25; 95% CI: 1.52-25.66; p=0.01). There were no significant associations between severity of disease and serum 25(OH)D levels (rs=-0.12, p=0.45), age (rs=-0.28, p=0.09), BMI (rs=-0.12, p=0.46), age at onset of disease (rs=-0.08, p=0.63) and duration of disease (rs=-0.10, p=0.54). CONCLUSION Based on the previous studies this is highly suspected that vitamin D would be a prominent factor in acne patients and more performances with bigger sample size could be useful to get positive results.
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Affiliation(s)
- Parviz Toossi
- Professor of dermatology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Azizian
- Resident of Dermatology, Rasoul-e-akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Hassan Yavari
- Young Researchers Club, Tehran Medical Branch, Islamic Azad University, Tehran, Iran
| | | | | | - Ramin Enamzade
- Dermatologist, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Effect of narrowband ultraviolet B phototherapy on serum vitamin D levels in patients with vitiligo. JOURNAL OF THE EGYPTIAN WOMEN’S DERMATOLOGIC SOCIETY 2016. [DOI: 10.1097/01.ewx.0000473579.35791.9a] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Abstract
Background: Vitiligo is a progressive depigmenting disorder characterized by loss of functional melanocytes from the epidermis. The etiopathogenesis of vitiligo is still unclear. Vitamin D has stimulatory effects on melanocytes and acts through its nuclear Vitamin D receptor (VDR) on target cells. Aims and Objectives: The purpose of this study was to declare the role of Vitamin D in the pathogenesis of vitiligo. Materials and Methods: This case-control study included 30 vitiligo patients and 30 age, gender-matched healthy controls. Blood samples were withdrawn from the study subjects, and the serum 25(OH) D level was determined by an enzyme-linked immunosorbent assay technique. Serum 25(OH) D levels were divided into: Normal or sufficient (≥30 ng/ml), insufficient (< 30-> 20ng/ml), and deficient (≤20 ng/ml) levels. Skin biopsies were obtained from the depigmented lesions and clinically normal skin of vitiligo patients and from the controls, and VDR gene expression was determined using real-time polymerase chain reaction. Results: Only 10 patients with vitiligo (33.3%) had sufficient serum 25(OH) D levels (≥30 ng/ml), 12 patients (40%) had insufficient levels, and 8 patients (26.7%) had deficient levels. On the other hand, most of the controls (96.7%) had sufficient levels. The mean serum 25(OH) D level in patients was significantly decreased compared to controls (P < 0.001). The VDR-mRNA expression was also significantly decreased in lesional and nonlesional skin of patients compared to controls (P < 0.001, P < 0.001, respectively). Conclusion: Vitamin D deficiency influences the extent of vitiligo and could contribute to the pathogenesis of vitiligo through its immunomodulatory role and its role in melanogenesis.
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Affiliation(s)
- Reham William Doss
- Department of Dermatology, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
| | - Abdel-Aziz El-Rifaie
- Department of Dermatology, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
| | - Yasser M Gohary
- Department of Dermatology, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
| | - Laila A Rashed
- Department of Biochemistry, Faculty of Medicine, Cairo University, Cairo, Egypt
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Mostafa WZ, Hegazy RA. Vitamin D and the skin: Focus on a complex relationship: A review. J Adv Res 2015; 6:793-804. [PMID: 26644915 PMCID: PMC4642156 DOI: 10.1016/j.jare.2014.01.011] [Citation(s) in RCA: 107] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2013] [Revised: 01/29/2014] [Accepted: 01/30/2014] [Indexed: 12/19/2022] Open
Abstract
The "sunshine" vitamin is a hot topic that attracted ample attention over the past decades, specially that a considerable proportion of the worldwide population are deficient in this essential nutrient. Vitamin D was primarily acknowledged for its importance in bone formation, however; increasing evidence point to its interference with the proper function of nearly every tissue in our bodies including brain, heart, muscles, immune system and skin. Thereby its deficiency has been incriminated in a long panel of diseases including cancers, autoimmune diseases, cardiovascular and neurological disorders. Its involvement in the pathogenesis of different dermatological diseases is no exception and has been the subject of much research over the recent years. In the current review, we will throw light on this highly disputed vitamin that is creating a significant concern from a dermatological perspective. Furthermore, the consequences of its deficiency on the skin will be in focus.
