The results of this study shows that the 308-nm excimer laser can be an effective and promising device for the treatment of various vitiligo types, other than generalized, in childhood.
Vitiligo is an acquired, progressive depigmenting disorder of unknown etiology. In this study, to clarify pathogenesis of vitiligo, the marginal skin of actively spreading and stable vitiligo was examined using ICAM-1, HLA-DR, CD4 and CD8 monoclonal antibodies. In immunohistochemical study, ICAM-1 was expressed in four of five epidermis in active lesions, but not in stable lesion. Dermal ICAM-1 was also expressed in all active and stable lesions. HLA-DR was also expressed in all active epidermis in active lesions, but two of five epidermis in stable lesion. Dermal HLA-DR was also expressed in all active and stable lesion. CD4 lymphocytes were expressed more strongly in active lesion, but CD8 lymphocytes were not different in both lesions. There was no significant difference of degree of positivity with CD4 and CD8 in normal control specimens. In conclusion, we think that ICAM-1 and HLA-DR expression, cytokines released from keratinocytes, melanocytes or lymphocytes and infiltration of activated T-lymphocytes play an important role in disease activity.
Vitiligo considerably influences the psychological well-being of patients. Disease-induced disfigurement can cause patients to experience a high level of stigmatization, which can lead to psychosocial stresses and negative impacts on quality of life (QOL). This study aims to ascertain the QOL of vitiligo patients compared to patients with other mild skin disorders. We also attempt to study which clinical features of vitiligo are closely related to the patient's QOL. One hundred and thirty-three vitiligo patients and 112 patients with mild skin disorders were analyzed. All participants were asked to fill out questionnaires covering comprehensive clinical profiles and the Korean version of Skindex-29. Statistical correlation between Skindex-29 and each clinical profile were analyzed. The symptom scale of Skindex-29 was significantly lower in vitiligo patients than in controls, but the function scale and the emotion scale were significantly higher in the vitiligo group than in controls. However, the difference in function scales between groups was significant in female patients, but not in male patients. Several clinical profiles, such as duration of disease, severity scores and previous history of treatments, showed close correlations with the function scale. Family history of vitiligo, Köebner phenomenon, patients' perspectives on disease prognosis, and discordance of the severity scores between physicians and patients also influenced the Skindex-29 subscales differently. In conclusion, the present study suggests that patients with vitiligo were highly affected in the functional and emotional aspects of QOL, with some sex differences. Various clinical features may play an important role in the QOL of vitiligo patients.
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