Strict anatomical coexistence of vitiligo and psoriasis vulgaris - a koebner phenomenon?
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Vitiligo
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Psoriasis, vitiligo, and mycosis fungoides (MF) are among the most frequently treated dermatological diseases by photo(chemo)therapy. The objectives are to determine which photo (chemo) therapeutic modality could achieve the best response in the treatment of psoriasis, vitiligo, and MF. The design used in this study is retrospective analytical study. The study included 745 patients' records; 293 with psoriasis, 309 with vitiligo, and 143 with early MF, treated in the Phototherapy Unit, Dermatology Department, Kasr El-Aini Hospital, Cairo University by either psoralen and ultraviolet A (PUVA), narrow band ultraviolet B (NB-UVB), psoralen and narrow band UVB (P-NBUVB), broad band UVB (BB-UVB), or broad band UVA (ΒΒ-UVA). Data were retrieved from the computer database of the unit and statistically analyzed. In psoriasis, oral and topical PUVA and NB-UVB were found to be equally effective, whereas oral PUVA had significantly better results than both UVA and BB-UVB at the end of therapy. In generalized vitiligo, PUVA and P-NBUVB had significantly better results than NB-UVB alone. In early MF, there was no statistically significant difference between the response to oral PUVA and NB-UVB. PUVA and NB-UVB are good choices in patients with psoriasis and early stage MF, whereas PUVA appears the best choice in the treatment of vitiligo.
Vitiligo
PUVA therapy
Ultraviolet b
Ultraviolet therapy
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Vitiligo and psoriasis are both common diseases. However, coexistence of these two diseases is rare. The pathogenesis of the coexistence of vitiligo and psoriasis is still unknown. Herein, we report three children (11-year-old, 8-year-old, and 7-year-old females) who attended our Department of Dermatology with coexisting vitiligo and psoriasis.
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Although the first case of psoriasis with vitiligo was reported in 1955, the pathogenesis of the association between these two dermatoses is still unknown (7). Herein, we report on a case of a 57-year-old man with coexisting vitiligo and psoriasis.
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The article discusses the common pathogenetic pathways of autoimmune skin diseases – psoriasis and vitiligo. Currently proposed treatments for vitiligo do not significantly reduce or completely restore skin pigmentation. The use of adalimumab for 6 years in a patient suffering from psoriasis, psoriatic arthritis (PsA), vitiligo and autoimmune thyroiditis made it possible to control the activity of psoriasis and PsA, and also contributed to the regression of depigmentation foci. The use of biologic disease-modifying antirheumatic drug therapy in this group of patients in order to achieve repigmentation may be promising.
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ABSTRACT We report a case of a 15‐year‐old Caucasian female, previously affected by non‐segmental vitiligo and psoriasis vulgaris, who developed a psoriatic eruption on sun‐exposed skin during the summer. Oral therapy with cyclosporine A achieved a rapid improvement of the clinical picture. The main features of photosensitive psoriasis and the association between psoriasis and vitiligo are discussed herein.
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Twenty-nine patients with vitiligo and psoriasis observed over a 5-year period were reviewed. The incidence of concurrence of both diseases was not increased, and the onset and course of the psoriasis and vitiligo were separate. Psoriatic lesions occurred on vitiliginous areas and normal skin with equal frequency. These patients had a larger number of associated diseases than normally seen in psoriatics.
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To the Editor.—
The occurrence of vitiligo and psoriasis in the same patient is a rare event. In theArchives, De Moragas and Winkelmann recently reported two cases in which the psoriasis occurred only in areas of vitiligo (101:235, 1970). To balance this report, I am recording a case in which psoriasis and vitiligo occurred in the same patient without localization of the psoriasis to depigmented areas. The patient is a white girl aged 15 with a six-year history of extensive vitiligo and a two-year history of psoriasis. Her legs (Fig 1), which were unaffected by vitiligo, apart from the patellar areas, showed extensive psoriatic plaques. The sacral area and buttocks (Fig 2), entirely involved by vitiligo, showed extensive areas of psoriasis with lesser involvement of the upper back. In addition, she showed typical involvement of scalp and nails by psoriasis. Accordingly, psoriasis need not selectively involve areas of vitiligo.Vitiligo
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We present a 53-years old male with a 10 years history of vitiligo who further developed psoriatic lesions clearly representing a Koebner´s phenomenon. He is currently being treated with phototherapy and narrowband UVB with an interin satisfactory outcome especially in the psoriasis.
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Vitiligo and psoriasis are common dermatoses that occur in 1∼3% and 0.5% of the general population, respectively.There have been several reports of the concurrence of these diseases in the English medical literature.Yet the pathogenesis of the association between these two dermatoses is still unknown.Psoriasis may occur coincidentally with vitiligo and it may be strictly confined to the vitiliginous patches or it may occur elsewhere.Despite the reports in the English literature, there has been only one case of vitiligo and psoriasis coexisting in the same patient and these diseases occurred in separate sites in the Korean dermatologic literature.A 30-year-old man recently presented with spreading vitiligo on the right forearm and a 3-month history of guttate psoriasis on the left forearm.He had a family history of psoriasis without any history of associated autoimmune disease.Herein, we report on a case of coexisting vitiligo and psoriasis in the same individual at different sites and we review the relevant literature.(
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