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Biomedical subjects

K Ongenae

Publications and source records attributed to K Ongenae.

13 recordsLinked to original sources

Psychosocial effects of vitiligo.

A limited number of studies have paid attention to the psychosocial well-being of patients affected with vitiligo. We review the psychosocial effects of vitiligo, how patients deal with them and the psychiatric morbidity in vitiligo patients. Given the appreciable comorbidity, it is important to consider these observations in the management of patients, for example in patient-physician interaction but also in treatment strategies and evaluation of treatments. The effects of the psychological state on the disease itself together with the potential therapeutic implications are reviewed. Based on these data, we suggest how to further improve patient's management.

Adaptation, Psychological↗

Effect of vitiligo on self-reported health-related quality of life.

BACKGROUND: Vitiligo is a pigmentary disorder affecting at least 1% of the total population. Although the disease does not produce direct physical impairment, it may considerably influence the psychological well-being of the patients. It has been suggested that patients suffer from low self-esteem, poor body image and a poor quality of life. The majority of the studies on the psychosocial impact of vitiligo were conducted in the U.S.A. and England. OBJECTIVES: This study aims to quantify the burden of vitiligo by estimating health-related quality of life in the Dutch-speaking Belgian population (Flanders). This is compared with the level of disability caused by psoriasis in a similarly recruited population. It is also our purpose to detect those at risk of experiencing a poor quality of life and to identify variables that might predict this impairment. PATIENTS AND METHODS: Patients with vitiligo (n = 119) and 162 patients with psoriasis were included in a postal survey. In order to obtain a patient-based measurement of quality of life we used the Dermatology Life Quality Index (DLQI), a widely validated questionnaire that is easy to use and allows comparison between several skin disorders. Other survey questions were related to demographic data and disease-related characteristics. RESULTS: We obtained excellent response rates in both patient groups. The overall mean DLQI score for vitiligo (4.95) was lower than that for psoriasis (6.26) (P = 0.01). Patients with vitiligo experienced significantly less impairment of life quality from the symptoms and treatment of the disease (P < 0.001). The highest individual mean scores in vitiligo were found for Q2 (feelings), Q4 (clothing), Q5 (social and leisure activities) and Q3 (daily routine). The interaction of disease and sex on the DLQI score was highly significant (P = 0.001). While men with vitiligo scored significantly lower than men with psoriasis (P < 0.001), we found a comparable overall DLQI score for women in these disease groups. The number of consultations (P = 0.005) and severity of the disease (P < 0.001) were independently related to the DLQI. CONCLUSIONS: Our study quantifies the burden on the quality of life caused by vitiligo and indicates specific areas of patients' lives which are most affected by the disease. Sex, number of consultations and subjective disease severity independently predict the quality of life. The quality of life impairment in women affected with vitiligo equals the impairment caused by psoriasis in our study population. These results should awake the interest of physicians in this 'cosmetic' disease, since appropriate treatment is likely to improve the quality of life of vitiligo patients.

Adult↗

Quality of life and stigmatization profile in a cohort of vitiligo patients and effect of the use of camouflage.

BACKGROUND: Few studies have paid attention to the effects of treatment interventions on the psychosocial consequences of vitiligo. OBJECTIVES: To quantify and analyse the psychosocial benefit of the use of camouflage in vitiligo patients. PATIENTS AND METHODS: 78 vitiligo patients completed the Dermatology Life Quality Index (DLQI) and an adapted stigmatization questionnaire, and 62 of them completed the DLQI after at least a 1-month use of camouflage. RESULTS: The initial mean overall DLQI score (n = 78) is 6.9 (SD 5.6). The mean global stigmatization score is 38%. Disease extent and disease severity are strong predictors of the DLQI (p < 0.0001). Vitiligo on the face/head/neck substantially affects the DLQI, independently of degree of involvement. The mean DLQI score before and after use of camouflage (n = 62) is 7.3 (SD 5.6) and 5.9 (SD 5.2; p = 0.006). Mainly the high-scoring items 'feelings of embarrassment and self consciousness' and 'choice of clothing' improve. Predictors of improvement are higher DLQI scores (p = 0.0005) and higher total severity scores (p = 0.03). CONCLUSIONS: Camouflage can be recommended, particularly in patients with higher DLQI scores or self-assessed disease severity. Patients with minor involvement of the face benefit from camouflage.

Adaptation, Psychological↗

Modified technique of autologous noncultured epidermal cell transplantation for repigmenting vitiligo: a pilot study.

BACKGROUND: Several reports have demonstrated that grafting of autologous melanocytes from normally pigmented donor skin can be used for repigmentation of achromic macules in vitiligo. OBJECTIVE: To investigate a modified approach in which noncultured autologous melanocytes and keratinocytes are grafted on superficially laser dermabraded vitiligo lesions in a suspension enriched with hyaluronic acid. METHODS: Four patients with stable vitiligo were treated using a noncultured melanocyte-keratinocyte suspension. The cellular suspension was grafted on vitiliginous lesions previously dermabraded with a CO2 laser. To improve the viscosity and fixation of the cellular suspension hyaluronic acid was added. Three weeks after grafting, psoralen plus ultraviolet A (PUVA) or ultraviolet B (UVB) therapy was started. Residual leukodermic areas were subsequently retreated. RESULTS: Repigmentation was observed within 2-4 weeks and continued to increase for 3 months after treatment. In all patients, 85-100% repigmentation was achieved. A temporary slight color mismatch was visible in all patients. The most homogeneous repigmentation was obtained 5 months after treatment. CONCLUSION: This modified procedure seems to be a simple and promising treatment for larger vitiliginous areas.

