OBJECTIVE: This article aims to familiarize physicians with the clinical manifestations, evaluation, diagnosis, and management of vitiligo.
METHODS: A Pubmed search was conducted in Clinical Queries using the key term "vitiligo". The search included meta-analyses, randomized controlled trials, clinical trials, observational studies, and reviews. The search was restricted to English language. The information retrieved from the above search was used in the compilation of the present article.
RESULTS: Approximately one quarter of patients with vitiligo have the onset before 10 years of age. Genetic, immunological, neurogenic and environmental factors may have a role to play in the pathogenesis. Vitiligo typically presents as acquired depigmented, well-demarcated macules/patches that appear milk- or chalk-white in color. Lesions tend to increase in number and enlarge centrifugally in size with time. Sites of predilection include the face, followed by the neck, lower limbs, trunk, and upper limbs. The clinical course is generally unpredictable. In children with fair skin, no active treatment is usually necessary other than the use of sunscreens and camouflage cosmetics. If treatment is preferred for cosmesis, topical corticosteroids, topical calcineurin inhibitors, and narrowband ultraviolet B phototherapy are the mainstays of treatment.
CONCLUSION: The therapeutic effect of all the treatment modalities varies considerably from individual to individual. As such, treatment must be individualized. In general, the best treatment response is seen in younger patients, recent disease onset, darker skin types, and head and neck lesions. Topical corticosteroids and calcineurin inhibitors are the treatment choice for those with localized disease. Topical calcineurin inhibitors are generally preferred for lesions on genitalia, intertriginous areas, face, and neck. Narrowband ultraviolet B phototherapy should be considered in patients who have widespread vitiligo or those with localized vitiligo associated with a significant impact on the quality of life who do not respond to treatment with topical corticosteroids and calcineurin inhibitors.
MATERIALS AND METHODS: This interventional experimental study was conducted on nine Dio UFII implants with hybrid sandblasted and acid-etched (SLA) surface treatments, divided equally into three groups. Control group A samples were not given UV irradiation, while groups B and C samples were given UVA (382 nm, 25 mWcm2) and UVC (260 nm, 15 mWcm2) irradiation, respectively. The atomic ratio of carbon, titanium, and oxygen was compared through XPS.
RESULTS: Mean carbon-to-titanium ratio and C1 peaks considerably increased in Group A compared to those in experimental Groups B and C. The intensity of Ti2p and O1s peaks was more pronounced for group C compared to that for groups A and B.
CONCLUSIONS: Although the decrease in surface hydrocarbons was the same in both UV-treated groups, the peak intensity of oxygen increased in the UVC-treated group. Thus, it can be concluded that compared with UVA irradiation, UVC irradiation has the potential to induce more hydrophilicity on SLA-coated implants.
MATERIALS AND METHODS: A total of 40 of the two types of fiber posts, namely, FRC Prostec (FRC) and Fiber KOR (KOR), were used for the experiment. UV irradiation was applied on top of the fiber post surface for 0, 15, 20, and 30 min. The irradiated surface of the fiber posts (n = 5) were immediately bonded with resin cement (Rely X U200) after UV irradiation. Shear bond strength (SBS) MPa was measured, and the dislodged area of post surfaces was examined with scanning electron microscopes. Changes in surface roughness (Ra) of the FRC group after UV irradiation were observed (n = 3) using atomic force microscopy. Data of SBS were statistically analyzed using one-way analysis of variance, followed by multiple comparisons (P < 0.05).
RESULTS: SBS was significantly higher for 20 min of UV irradiation of the FRC group while significantly higher SBS was observed with 15 min of UV irradiation of the KOR group. Resin cement was more evident (cohesive failure) on the dislodged post surface of the UV treated groups compared with the control. The surface roughness of the FRC post was Ra = 175.1 nm and Ra = 929.2 nm for the control and the 20 min group, respectively.
CONCLUSIONS: Higher surface roughness of the UV irradiated group indicated formation of mechanical retention on the fiber post surface. Evidence of cohesive failure was observed which indicated higher SBS of fiber post with the UV irradiated group.