OBJECTIVE: To observe the clinical effect of needle cauterization on vitiligo with deficiency cold and blood stasis. METHODS: A total of 62 patients of vitiligo with deficiency cold and blood stasis were randomly divided into an observation group and a control group, 31 cases each group.On the basis of 308 nm excimer light irradiation combined with ironing with Chinese medicine, the control group was treated with tacrolimus ointment for external use, twice a day; the observation group was treated with needle cauterization at vitiligo spots, once a week.Both groups were treated for 10 weeks. Before and after treatment, the area of vitiligo spot, TCM syndrome score, serum levels of inflammatory indexes (interleukin[IL]-6 and IL-17) were observed in the two groups, and the clinical effect was evaluated. RESULTS: After treatment, the areas of vitiligo spot, TCM syndrome scores and serum levels of IL-6, IL-17 were decreased compared with those before treatment in both groups (P<0.05), and the above indexes in the observation group were lower than those in the control group (P<0.05). The total effective rate in the observation group was 93.5% (29/31), which was higher than 77.4% (24/31) in the control group (P<0.05). CONCLUSION Needle cauterization could reduce the areas of vitiligo spot in patients of vitiligo with deficiency cold and blood stasis, improve the clinical symptoms, its mechanism may be related to the reduction of serum levels of inflammatory indexes.
Humans ; Vitiligo/physiopathology* ; Male ; Female ; Adult ; Young Adult ; Middle Aged ; Adolescent ; Interleukin-6/blood* ; Interleukin-17/blood* ; Cautery ; Acupuncture Therapy/instrumentation* ; Needles ; Cold Temperature ; Treatment Outcome

Objective To investigate the relationship between serum platelet-activating factor (PAF) level, T cell immune function and disease activity in vitiligo patients. Methods A total of 102 patients with vitiligo treated in our hospital from July 18th, 2022 to July 26th, 2023 were enrolled as study subjects. According to VIDA score, the patients were divided into an advanced-stage group (n=54) and a stable stage group (n=49). PAF and T lymphocyte levels were compared between the two groups. Logistic regression analysis was performed to examine the relationship between PAF levels and disease activity, as well as their correlation with T cell subsets. Unconditional logistic regression modeling was employed to analyze the interaction between PAF levels and T cell subsets in disease activity. Results No significant difference was observed in CD3⁺ levels between advanced and stable stage vitiligo patients. PAF and CD8⁺ levels in advanced group were significantly higher than those in stable group, while CD4⁺ levles and CD4⁺/CD8⁺ ratios were significantly lower than those in stable group. When PAF level was 18.24 ng/L, the maximum Youden index reached 0.670, with corresponding sensitivity of 84.22% and specificity of 82.77%. The area under ROC curve AUC was 0.858. The intensity of association between PAF level and disease activity was nonlinear dose-response relationship. Among patients with VIDA score ≥1, significant differences were observed in both CD4⁺ and CD8⁺ levels across different PAF levels, and the CD4⁺/CD8⁺ ratios in vitiligo patients with different VIDA scores was significantly different. Interaction analysis revealed that after adjusting for confounding factors, the effect of PAF levels and T cell subsets on disease activity in vitiligo patients showed significant interaction in both additive model (RERI=4.674, 95%CI: 1.032~11.942; AP=0.763, 95%CI: 0.336~1.201; S=6.854, 95%CI: 1.904~16.520) and multiplicative model (OR=3.461, 95%CI: 1.365~8.713). Conclusion Serum PAF, CD4⁺, CD8⁺ and CD4⁺/CD8⁺ of vitiligo patients are closely related to disease activity, and PAF level interacts with T cell subsets (CD4⁺, CD8⁺, CD4⁺/CD8⁺) in the disease activity of vitiligo patients. PAF and T cell immune function may contribute to the occurrence and development of vitiligo, which could serve as clinical indicators of disease activity to guide timely management.
Humans ; Vitiligo/blood* ; Platelet Activating Factor/immunology* ; Male ; Female ; Adult ; Middle Aged ; Young Adult ; T-Lymphocytes/immunology* ; Adolescent ; T-Lymphocyte Subsets/immunology*

OBJECTIVETo detect the serum levels of melanocyte antibodies and explore the relation between melanoma antigen recognized by T-cells (MART-1) and vitiligo in children.

METHODSThe serum samples were collected from children with vitiligo to test the autoantibodies, and divided into low- and high-titer group according to the test results. Melanocytes were incubated with the serum samples, and the changes of melanocyte surface antigen were evaluated using specific MART-1 antibody.

RESULTSThe serum melanocyte antibody levels in children with vitiligo were significantly higher than those in normal subjects. The expression level of melanocyte surface antigen MART-1 increased obviously after incubation of the melanocyte with high antibody titer serum samples, and MART-1 was found to specifically bind to specific MART-1 antibody.

