Vitiligo Hastalarında Sigara Kullanımının Hastalık Semptom ve Bulguları Üzerinde Etkisi Var Mıdır?

Öz

Amaç: Kliniğimizde vitiligo nedeniyle takip edilen hastalarda sigara kullanımının hastalık semptom ve bulguları üzerine etkisi olup olmadığını araştırmayı amaçladık.

Materyal ve Metod: Çalışmamızda Sakarya Üniversitesi Tıp Fakültesi Eğitim ve Araştırma Hastanesi (SÜEAH) Dermatoloji Kliniğinde poliklinik takibi olan hastaların retrospektif olarak dosyaları taranarak klinik ve laboratuvar verileri kayıt altına alındı. Hastaların demografik verileri, komorbid hastalıkları ve hastalıkları ile ilişkili bulguları retrospektif dosya verilerinden kaydedildi.

Bulgular: Çalışmaya 217 hasta alındı.  52 hasta sigara kullanan (grup I) ve 165 hasta sigara kullanmayan grupta (Grup II) idi. Grup I ile Grup II karşılaştırıldığında sigara kullananların yaş olarak daha büyük ve erkek baskınlığında olduğu görüldü. Sigara içmeyen grupta Keobner fenomeni, halo nevüs ve lökotrişi anlamlı derecede fazla saptandı. Repigmentasyon sigara içenlerde daha az izlendi. HDL düzeyi sigara içen grupta daha düşük bulundu.

Tartışma: Vitiligo hastalarında sigaranın bırakılması repigmentasyonun sağlanması açısından önemlidir.

Anahtar Kelimeler

• vitiligo,repigmentasyon,sigara

Does Smoking Have Impact on Symptoms and Signs of Disease in Vitiligo Patients?

Abstract

Aim: We aimed to investigate whether smoking affects the symptoms and signs of vitiligo in patients followed up for vitiligo in our clinic.

Materials and Methods: In our study, the files of patients who were followed up in outpatient clinic in Dermatology Clinic of Sakarya University Medical Faculty Training and Research Hospital (SÜEAH) were retrospectively scanned and clinical and laboratory data were recorded. Patients' demographic data, comorbid diseases and their findings related to their diseases were recorded from retrospective file data.

Results: Two hundred and seventeen patients were included in the study. Fifty-two patients were in smokers group (group I) and 165 patients were in non-smokers group (Group II). When Group I and Group II were compared, it was seen that smokers were older and male dominated. Keobner phenomena, halo nevus and leukotrichia were significantly higher in nonsmoker group. Repigmentation was less frequent in smokers. HDL levels were lower in the smoker group.

Conclusion: Smoking cessation in vitiligo patients is important in terms of repigmentation.

Keywords

• vitiligo,repigmentation,smoking

References

1. 1. Alikhan A, Felsten LM, Daly M, Petronic-Rosic V. Vitiligo: a comprehensive overview. Part I. Introduction, epidemiology, quality of life, diagnosis, differential diagnosis, associations, histopathology, etiology, and work-up. J Am Acad Dermatol. 2011; 65:473–91.
2. 2. Jeon IK, Park CJ, Lee MH, Lee DY, et al. A multicenter collaborative study by the Korean society of vitiligo about patients' occupations and the provoking factors of vitiligo. Ann Dermatol. 2014; 26:349–56.
3. 3. Dammak I, Boudaya S, Ben Abdallah F, Turki H, et al. Antioxidant enzymes and lipid peroxidation at the tissue level in patients with stable and active vitiligo. Int J Dermatol. 2009; 48:476–480.
4. 4. Passi S, Grandinetti M, Maggio F, Stancato A, et al. Epidermal oxidative stress in vitiligo. Pigment Cell Res. 1998; 11:81–85.
5. 5. Schallreuter KU, Wood JM, Berger J. Low catalase levels in the epidermis of patients with vitiligo. J Invest Dermatol. 1991; 97:1081–1085.
6. 6. Yildirim M, Baysal V, Inaloz HS, Can M. The role of oxidants and antioxidants in generalized vitiligo at tissue level. J Eur Acad Dermatol Venereol. 2004; 18:683–686.
7. 7. H.H. Park and M.H. Lee. Serum levels of vitamin B12 and folate in Korean patients with vitiligo, Acta Derm Venereol 85(2005), 66-7.
8. 8. Boissy R E & Manga P. On the etiology of contact/occupational vitiligo. Pigment Cell Res 17, 208–214 (2004).

