To our knowledge, this is the first study comparing home and outpatient NB-UVB therapy for the treatment of vitiligo. In a randomized study in psoriasis, Koek et al. recently showed that home NB-UVB therapy was equally safe and effective, and a useful alternative to outpatient NB-UVB therapy. 7 This outcome is in line with our results.Although this study has several limitations (retrospective, not randomized, based on daily practice, unbalanced regarding skin types involved, and based primarily on patient-reported outcomes), we provide preliminary evidence for the efficacy and safety of home NB-UVB therapy. Concerns about home NB-UVB therapy regularly expressed among dermatologists (over-treatment, higher occurrence of short-and long-term side-effects, and reduced treatment efficacy) could not be confirmed.In conclusion, this study shows that patient-reported outcomes of home and outpatient NB-UVB therapy are comparable, with similar repigmentation and occurrence of side-effects. However, satisfaction with the result was significantly lower in the home group. On the other hand, the time investment for home patients was significantly less. Therefore, we suggest that home NB-UVB therapy is a valuable alternative to outpatient NB-UVB therapy in the treatment of nonsegmental vitiligo.

Imiquimod is an immunomodulator of the imidazoquinoline group which possesses antiviral and antitumour activities. Although its mechanism of action has not been entirely elucidated yet, imiquimod 5% cream has been shown to be an efficient, long-lasting and safe therapy for multiple actinic keratoses in non-immunosuppressed patients and in transplant recipients. We report the case of a 44-year-old patient with a third renal transplant who developed an acute tubular necrosis confirmed by renal biopsy after the use of imiquimod 5% cream. The result of a literature search revealed a wide variety of side effects attributable to the use of imiquimod.

Abstract:Nitric oxide (NO) is a potent regulator of keratinocyte growth and differentiation that has been implicated in the pathogenesis of psoriasis (Ps). The NOS3 -786 T/C (SNP id rs2070744; www.ensembl.org ), intron 4 variable number tandem repeat (VNTR), and Glu298Asp (SNP id rs1799983) polymorphisms, have been associated with differences in NO plasma concentrations and with the risk of hypertension (HT) and ischemic cardiac disease (IC). The aim of this study was to determine whether the above mentioned NOS3 variants contributed to the risk of Ps, and were associated with the risk for HT and CAD in these patients. A total of 368 patients with chronic plaque Ps and 400 healthy controls were genotyped for the NOS3 -786 T/C, intron 4 VNTR, and Glu298Asp polymorphisms. Carriers of the -786 C allele were significantly more frequent among the patients (p<0.001). Carriers of the 4-repeats allele (45+44 genotypes) were also more frequent a (p<0.001). No significant difference was found for the Glu298Asp polymorphism. None of the NOS3 variants was associated with Ht and CAD in our population. In conclusion, NOS3 gene polymorphism would be risk factors for developing Ps.

Psoriatic patients have a higher prevalence of diabetes mellitus type 2 (DM). Since dipeptidyl peptidase IV (DPP-IV) dysregulation is present in DM and psoriasis, DPP-IV inhibitors have been proposed as therapeutic agents for both conditions. We report a psoriasiform eruption induced by sitagliptin, a DPP-IV inhibitor. The role of DPP-IV in the pathogenesis of DM is well established; however data on psoriatic patients is contradictory. More studies are required to elucidate the effect of DPP-IV inhibitors and their relationship with DM and psoriasis.

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