CONCLUSIONMelanocytes MART-1 may correlate to the autoimmune mechanism in children with vitiligo.

Adolescent ; Autoantibodies ; blood ; Child ; Child, Preschool ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; MART-1 Antigen ; immunology ; Male ; Melanocytes ; immunology ; T-Lymphocytes ; immunology ; Vitiligo ; immunology

OBJECTIVETo observe the clinical efficacy of Zengse Pill ( ZSP) on patients with vitiligo of qi-stagnancy and blood-stasis syndrome type (V-QB), and to preliminarily explore its mechanism of action.

METHODSSixty-five V-QB patients, with their diagnosis confirmed by clinical examination, were randomized by digital table method into two groups, with 31 patients in the control group and 34 in the treatment group. Cobamamide (2 tablets) was administered orally to all patients, and Psoralea tincture (a self-formulated preparation) was applied externally thrice a day. In addition, for patients in the treatment group, ZSP was given orally, at 5 pills per dose, 3 times every day. The therapeutic course for both groups was 3 months. Patients were re-examined every half-month, and changes in the skin lesions were observed and recorded. The levels of lymphocyte subsets, serum immune globulin, and complement C3 and C4 in patients were determined before and after the therapeutic course and compared with the corresponding indexes determined in 21 healthy subjects.

RESULTSThe total effective rate in the treatment group was 82.4%, which was markedly higher than that in the control group (54.8%), showing a significant difference (P<0.05). After treatment, CD(4) (+) percentage, CD(4) (+)/CD(8) (+) ratio, and blood levels of C3 and C4 increased, while CD(8) (+) percentage decreased in the treatment group (P<0.05 or P<0.01). All these indexes remained unchanged in the control group, and the respective comparisons between groups showed significant differences (P<0.01).

CONCLUSIONZSP has a definite clinical effect on the treatment of V-QB but with no evident adverse reactions, and it can increase the CD(4) (+) percentage, CD(4) (+)/CD(8) (+) ratio, and the levels of serum C3 and C4, thus regulating the immunity of the organism, which might be one of its mechanisms of action.

Adolescent ; Adult ; CD4-CD8 Ratio ; Complement C3 ; analysis ; Complement C4 ; analysis ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Immunoglobulins ; blood ; Lymphocyte Subsets ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Qi ; Vitiligo ; drug therapy ; immunology

Generalized vitiligo associated with allogeneic bone marrow or stem cell transplantation has rarely been reported. We experienced two cases of generalized vitiligo after allogeneic bone marrow and stem cell transplantation. The first patient was received an allogeneic bone marrow transplantation and subsequent allogeneic peripheral blood stem cell transplantation for severe aplastic anemia from his sister. The second patient underwent allogeneic bone marrow transplantation for acute myelogeneous leukemia from his sister. Generalized vitiligo developed after transplantation. Neither vitiligo nor evidences of autoimmune diseases were found in their stem cell donors. Vitiligo was effectively treated with narrow band UVB irradiation.
Anemia, Aplastic ; Autoimmune Diseases ; Bone Marrow ; Bone Marrow Transplantation ; Humans ; Leukemia ; Peripheral Blood Stem Cell Transplantation ; Siblings ; Stem Cell Transplantation* ; Stem Cells* ; Tissue Donors ; Vitiligo*

OBJECTIVETo observe the therapeutic effect of Xiaobai Mixture (XBM) in treating vitiligo.

METHODSSeventy-four patients with vitiligo were randomly divided into the XBM group treated with XBM and the control group treated with 8-MOP. The therapeutic effect, nail-fold microcirculation, plasma endothelin-1, serum immunoglobulin were observed and compared.

RESULTSThe therapeutic effect of XBM was better than that of 8-MOP (P < 0.05). XBM could also obviously improve the nail-fold microcirculation, elevate the plasma endothelin-1 level and lower the serum IgG (P < 0.01).

CONCLUSIONXBM has superiority in treating vitiligo.

Adolescent ; Adult ; Drugs, Chinese Herbal ; therapeutic use ; Endothelin-1 ; blood ; Female ; Humans ; Immunoglobulin G ; blood ; Male ; Microcirculation ; Middle Aged ; Nails ; blood supply ; Phytotherapy ; Vitiligo ; drug therapy

