Vitiligo is an autoimmune disease of the skin mediated by CD8 T cells that kill melanocytes and create white spots. Skin lesions in vitiligo frequently return after discontinuing conventional treatments, supporting the hypothesis that autoimmune memory is formed at these locations. We found that lesional T cells in mice and humans with vitiligo display a resident memory (T) phenotype, similar to those that provide rapid, localized protection against reinfection from skin and mucosal-tropic viruses. Interleukin-15 (IL-15)-deficient mice reportedly have impaired T formation, and IL-15 promotes T function ex vivo. We found that both human and mouse T express the CD122 subunit of the IL-15 receptor and that keratinocytes up-regulate CD215, the subunit required to display the cytokine on their surface to promote activation of T cells. Targeting IL-15 signaling with an anti-CD122 antibody reverses disease in mice with established vitiligo. Short-term treatment with anti-CD122 inhibits T production of interferon-γ (IFNγ), and long-term treatment depletes T from skin lesions. Short-term treatment with anti-CD122 can provide durable repigmentation when administered either systemically or locally in the skin. On the basis of these data, we propose that targeting CD122 may be a highly effective and even durable treatment strategy for vitiligo and other tissue-specific autoimmune diseases involving T.

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Vitiligo is a chronic depigmenting disorder of multifactorial etiology affecting 0.5% to 1% of the population. The white macules characteristic of vitiligo have been shown to have a profound impact on quality of life (QOL) in affected individuals. 1,2 The goal of this cross-sectional study was to determine the location(s) of vitiligo lesions that has the greatest effect on QOL.Methods | All patients enrolled in the Dallas Vitiligo Registry (DVR) at the University of Texas Southwestern (UTSW) Medical Center from April 2013 to August 2015 were reviewed. The DVR was approved by the UTSW Medical Center institutional review board and all patients gave informed consent. They were not compensated for their participation. A total of 184 patients were examined. It was determined that a total sample size of 184 would provide 80% power with a type 1 error of .05. The location of each affected area of skin was documented and the total body surface area affected as well as the vitiligo area severity index was calculated. Each participant also completed the VitiQoL, a vitiligo-specific QOL instrument. 3 The VitiQoL contains 16 questions divided into 3 domains: participation limitation, stigma, and behavior. Questions in the participation limitation domain include those asking about the patient's ability to perform daily activities and social and leisure activities. Stigma includes questions about embar-

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We performed a cross-sectional study of Hispanic and non-Hispanic parents of children with acne using a survey designed to determine their level of awareness of acne and its treatment; 82% of Hispanic parents and 40% of non-Hispanic parents agreed that a health care provider should treat mild acne (p < 0.001). Hispanic parents of adolescents with acne agreed more frequently than non-Hispanic parents that children with mild and moderate acne should be taken to a health care provider for treatment, but they tended not to visit health care providers. Future studies should aim to determine the reasons for this discrepancy, after which culturally sensitive educational programs can be developed to address this disparity.

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