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Affiliation(s)
- Wedad Z. Mostafa
- Department of Dermatology, Faculty of Medicine, Cairo University, Cairo, Egypt
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40
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Khurrum H, AlGhamdi KM. The Relationship Between the Serum Level of Vitamin D and Vitiligo: A Controlled Study on 300 Subjects. J Cutan Med Surg 2015; 20:139-45. [PMID: 26458407 DOI: 10.1177/1203475415610071] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
BACKGROUND Low vitamin D levels have been associated with several autoimmune diseases. Vitiligo could be associated with low vitamin D levels. OBJECTIVE To determine the level of serum vitamin D in vitiligo patients compared to controls and reveal the possible association of vitamin levels with the pathogenesis of vitiligo. PATIENTS AND METHODS A case-controlled study was conducted. After excluding factors that may affect serum vitamin D levels, blood samples were taken from vitiligo patients and controls. The association between vitamin D levels and various vitiligo subgroups (duration of vitiligo, site of onset, age, etc) was measured and correlated. RESULTS A total of 150 vitiligo patients, 90 (60%) males with a mean age of 30.6 ± 11.4 years, were recruited. The study also had 150 age- and gender-matched vitiligo-free control subjects. There was no significant difference in median serum vitamin D levels between the cases and the controls (P = .25). The serum levels of vitamin D of the vitiligo patients were found to be lower in males (P = .01), the younger age group (P = .01), and patients not treated with ultraviolet (UV) treatment (P = .01). CONCLUSION There is no difference between the vitamin D levels of the vitiligo patients and the control subjects. However, deficiency of 25(OH)D levels within the vitiligo subgroups may be linked to younger age, male gender, short duration of vitiligo, and non-use of phototherapy.
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Affiliation(s)
- Huma Khurrum
- Vitiligo research chair, King Saud University, Riyadh, Saudi Arabia
| | - Khalid M AlGhamdi
- Dermatology Department, Director Vitiligo Research Chair, College of Medicine, King Saud University,Riyadh, Saudi Arabia
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41
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Kordonouri O, Klingensmith G, Knip M, Holl RW, Aanstoot HJ, Menon PSN, Craig ME. ISPAD Clinical Practice Consensus Guidelines 2014. Other complications and diabetes-associated conditions in children and adolescents. Pediatr Diabetes 2014; 15 Suppl 20:270-8. [PMID: 25182319 DOI: 10.1111/pedi.12183] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Accepted: 06/14/2014] [Indexed: 12/27/2022] Open
Affiliation(s)
- Olga Kordonouri
- Diabetes Centre for Children and Adolescents, Children's Hospital auf der Bult, Hannover, Germany
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42
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Zhang Y, Mooneyan-Ramchurn JS, Zuo N, Feng Y, Xiao S. Vitiligo nonsurgical treatment: a review of latest treatment researches. Dermatol Ther 2014; 27:298-303. [PMID: 25041437 DOI: 10.1111/dth.12143] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Yanfei Zhang
- Department of Dermatology, The Second Affiliated Hospital, College of Medicine; Xi'an Jiaotong University; Xi'an Shaanxi Province China
| | | | - Nan Zuo
- Department of Dermatology, The Second Affiliated Hospital, College of Medicine; Xi'an Jiaotong University; Xi'an Shaanxi Province China
| | - Yiguo Feng
- Department of Dermatology, The Second Affiliated Hospital, College of Medicine; Xi'an Jiaotong University; Xi'an Shaanxi Province China
| | - Shengxiang Xiao
- Department of Dermatology, The Second Affiliated Hospital, College of Medicine; Xi'an Jiaotong University; Xi'an Shaanxi Province China
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43
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Oiso N, Sato M, Kawada A. Vitiligo after combination therapy of pegylated interferon-α-2a, ribavirin and vitamin D in a patient with chronic hepatitis C. J Dermatol 2013; 40:772-3. [PMID: 23855823 DOI: 10.1111/1346-8138.12234] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Naoki Oiso
- Department of Dermatology, Kinki University Faculty of Medicine, Osaka-Sayama, Japan
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