4.0 Article

Tumor necrosis factor-α in vitiligo: direct correlation between tissue levels and clinical parameters

Journal

CUTANEOUS AND OCULAR TOXICOLOGY
Volume 30, Issue 3, Pages 225-227

Publisher

INFORMA HEALTHCARE
DOI: 10.3109/15569527.2011.560913

Keywords

Biologic agents; etanercept; immunohistochemistry

Funding

  1. Societa Italiana di Dermatologia e Malattie Sessualmente Trasmesse (SIDeMaST)

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Background: Experimental evidences have shown that tumor necrosis factor (TNF)-alpha may play a role in the pathogenesis of nonsegmental vitiligo, and successful cases of vitiligo treated with TNF-alpha inhibitors have been recently reported. Materials and methods: Two cases of refractory generalized vitiligo, which showed high tissue levels of TNF-alpha, were commenced anti-TNF-alpha antibody etanercept 50 mg weekly. A retrospective study, considering chart review and immunohistochemical staining for TNF-alpha, was then carried out on eight additional patients affected by untreated vitiligo. Results: Etanercept achieved improvement of vitiligo in two patients at 6-month follow-up. Five out of eight specimens showed a strong cytoplasmic staining for TNF-alpha. Considering all 10 cases, patients with a strong TNF-alpha staining were characterized by a higher vitiligo disease activity score than patients with a weak staining. Discussion: These findings, albeit limited in significance by the low number of cases and the retrospective nature of the study, confirm a probable role of TNF-alpha in the pathogenesis of vitiligo. The intensity of TNF-alpha staining in vitiligo lesions may be worth to be further studied as a biomarker for potentially successful anti-TNF-alpha treatment of nonsegmental vitiligo in cases refractory to conventional treatment.

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