9. 9. Schallreuter KU, Salem MA, Gibbons NC, Martinez A, et al. Blunted epidermal L-tryptophan metabolism in vitiligo affects immune response and ROS scavenging by Fenton chemistry, part 1: Epidermal H2O2/ ONOO (−)-mediated stress abrogates tryptophan hydroxylase and dopa decarboxylase activities, leading to low serotonin and melatonin levels. FASEB J 26, 2457–2470 (2012).
10. 10. Sravani PV, Babu NK, Gopal K, Rama Rao GR, et al. Determination of oxidative stress in vitiligo by measuring superoxide dismutase and catalase levels in vitiliginous and non-vitiliginous skin. Indian J Dermatol Venereol Leprol 75, 268–271 (2009).
11. 11. Zhou Z, Li CY, Li K, Wang T, et al. Decreased methionine sulphoxide reductase A expression renders melanocytes more sensitive to oxidative stress: a possible cause for melanocyte loss in vitiligo. Br J Dermatol 161, 504–509 (2009).
12. 12. Denat L, Kadekaro AL, Marrot L, Leachman SA, et al. Melanocytes as instigators and victims of oxidative stress. J Invest Dermatol 134, 1512–1518 (2014).
13. 13. Laddha NC, Dwivedi M, Mansuri MS, Gani AR, et al. Vitiligo: interplay between oxidative stress and immune system. Exp Dermatol 22, 245–250 (2013).
14. 14. Wang X, Li K, Liu L, Shi Q, et al. AHR promoter variant modulates its transcription and downstream effectors by allele-specific AHR-SP1 interaction functioning as a genetic marker for vitiligo. Sci Rep 5, 13542 (2015).
15. 15. Jian Z, Li K, Song P, Zhu G, et al. Impaired activation of the Nrf2-ARE signaling pathway undermines H2O2-induced oxidative stress response: a possible mechanism for melanocyte degeneration in vitiligo. J Invest Dermatol 134, 2221–2230 (2014).
16. 16. Beckman JS & Koppenol WH. Nitric oxide, superoxide, and peroxynitrite: the good, the bad, and ugly. Am J Physiol 271, C1424–1437 (1996).
17. 17. Gill L, Zarbo A, Isedeh P, Jacobsen G, et al. Comorbid autoimmune diseases in patients with vitiligo: A cross-sectional study. J Am Acad Dermatol. 2016 Feb;74(2):295-302.
18. 18. J. P. Ortonne, D. B. Mosher, and T. B. Fitzpatrick. “Vitiligo and other hypomelanoses of hair and skin,” in Topics in Dermatology, J. P. Ortonne, D. B. Mosher, and T. B. Fitzpatrick, Eds., pp. 257–258, Plenum Medical Book, New York, NY, USA, 1983.
19. 19. Ortonne JP, Bahadoran P, Fitzpatrick TB, Mosher DB, et al. Hypomelanoses and hypermelanoses. Fitzpatrick’s Dermatology in General Medicine. Ed. Freedberg IM, Eisen AZ, Wolff K, Goldsmith LA, Katz SI. 6th ed. New York, McGraw Hill, 2003; 836-881.
20. 20. Barona MI, Arrunátegui A, Falabella R, Alzate A. An epidemiologic case-control study in a population with vitiligo. J Am Acad Dermatol. 1995; 33:621–625.