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Article ; Online: The real-life efficacy of methotrexate in vitiligo: A retrospective study and literature review.

Speeckaert, Reinhart / van Geel, Nanja

Journal of the European Academy of Dermatology and Venereology : JEADV

2023 Volume 37, Issue 11, Page(s) 2267–2269

MeSH term(s)	Humans ; Methotrexate/therapeutic use ; Vitiligo/drug therapy ; Retrospective Studies ; Hypopigmentation ; Treatment Outcome
Chemical Substances	Methotrexate (YL5FZ2Y5U1)
Language	English
Publishing date	2023-08-19
Publishing country	England
Document type	Review ; Letter ; Research Support, Non-U.S. Gov't
ZDB-ID	1128828-0
ISSN	1468-3083 ; 0926-9959
ISSN (online)	1468-3083
ISSN	0926-9959
DOI	10.1111/jdv.19400
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Zs.A 3492: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Ultraviolet photography in vitiligo using a smartphone camera attachment for checking sunscreen coverage.

Speeckaert, Reinhart / van Geel, Nanja

Journal of the American Academy of Dermatology

2023 Volume 90, Issue 2, Page(s) e73–e74

MeSH term(s)	Humans ; Vitiligo ; Smartphone ; Sunscreening Agents ; Hypopigmentation ; Photography ; Ultraviolet Rays
Chemical Substances	Sunscreening Agents
Language	English
Publishing date	2023-10-21
Publishing country	United States
Document type	Journal Article
ZDB-ID	603641-7
ISSN	1097-6787 ; 0190-9622
ISSN (online)	1097-6787
ISSN	0190-9622
DOI	10.1016/j.jaad.2023.10.030
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Zs.A 1540: Show issues

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Article ; Online: What vitiligo patients want to know outside the dermatologist's office: an analysis of online search behaviour.

Speeckaert, Reinhart / Van Geel, Nanja

European journal of dermatology : EJD

2021 Volume 31, Issue 5, Page(s) 667–669

MeSH term(s)	Consumer Health Information/methods ; Humans ; Internet ; Patient Education as Topic ; Vitiligo/psychology ; Vitiligo/therapy
Language	English
Publishing date	2021-10-27
Publishing country	France
Document type	Journal Article
ZDB-ID	1128666-0
ISSN	1952-4013 ; 1167-1122
ISSN (online)	1952-4013
ISSN	1167-1122
DOI	10.1684/ejd.2021.4141
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Zs.A 3484: Show issues

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Article ; Online: A meta-analysis of the placebo response in vitiligo: Causes and consequences for the interpretation of clinical trials.

Speeckaert, Reinhart / Speeckaert, Marijn M / van Geel, Nanja

Pigment cell & melanoma research

2023 Volume 37, Issue 1, Page(s) 74–80

Abstract: The current understanding of the placebo response in vitiligo is limited. Nonetheless, it is difficult to compare the outcomes of vitiligo trials if the repigmentation rates in placebo patients vary significantly. We conducted a meta-analysis of the ... ...

Abstract	The current understanding of the placebo response in vitiligo is limited. Nonetheless, it is difficult to compare the outcomes of vitiligo trials if the repigmentation rates in placebo patients vary significantly. We conducted a meta-analysis of the placebo response in vitiligo trials. Overall, repigmentation rates in patients receiving placebo were 22%, ranging substantially from 0 to 60%. Repigmentation (>25%) was still relatively common for placebo (9.35%), but fell to 5% when >50% improvement was analyzed. Higher frequencies of placebo responses correlated with more repigmentation in the intervention groups. Facial vitiligo and sunlight exposure was linked to higher placebo responses. Roughly estimating the amount of improvement using quartiles (0-25, 25%-50%, 50%-75%, 75%-100% repigmentation) resulted in higher placebo rates compared to other assessment methods. In clinical studies with older patients, the ratio of placebo reactions to treatment responses was higher. This is likely because clinical trials with older patients reported less repigmentation after treatment than studies with younger patients. The percentual difference in affected body surface area during the study period ranged from 6.2% worsening to 17.6% improvement in the placebo groups. This high variability in placebo responses illustrates the need for standardized outcome measures and more head-to-head trials in vitiligo.
MeSH term(s)	Humans ; Vitiligo/drug therapy ; Treatment Outcome
Language	English
Publishing date	2023-09-27
Publishing country	England
Document type	Meta-Analysis ; Journal Article
ZDB-ID	2409570-9
ISSN	1755-148X ; 1600-0749 ; 0893-5785 ; 1755-1471
ISSN (online)	1755-148X ; 1600-0749
ISSN	0893-5785 ; 1755-1471
DOI	10.1111/pcmr.13132
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Article ; Online: Beyond visual inspection: The value of infrared thermography in skin diseases, a scoping review.

