Vitiligo Hastalarında İnce Lif Nöropatisinin Değerlendirilmesi

Abstract

Amaç: Bu çalışma, normal standart sinir iletim çalışmaları olan vitiligo hastalarında ince lif nöropatisini tespit etmek için tasarlanmıştır.

Meteryal Metod: Bu vaka- kontrol çalışması Mart 2016-Haziran 2016 tarihleri ​​arasında Sakarya Üniversitesi Tıp Fakültesi Eğitim ve Araştırma Hastanesi Nöroloji Anabilim Dalı'nda ENMG laboratuvarında gerçekleştirildi. Çalışmaya 123 vitiligo hastasından dışlama kriterlerine göre seçilmiş 18-60 yaş arasında 40 vitiligo hastası ile kontrol amaçlı yaşları ve cinsiyetleri eşleştirilmiş 40 sağlıklı birey dahil edildi. Katılımcılar iki gruba ayrıldı (vitiligo ve kontrol grupları). Katılımcıların demografik verileri kaydedildi. İnce lif iletimini değerlendirmek için kutanöz sessiz period  (KSP) iletim çalışması yapıldı. Vitiligo şiddeti vitiligo alan skorlama indeksi ile değerlendirildi.

Bulgular: Üst ve alt ekstremitelerin KSP distal latans ve süre değerleri iki grupta benzerdi (vitiligo ve kontrol). Vitiligo hastalarında hastalığın şiddeti ve süresi ile üst ve alt ekstremitelerin KSP değerleri arasında ilişki saptanmadı.

Sonuç: Bu çalışmanın, vitiligonun her bir: miyelinli A delta lifleri ve küçük lifler olan demiyelinize C lifleri üzerindeki etkilerini gözlemlememize izin verdiği için değerli olduğunu düşünmekteyiz. 

Keywords

• kutanöz sessiz period; vitiligo; ince lif nöropatisi

Thin Fiber Neuropathy Associated with Vitiligo

Abstract

Objective: This study is designed to detect thin fiber neuropathy, if any with patients who had vitiligo and had normal standard nerve conduction studies.

Matherials and Methods: This case - control study was conducted between March 2016-June 2016 in ENMG laboratory of our neurology clinic. Amoung 123 vitiligo patients, 40vitiligo patients between ages 18-60 without evident neuropathy by standard nerve conduction studies were included in this study. Furthermore 40 healthy individuals without vitiligo or any neuropathy with matching age and gender were included in this study. All participants divided into two groups (vitiligo and control groups). Demographic data were recorded with weight, height, body mass index (BMI) data of participants. Cutaneous silent period conduction study was performed in median and sural nerves to evaluate small fiber conduction.

Results: CSP duration and distal latency measurements abductor pollicis braves muscle on the upper extremity and tibialis anterior muscle on the lower extremity were similar in both CTS and control groups. Our findings show no association with vitiligo and small fiber neuropathy,  

Conclusion: We suppose that this study is valuable for allowing us to observe the effects of vitiligo on each: myelinated A delta fibers and demyelinated C fibers, which are small fibers.

Keywords

• cutaneous silent period; vitiligo; thin fiber neuropathy

References

1. 1. Floeter MK. Cutaneous silent periods. Muscle Nerve 2003;28:391–401.2. Uncini, T. Kujirai, B. Gluck, S. Pullman. Silent period induced by cutaneous stimulation. Electroencephalogr Clin Neurophysiol1991;81,5:344–352.3. SerraoM, Parisi L, Pierelli F, RossiP. Cutaneous afferents mediating the cutaneous silent period in the upper limbs: evidences for a role of low-threshold sensory fibres. Clinical Neurophysiology 2001;11:2007–2014.4. Tiric-Campara M, Denislic M, Djelilovic-Vranic J, et al. Cutaneous Silent Period in the Evaluation of Small Nerve Fibres. Med Arh 2014; 68:98-101.5. Colucci R. Oxidative stres and immune system in vitiligo and thyroid diseases. Oxid Med Cell Longev 2015;2015:631927. 6. Bahadır S, Yaylı S. Childhood Vitiligo: Epidemiologyand Etiology. Turkderm 2006; 40: 81-86.7. Alikhan A. 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;65:473-491.8. Karadag AS, Tutal E, Ertugrul DT. Insulin resistance is increased in patients with vitiligo. Acta Derm Venereol 2011;91:541-544.9. Karadag AS, Tutal E, Ertugrul DT, Akin KO, Bilgili SG. Serum holotranscobalamine, vitamin B12, folic acid and homocysteine levels in patients with vitiligo. Clin Exp Dermatol 2012;37:62-64.10. Lotti T, D'Erme A.M. Vitiligo as a systemic disease. Clin Dermatol 2014;32:430-434.11. American Academy of Neurology, American Association of Electrodiagnostic Medicine and the American Academy of Physial Medicine and Rehabilitation. Practice parameter for electrodiagnostic studies in carpal tunnel syndrome (summary statement). Neurology 1993; 43:2404-2405.12. Kofler M.Functional organization of exteroceptive inhibition following nociceptive electrical fingertip stimulation in humans. Clin Neurophysiol 2003; 114: 973–980.13. Hamzavi I, Jain H, McLean D, Shapiro J, Zeng H, Lui H.Parametric modeling of narrowband UV-B phototherapy for vitiligo using a novel quantitative tool: the Vitiligo Area Scoring Index. Arch Dermatol 2004;140:677-683.14. Elsherif M.A, Spinner R.J, RachelY.M. The coexistence of peripheral nerve sheath tumors and vitiligo:more than coincidence? Acta Neurochir 2016; 158: 95-99.15. Shin MK, Uhm YK, Lee JH, Kim SK, Chung JH, Lee MH.Association between CDK5RAP1 polymorphisms and susceptibility to vitiligo in the Korean population.Eur J Dermatol 2012;22:495-499.16. Lerner AB, Case JD, Mori W, Wright MR. Melatonin in peripheral nerve. Nature 1959; 183:1821.17. Wu CS, Yu HS, Chang HR, Yu CL, Yu CL, Wu BN. Cutaneous blood flow and adrenoceptor response increase in segmental-type vitiligo lesions. J Dermatol Sci 2000;23:53–62.18. Bir LS, Aktan S. Sympathetic skin response in psoriasis and vitiligo. J Auton Nerv Syst 1999;77:68-71.19. Dolu N, Ferahbas A, Ozesmi C, Peker D, Acik C. Effect of PUVA therapy on electrodermal activity parameters in vitiligo patients. Auton Neurosci 2005;118:102-107.20. Merello M, Nogues M, Leiguarda R, Saubidet C. L., Florin A. Abnormal sympathetic skin response in patients with autoimmune vitiligo and primary autoimmune hypothyroidism. J Neurol 1993;240:72-74.