4 research outputs found
Comorbid autoimmune diseases in a cohort of patients with vitiligo
Background: Vitiligo has been reported to be associated with autoimmune diseases. However, few large-scale studies have been conducted to quantify the burden of autoimmune disease in patients with vitiligo. Objective: To determine the prevalence of comorbid autoimmune diseases in patients with vitiligo seen at the Henry Ford Hospital Department of Dermatology in Detroit, Michigan, during a period of almost 11 years. Methods: Using the International Classification of Diseases, 9th revision code 709.01, we searched the Henry Ford Health System Medical Record Database to identify 1873 patients with vitiligo seen between January 2002 and November 2012. We manually reviewed all 1873 electronic medical records to validate the diagnosis of vitiligo and collect data. Patients were excluded if they did not have at least 2 dermatology notes (N = 595) and if they were never diagnosed with vitiligo by a dermatologist (N = 180), resulting in a final study population of 1098 patients with vitiligo. As designed a priori, we assessed the prevalence of comorbid autoimmune diseases in these patients. Results: The final study population included 1098 patients with vitiligo. Nearly 20% had at least 1 comorbid autoimmune disease. Compared to the general US population, we found a higher prevalence of thyroid disease (12.9% of those 12 years or older,
An in vivo model for post-inflammatory hyperpigmentation.
Background: Post-inflammatory hyperpigmentation (PIH) is an acquired hypermelanosis occurring after cutaneous inflammation. A validated, in vivo model of acne-induced PIH was previously established using 35% trichloracetic acid (TCA). We aim to determine the minimum TCA concentration that induces PIH that results in validated measurements that are most similar to acne-induced PIH. Methods: Thirty subjects (skin types I-VI) were enrolled; 20 had a history of PIH, and 10 had a history of post-inflammatory erythema with acne resolution. Study procedures have been completed by 25/30 subjects. At day 0, two acne papules were identified on the back and 35%, 30%, 25%, and 20% TCA was applied to the buttocks. At day 28, clinical photography, Investigator Global Assessment (IGA) of hyperpigmentation and erythema, and colorimetry were performed for all lesions and adjacent uninvolved sites.Results: For 25 subjects, IGA and colorimeter data for day 28 were analyzed with one way repeated measures ANOVA. There were no significant differences of IGA scores of hyperpigmentation between acne and 25% and 30% TCA-induced lesions. Colorimetry L* (lightness) found no significant difference between acne and 30% and 35% TCA-induced lesions. Colorimeter parameter a* (erythema) demonstrated similarities between acne and 35% TCA-induced lesions.Conclusion: Our results show that 25% TCA has the potential to induce PIH similar to acne without necrosis. A higher concentration TCA (35%) resulted in the erythema similar to acne. We suggest that TCA-induced changes could serve as a model for the study of PIH
Ultraviolet radiation, both UVA and UVB, influences the composition of the skin microbiome
Inhabiting each square centimeter of skin are approximately 1 million bacteria from hundreds of distinct species. Recent studies have begun to investigate the complex relationship between host and microorganisms leading to non-infectious pathologies such as acne, atopic dermatitis, and psoriasis. Though the skin is continuously exposed to external environmental stressors such as ultraviolet (UV) radiation, there have been no studies examining the effects of UV on the skin microbiome. To test our hypothesis that UV will alter the cutaneous microbiome, 22 participants were exposed to various doses of UVA (22-47 J/cm2) or UVB (100-350 mJ/cm2) and skin was swabbed before, immediately after, and 24h after UV exposure. DNA was isolated from the swabs and sequenced to identify the microbial composition for each sample. There was vast intra- and inter-subject variation in the skin microbiome at all time points, and phylum- and species-level differences were identified. Specifically, within the Proteobacteria phyla, an increase of the order Burkholderiales was observed after UV compared to pre-UV (59% vs 24%, p=0.0172). There was no clear difference in microbial composition between UVA- and UVB-irradiated skin; however, the sensitivity of various microbes to UV as well as their re-colonization potential following exposure differed. Taken together, the results demonstrate that UV radiation, both UVA and UVB, has profound qualitative and quantitative influences on the composition of the skin microbiome, which may affect skin diseases in which UV radiation is a factor, and may contribute to the efficacy of phototherapy and photochemotherapy
Ultraviolet radiation, both UVA and UVB, influences the composition of the skin microbiome
BACKGROUND: Studies have begun to investigate the complex relationship between host and microorganisms in non-infectious pathologies such as acne, atopic dermatitis and psoriasis. Though the skin is exposed to environmental stressors such as ultraviolet radiation (UVR), no studies exist examining the effects of both UVA and UVB on the skin microbiome. OBJECTIVE: To test the effect of UVA and UVB on human skin microbiome. METHODS: To test whether UV will alter the cutaneous microbiome, participants were exposed to doses of UVA (22-47 J/cm(2) ) or UVB (100-350 mJ/cm(2) ) and samples were collected. DNA was isolated and sequenced to identify the microbial composition of each sample. RESULTS: There was vast intra- and inter-subject variation at all time points, and phylum and species-level differences were identified. These included an increase in the phylum Cyanobacteria and a decrease in the family Lactobacillaceae and Pseudomonadaceae. The sensitivity of microbes to UVR and their re-colonization potential following exposure differed in UVA vs UVB samples. LIMITATIONS: The sample size was small, and the study was limited to males. CONCLUSION: The results demonstrate that UVR has profound qualitative and quantitative influences on the composition of the skin microbiome, possibly effecting skin pathology in which UVR is a factor