Speeckaert, Reinhart / Hoorens, Isabelle / Lambert, Jo / Speeckaert, Marijn / van Geel, Nanja

Journal of the European Academy of Dermatology and Venereology : JEADV

2024

Abstract: Although warmth is a key sign of inflammatory skin lesions, an objective assessment and follow-up of the temperature changes are rarely done in dermatology. The recent availability of accurate, sensitive and cost-effective thermography devices has made ... ...

Abstract	Although warmth is a key sign of inflammatory skin lesions, an objective assessment and follow-up of the temperature changes are rarely done in dermatology. The recent availability of accurate, sensitive and cost-effective thermography devices has made the implementation of thermography in clinical settings feasible. The aim of this scoping review is to summarize the evidence around the value and pitfalls of infrared thermography (IRT) when used in the dermatology clinic. A systematic literature search was done for original articles using IRT in skin disorders. The results concerning the potential of IRT for diagnosis, severity staging and monitoring of skin diseases were collected. The data on the sensitivity and specificity of IRT were extracted. Numerous studies have investigated IRT in various skin diseases, revealing its significant value in wound management, skin infections (e.g. cellulitis), vascular abnormalities and deep skin inflammation (e.g. hidradenitis suppurativa). For other dermatological applications such as the interpretation of intradermal and patch allergy testing, hyper-/anhidrosis, erythromelalgia, cold urticaria and lymph node metastases more complex calculations, provocation tests or active cooling procedures are required. Dermatologists should be aware of a learning curve of IRT and recognize factors contributing to false positive and false negative results. Nonetheless, enough evidence is available to recommend IRT as a supplement to the clinical evaluation for the diagnosis, severity and follow-up of several skin diseases.
Language	English
Publishing date	2024-01-22
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	1128828-0
ISSN	1468-3083 ; 0926-9959
ISSN (online)	1468-3083
ISSN	0926-9959
DOI	10.1111/jdv.19796
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Zs.A 3492: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 413: Show issues

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Article ; Online: A meta-analysis of chemokines in vitiligo: Recruiting immune cells towards melanocytes.

Speeckaert, Reinhart / Belpaire, Arno / Speeckaert, Marijn M / van Geel, Nanja

Frontiers in immunology

2023 Volume 14, Page(s) 1112811

Abstract: Chemokine research offers insightful information on the pathogenesis of cutaneous immune disorders, such as vitiligo. Compared to cytokines, the higher detectable levels of chemokines display promising potential as future disease biomarkers. Nonetheless, ...

Abstract	Chemokine research offers insightful information on the pathogenesis of cutaneous immune disorders, such as vitiligo. Compared to cytokines, the higher detectable levels of chemokines display promising potential as future disease biomarkers. Nonetheless, some published study results are contradictory, which can be attributed to patient characteristics and methodological differences. In this study, a meta-analysis was performed to compare chemokine expression in blood and skin samples from vitiligo patients versus healthy controls. Furthermore, the relationship between chemokine expression and disease activity was evaluated. Chemokine levels were investigated in 15 articles in the circulation and in 9 articles in vitiligo skin. Overall, some clear trends were observed. CXCR3 signaling by CXCL10 and CXCL9 has been confirmed by several reports, although CXCL10 showed more robust findings in blood samples. In this meta-analysis, CCL5, CXCL8, CXCL12, and CXCL16 levels were also significantly elevated. This indicates a complex immune pathway activation in vitiligo that overall supports a Th1-dominant response. Chemokines linked to the Th2 and Th17 pathways were less prevalent. Despite these findings, study protocols that examine a broader range of chemokines are encouraged, because current research is mostly focused on a small number of chemokines that were differentially expressed in previous studies.
MeSH term(s)	Humans ; Vitiligo ; Chemokine CXCL10/metabolism ; Skin/pathology ; Melanocytes/metabolism ; CD8-Positive T-Lymphocytes/metabolism
Chemical Substances	Chemokine CXCL10
Language	English
Publishing date	2023-02-24
Publishing country	Switzerland
Document type	Meta-Analysis ; Journal Article ; Review ; Research Support, Non-U.S. Gov't
ZDB-ID	2606827-8
ISSN	1664-3224 ; 1664-3224
ISSN (online)	1664-3224
ISSN	1664-3224
DOI	10.3389/fimmu.2023.1112811
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Article: The Impact of Antioxidants on Vitiligo and Melasma: A Scoping Review and Meta-Analysis.