Adjuvants, Immunologic↗

Autologous cellular suspensions and sheets in the treatment of achromic disorders: the need for future controlled studies.

Transplantation techniques using cultured and noncultured keratinocyte and/or melanocyte suspensions or sheets have been reported as successful in inducing repigmentation in achromic epidermal diseases such as vitiligo and piebaldism. However, the role of a lot of variable factors in the transplantation procedure remains unclear. Occasionally control sites are included in the reported patient series. We point out the need for future controlled studies when performing transplantations of cellular suspensions and sheets. This approach will help to understand how these techniques induce repigmentation and may eventually indicate the essential requirements for successful results.

Cell Transplantation↗

Surgical techniques for vitiligo: a review.

Although the treatment of vitiligo has improved during the last decade, therapy is still not satisfying for many patients. This is probably due to the fact that the aetiopathogenesis is unknown. Several treatment modalities, such as PUVA, UVB and local corticosteroids are currently used in the treatment of active vitiligo. However, these treatments usually induce incomplete repigmentation. Surgical methods intended to repigment leucoderma are an interesting therapeutic option if patients have stable disease. Two types of surgical techniques are available: tissue grafts and cellular grafts, with in between autologous cultured epithelial grafts. Tissue grafts are full-thickness punch grafts, split-thickness grafts and suction blister grafts. With tissue grafts, only a limited surface area can be treated but with good results in the majority of cases. Cellular grafts include non-cultured keratinocytes/melanocytes and cultured melanocytes. The exact success rate of repigmentation with cellular grafts is still unknown, since only a small number of studies have been published. Starting from autologous cellular suspensions, epithelial grafts of various compositions can be cultured in vitro. They can be used for larger areas. The purpose of this review is to describe the applications of different surgical techniques used to treat recalcitrant vitiligo.

Cell Transplantation↗

Contact allergy to resorcinol monobenzoate.

Resorcinol monobenzoate is an ultraviolet light absorber used in cellulose plastics and is known to cause allergic contact dermatitis reactions. It is the most important allergen in spectacle frames but can be a potential allergen in shoes as well. We report 7 cases of allergy to resorcinol monobenzoate with different clinical presentations. Our series further illustrates several possible cross-sensitizers.

Adult↗

Erythromelalgia: a clue to the diagnosis of polycythemia vera.

We report the case of a 74-year-old woman with recurrent episodes of symmetrical congestion and erythema in the distal lower legs causing a burning distress. Laboratory and clinical investigations revealed an underlying myeloproliferative disorder. The cutaneous symptoms were atypical of erythromelalgia. Salicylates and treatment of the underlying polycythemia were able to eliminate the skin lesions but not entirely suppress the subjective discomfort.

Aged↗

Autologous transplantation techniques for vitiligo: how to evaluate treatment outcome.

Effective methods for measuring treatment outcome in vitiligo are essential to accurately assess possible therapeutic modalities. This systematic review article aims to bring the problems concerning evaluation of treatment outcome in vitiligo studies using transplantation techniques to the attention of clinical investigators. Furthermore we highlight the interpretation of the achieved result from both physicians' and patients' view point using a questionnaire put to 558 dermatologists and 152 vitiligo patients in Belgium. There is no consensus about the choice of an evaluation method in surgical vitiligo studies. The interpretation of a 'successful' treatment result seemed to differ among dermatologists and vitiligo patients. We conclude that further research is needed to develop a universally accepted, objective, reliable and useful measurement method to evaluate the efficacy of surgical vitiligo treatments. A combination of both a clinical and a psychological measurement is likely to be the most appropriate choice.

Esthetics↗

Etiological factors and underlying conditions in patients with leucocytoclastic vasculitis.

This study concerns a retrospective analysis of 63 consecutive patients presenting with leukocytoclastic vasculitis at the Departments of Dermatology or Rheumatology of the University Hospital Ghent (Belgium) (period 1988-1993). The diagnosis of leukocytoclastic vasculitis was confirmed by histopathology in all cases. All patients were screened for underlying causes, including drugs, infection, systemic autoimmune disease or neoplasia. In 34 patients, an etiological factor was identified: drugs (5 patients), infection (6 patients), drugs or infection (4 patients), systemic autoimmune disease (10 patients), Henoch Shönlein (6 patients), neoplasia (2 patients) and cryoglobulinemia (1 patient). In the group of patients with leukocytoclastic vasculitis in the context of systemic autoimmune disease, 4 patients suffered from systemic lupus erythematosus, 2 from Wegener's disease, 2 from Behçet's disease, 1 from polyarteritis nodosa and 1 from rheumatoid arthritis. In the remaining 29 patients, no cause for the vasculitis could be identified.

Adolescent↗