BACKGROUND: The increase of the incidence of autoimmune diseases and the autoimmune pathogenesis of vitiligo were reported. OBJECTIVE: We studied the frequency of autoimmune disorders and positivity of antinuclear antibody in Korean vitiligo patients. METHODS: Vitiligo patients (439 patients) and control subjects (197 patients) were interviewed about their history of autoimmune diseases. Laboratory studies including complete blood cell count, urine analysis, blood chemistry, fasting blood sugar, thyroid function test (T3, free T4, TSH), and antinuclear antibody were performed for the screening of autoimmune disorders. RESULTS: The diseases associated with vitiligo were microcytic hypochromic anemia (3.64%), non-insulin dependent diabetes mellitus (2.96%), thyroid disease (3.96%), atrophic gastritis, and alopecia areata. In the control subjects, the associated diseases were microcytic hypochromic anemia (1.62%), non-insulin dependent diabetes mellitus (4.65%), and thyroid disease (3.49%). These results show that the frequency of autoimmune disorders in vitiligo patients is not significantly higher than that in control subjects. Six (54.5%) out of 11 vitiligo patients with thyroid disease were diagnosed as having thyroid disease for the first time. Four (0.91%) out of 438 vitiligo patients showed positive to antinuclear antibody. Positivity of antinuclear antibody was not higher in vitiligo patients than that in control subjects (1.16%). CONCLUSION: Frequency of autoimmune diseases and positive reaction to antinuclear antibody in vitiligo patients were not significantly higher than those in control subjects.
Alopecia Areata ; Anemia, Hypochromic ; Antibodies, Antinuclear ; Autoimmune Diseases ; Blood Cell Count ; Blood Glucose ; Chemistry ; Diabetes Mellitus ; Fasting ; Gastritis, Atrophic ; Humans ; Incidence ; Mass Screening ; Thyroid Diseases ; Thyroid Function Tests ; Vitiligo*

BACKGROUND: Vitiligo was divided into two types, segmental and non-segmental vitiligo. OBJECTIVE: The purpose of our study is to investigate the clinical differences of segmental and non-segmental vitiligo. METHODS: A cross-sectional study, using standard questionnaire items on 1190 cases of vitiligo was performed. RESULTS: The results were summarized as follows 1. The non-segmental vitiligo was 2.4fold more common than segmental vitiligo. 2. The mean age of onset was older in non-segmental vitiligo than in segmental vitiligo. 3. The mean duration was longer in non-segmental vitiligo. 4. The depigmented area was larger in non-segmental vitiligo. 5. The incidences of Koebner phenomenon, progressiveness and mucosal involvement were more common in non-segmental vitiligo. 6. There were no differences about sex ratio, blood typing, family history, and associated disorders. CONCLUSION: Segmental and non-segmental vitiligo differ substantially in various clinical manifestations, which suggests that two types of vitiligo have different pathogenic mechanism.
Age of Onset ; Blood Grouping and Crossmatching ; Cross-Sectional Studies ; Humans ; Incidence ; Sex Ratio ; Vitiligo* ; Surveys and Questionnaires

The association of vitiligo and pernicious anemia has been previously documented. The low levels of folic acid and vitamin B12 were thought to be related to vitiligo. To date, there have been very few reports about the serum levels of folic acid and vitamin B12 in patients with vitiligo. Using radioimmunoassay, we measured the serum levels of folic acid and vitamin B12 in 100 Korean patients with vitiligo. The mean serum levels of folic acid and vitamin B12 were 6.31 +/- 2.82 ng/ml and 630.25 +/- 230.94 pg/ml, respectively, in patients with vitiligo. These levels showed no significant difference compared to the normal control group, suggesting that folic acid and vitamin B12 do not appear to play a role in the pathogenesis of vitiligo.
Adolescence ; Adult ; Aging/blood ; Child ; Female ; Folic Acid/blood* ; Human ; Male ; Middle Age ; Sex Characteristics ; Vitamin B 12/blood* ; Vitiligo/blood*

Vitiligo is a disease in which melanocytes are selectively destroyed. The disease is thought to be an autoimmune process being there are antibodies to pigment cells in the sera of patients and animals with vitiligo. In the present study, sera from vitiligo patients were examined for reactivity with the human melanoma cell line, SK-Mel-28, by Western blot analysis of solubilized membrane antigens of these cells to identify the pigment cell antigens defined by antibodies in the patients with vitiligo. Antibody reactivity to human melanoma cells (SK-Mel-28) was investigated in 14 patients with vitiligo, and 16 with normal control individuals. Antibodies to the 116-113, 60, 40 KD antigens were associated with vitiligo being present in 79%, 86%, and 43% respectively of the patients with vitiligo, but in only 6%, 38% and 6% of the normal controls. In contrast, antibodies to the 160-155, 78 and 64 KD antigens were equally common in vitiligo and in normal individuals. The results suggest that autoreactivity to pigment cells occurs more commonly in patients with vitiligo than in the normal control and high autoreactivity to pigment cells in the vitiligo sera might be an impertinent epiphemenon to destroyed pigment cell.
Antibodies, Neoplasm/*blood ; Antigens, Neoplasm/immunology ; Autoantibodies/blood ; Blotting, Western ; Human ; Melanoma/*immunology ; Vitiligo/*immunology