Speeckaert, Reinhart / Bulat, Vedrana / Speeckaert, Marijn M / van Geel, Nanja

Antioxidants (Basel, Switzerland)

2023 Volume 12, Issue 12

Abstract: Reactive oxygen species (ROS) generated during melanogenesis make melanocytes particularly vulnerable to oxidative stress, influencing their survival and melanin synthesis. Oxidative stress, significantly present in vitiligo and recently also detected in ...

Abstract	Reactive oxygen species (ROS) generated during melanogenesis make melanocytes particularly vulnerable to oxidative stress, influencing their survival and melanin synthesis. Oxidative stress, significantly present in vitiligo and recently also detected in melasma, triggers inflammatory cascades and melanogenesis, making antioxidants a promising therapeutic avenue. A systematic search was conducted on Embase and Pubmed to study the efficacy of antioxidants for treating vitiligo and/or melasma. Meta-analysis was performed to assess the difference in Melasma Severity Index (MASI) scores between baseline and follow-up. Various antioxidants like polypodium leucotomos, ginkgo biloba, catalase/superoxide dismutase, and vitamin E have potential in vitiligo. For melasma, vitamin C, silymarin, and niacinamide were among those showing promise in reducing pigmentation, with vitamin C displaying significant effects in meta-analysis. Different antioxidants improve both vitiligo and melasma, with an increased minimal erythema dose (MED) following UV exposure being significant for vitiligo and tyrosinase inhibition being crucial for melasma. However, the efficacy of individual antioxidants varies, and their exact mechanisms, especially in stimulating melanocyte proliferation and anti-inflammatory pathways, require further investigation to understand better and optimize their use.
Language	English
Publishing date	2023-12-06
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2704216-9
ISSN	2076-3921
ISSN	2076-3921
DOI	10.3390/antiox12122082
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Article ; Online: From IL-17 to IFN-γ in inflammatory skin disorders: Is transdifferentiation a potential treatment target?

Belpaire, Arno / van Geel, Nanja / Speeckaert, Reinhart

Frontiers in immunology

2022 Volume 13, Page(s) 932265

Abstract: The targeted inhibition of effector cytokines such as interleukin 17 (IL-17) in psoriasis and IL-13 in atopic dermatitis offers impressive efficacy with a favorable side effect profile. In contrast, the downregulation of interferon gamma (IFN-γ) in T ... ...

Abstract	The targeted inhibition of effector cytokines such as interleukin 17 (IL-17) in psoriasis and IL-13 in atopic dermatitis offers impressive efficacy with a favorable side effect profile. In contrast, the downregulation of interferon gamma (IFN-γ) in T helper (Th) 1-dominant skin disorders may lead to more adverse events, given the crucial role of IFN-γ in antiviral and antitumoral immunity. Modulating Th17 and Th2 cell differentiation is performed by blocking IL-23 and IL-4, respectively, whereas anti-IL-12 antibodies are only moderately effective in downregulating Th1 lymphocyte differentiation. Therefore, a targeted approach of IFN-γ-driven disorders remains challenging. Recent literature suggests that certain pathogenic Th17 cell subsets with Th1 characteristics, such as CD4
MeSH term(s)	Cell Transdifferentiation/genetics ; Cell Transdifferentiation/immunology ; Humans ; Interferon-gamma/genetics ; Interferon-gamma/immunology ; Interleukin-17/genetics ; Interleukin-17/immunology ; Psoriasis/drug therapy ; Psoriasis/genetics ; Psoriasis/immunology ; Th17 Cells/immunology
Chemical Substances	IFNG protein, human ; IL17A protein, human ; Interleukin-17 ; Interferon-gamma (82115-62-6)
Language	English
Publishing date	2022-07-28
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2606827-8
ISSN	1664-3224 ; 1664-3224
ISSN (online)	1664-3224
ISSN	1664-3224
DOI	10.3389/fimmu.2022.932265
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Article ; Online: The delicate relation between melanocytes and skin immunity: A game of hide and seek.

