Erbium:YAG laser resurfacing effectively improves melasma; however, the almost universal appearance of transient postinflammatory hyperpigmentation necessitates prompt and persistent intervention.
Although genetics plays an essential role in the pathogenesis of vitiligo, vitiligo pathogenesis is still unclear. Our aim was to investigate the role of IFN-γ expression and polymorphism in vitiligo susceptibility and whether intercellular adhesion molecule-1 (ICAM-1), tumor necrosis factor (TNF)-α, and TNF-β play a role in vitiligo pathogenesis as important inflammatory parameters. Eighty-five patients with vitiligo and 90 controls were investigated for IFN-γ gene expression by quantitative real-time PCR and genotyped for IFN-γ +874T/A (rs2430561) and IFN-γ +2109A/G (rs1861494) gene polymorphisms by sequence-specific primer (SSP)-PCR and PCR-restriction fragment length polymorphism (RFLP), respectively. Serum levels of inflammatory parameters were measured using ELISA. Frequencies of the +874 TT genotype and T allele were significantly higher in patients with active vitiligo than in stable patients (P = 0.01 and 0.03, respectively). Calculation of odds ratio suggested a 1.7-fold increased risk of vitiligo in individuals having the TA haplotype. We observed overexpression of IFN-γ mRNA with elevated serum levels of IFN-γ, ICAM-1, TNF-α, and TNF-β in patients with vitiligo when compared with the control group (P = 0.001, for all). In addition, these levels were elevated in patients with active vitiligo compared with stable patients with vitiligo (P = 0.008, 0.006, 0.01, 0.01, and 0.03, respectively), which suggests the involvement of these cytokines in disease activity. In conclusion, IFN-γ is a promising immunological marker in vitiligo pathogenesis.
Vitiligo is a skin disorder commonly acquired. Although different therapies are used, they are refractory to therapy in many cases. Trauma has been reported to cause hyperpigmentation by the pigment incontinence, which results in the build‐up of melanophages in the upper dermis after basal cell layer destruction. To detect the effectiveness of trichloroacetic acid (TCA) 70% in the treatment of nonsegmental vitiligo after skin microneedling by dermapen or intradermal injection of 5‐fluorouracil.
Patients and methods
A prospective comparative study was enrolled with 32 patients with vitiligo who were assigned to two equal groups. Each containing 16 patients; group 1 was treated by microneedling followed by TCA 70%, group 2 was treated by intradermal 5‐FU injection. This was done every 2 weeks for 2 months.
Results
According to the Physician's Global Assessment, there was no significant (P < .05) difference in the therapeutic response between the two studied groups.
Conclusions
Both microneedling plus TCA 70% and 5‐FU intradermal injection are a simple means of treating vitiligo with cosmetically accepted repigmentation of all age groups, as well as a relatively safe alternative or additive method that can be used before (or in combination with) any of the well‐known and widely approved method for stable nonsegmented vitiligo treatment.
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