Studies aimed at understanding the pathology, genetics, and therapeutic response of vitiligo rely on asking a single question about 'physician-diagnosed' vitiligo on surveys to identify subjects for research. However, this type of self-reporting is not sufficient. Our objective was to determine if the patient-administered Vitiligo Screening Tool (VISTO) is a sensitive and specific instrument for the detection of vitiligo in an adult population. The VISTO consists of eight closed-ended questions to assess whether the survey participant has ever been diagnosed with vitiligo by a healthcare worker and uses characteristic pictures and descriptions to inquire about the subtype and extent of any skin lesions. 159 patients at the Brigham and Women's Hospital dermatology clinic with or without a diagnosis of vitiligo were recruited. A board-certified dermatologist confirmed or excluded the diagnosis of vitiligo in each subject. 147 completed questionnaires were analyzed, 47 cases and 100 controls. The pictorial question showed 97.9% sensitivity and 98% specificity for diagnosis of vitiligo. Answering "yes" to being diagnosed with vitiligo by a dermatologist and choosing one photographic representation of vitiligo showed 95.2% sensitivity and 100% specificity for diagnosis of vitiligo. We conclude that VISTO is a highly sensitive and specific, low-burden, self-administered tool for identifying vitiligo among adult English speakers. We believe this tool will provide a simple, cost-effective way to confirm vitiligo prior to enrollment in clinical trials as well as for gathering large-scale epidemiologic data in remote populations. Future work to refine the VISTO is needed prior to use in genotype-phenotype correlation studies.
Background: Vitiligo is a chronic, progressive condition of skin depigmentation that has a negative impact on quality of life.
Changes in ocular blood flow occur in systemic diseases. A high peak systolic velocity (PSV) in the ophthalmic artery (OA) has been observed in diabetes mellitus and hypertension, conditions often associated with high tissue renin-angiotensin system (RAS) activity and reduced renal plasma flow (RPF). Since our group has demonstrated that sodium restriction ( a high RAS state ) is associated with a decrease in RPF which is correctable with ACE inhibition, we hypothesized that sodium restriction would result in higher ophthalmic PSV. Sixteen healthy volunteers (age 46.2±13.2, male 69%, white 75%, BMI 26±3.7) were placed on a low sodium (LS) diet (10 mmol/day) for 1 week followed by high sodium (HS) diet (200 mmol/day). Sodium balance was assessed by 24hr urine collection. BP, RPF (PAH clearance) and OA hemodynamic measurements (Multigon, NY) were made after overnight fasting and rest in the supine position. Sodium restriction did not affect BP (systolic/diastolic LS: 121/73 ± 12/7 vs HS: 122/72 ± 15/9 mmHg, mean ± SD, NS) or heart rate (69 ± 16 vs 70 ± 15/min, NS). As expected, RPF was lower on LS compared with HS (599.2 ± 89.8 vs 633.4 ± 93.5ml/min/1.73 m 2 , p=0.006). Sodium restriction was associated with higher OA peak (38.8 ± 6.4 vs 33.2 ± 6.0 cm/sec, p=0.018) and mean (19.7±2.9 vs 17.1±3.5, p=0.003) systolic velocity ( Figure ). There was no change in end-diastolic velocity (10.6±2.5 vs 9.7±2.4, p=0.266) with sodium restriction. In conclusion, sodium restriction was associated with an increase in OA peak and mean systolic velocity in healthy individuals. Further studies are required to investigate the potential relevance of our results to diabetic and hypertensive retinopathy.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.