Speeckaert, Reinhart / Belpaire, Arno / Speeckaert, Marijn / van Geel, Nanja

Pigment cell & melanoma research

2022 Volume 35, Issue 4, Page(s) 392–407

Abstract: Melanocytes exhibit a complex and intriguing relationship with the skin immune response, leading to several clinical conditions. In some disorders, inappropriate melanocyte destruction (e.g., vitiligo, halo naevi) is problematic, while in others, immune ... ...

Abstract	Melanocytes exhibit a complex and intriguing relationship with the skin immune response, leading to several clinical conditions. In some disorders, inappropriate melanocyte destruction (e.g., vitiligo, halo naevi) is problematic, while in others, immune tolerance should be broken (melanoma). Important parts of the dysregulated pathways have been unraveled in pigment disorders, ranging from upregulated interferon (IFN)-γ signaling to memory T cells, regulatory T cells, and immune checkpoints. Although a network of many factors is involved, targeting key players such as IFN-γ or checkpoint inhibitors (e.g., programmed death-ligand 1 (PD-L1)] can shift the balance and lead to impressive outcomes. In this review, we focus on the immunological mechanisms of the most common inflammatory disorders where the interaction of the immune system with melanocytes plays a crucial role. This can provide new insights into the current state of melanocyte research.
MeSH term(s)	Humans ; Hypopigmentation/metabolism ; Melanocytes/metabolism ; Melanoma/metabolism ; Skin ; Vitiligo
Language	English
Publishing date	2022-04-07
Publishing country	England
Document type	Journal Article ; Review ; Research Support, Non-U.S. Gov't
ZDB-ID	2409570-9
ISSN	1755-148X ; 1600-0749 ; 0893-5785 ; 1755-1471
ISSN (online)	1755-148X ; 1600-0749
ISSN	0893-5785 ; 1755-1471
DOI	10.1111/pcmr.13037
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Article ; Online: Hot spots for clinical signs of disease activity in vitiligo.

Delbaere, Liesbeth / van Causenbroeck, Jérôme / Duponselle, Jolien / Van Goethem, Céline / Speeckaert, Reinhart / van Geel, Nanja

Experimental dermatology

2023 Volume 33, Issue 1, Page(s) e14975

Abstract: There is evidence of a link between disease activity in vitiligo and clinical visible signs such as confetti-like depigmentation, Koebner phenomenon and hypochromic areas/borders. Despite its established value, dermatologists and researchers continue to ... ...

Abstract	There is evidence of a link between disease activity in vitiligo and clinical visible signs such as confetti-like depigmentation, Koebner phenomenon and hypochromic areas/borders. Despite its established value, dermatologists and researchers continue to have a limited understanding of the vitiligo disease activity signs. The primary goal of this study was to identify 'hot spots' of disease activity signs in vitiligo patients in order to improve detection in clinical practice. Furthermore, the prevalence, clinical profiles of predisposed patients, interrelationship between the disease activity signs and potential pitfalls in the recognition of the signs were evaluated. The Vitiligo Signs of Activity Score (VSAS) was used to score the presence of the disease activity signs in 441 non-segmental and 57 segmental vitiligo patients. More detailed predilection areas were scored in a subset of patients, using 65 predefined body locations. At least one disease activity sign was observed in 51.0% and 8.8% of the non-segmental and segmental vitiligo patients, respectively. Confetti-like depigmentation was most observed on the elbows, Koebner phenomenon on the back of the hands, and hypochromic areas/borders in the armpits. The three signs were significantly more observed in patients with more involved body locations. Moreover, hypochromic areas/borders were more common in younger patients. Confetti-like depigmentation had the highest interrelationship with the other signs and was the easiest to recognise. Knowledge around hot spots of the disease activity signs will enhance and simplify their detection in clinical practice. Based on the results, confetti-like depigmentation appears to be the most straightforward sign to evaluate.
MeSH term(s)	Humans ; Vitiligo/diagnosis ; Hypopigmentation ; Dermatitis ; Hand
Language	English
Publishing date	2023-11-17
Publishing country	Denmark
Document type	Journal Article
ZDB-ID	1130936-2
ISSN	1600-0625 ; 0906-6705
ISSN (online)	1600-0625
ISSN	0906-6705
DOI	10.1111/exd.14975
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