Volume 24, Issue 106, November - December, 2020

Tumor Necrosis Factor alpha (TNF-α), as a biomarker for disease activity among Iraqi patients with generalized vitiligo, independent on disease duration and extent of skin involvement

Ronak Saeed Ahmed^1♦, Dana Ahmed Sharif², Mohammad Yousif Jaf³, Ali Hattem Hussain⁴

¹PhD candidate at the University of Sulaimani, College of Medicine, Department of Medicine, Dermatology Unit, Sulaymaniyah, Iraq; Email: dr-ronaksa@hotmail.com
²Assistant professor of Medicine (MRCPUK, FRCRUK), Head of Department of Medicine, University of Sulaimani, College of Medicine, Sulaymaniyah, Iraq; Email: d_sharif@hotmail.com
³Assistant professor of Dermatology (MD, FICMS), University of Sulaimani, College of Medicine, Dermatology Unit, Sulaymaniyah, Iraq; Program Director, Kurdistan Board of Dermatology -Kurdistan Board for Medical Specialization, Iraq; Email: mohammad@derma-care.org
⁴Assistant Professor of Microbiology (MD,PhD), Nursing Department, Technical College of Health, Sulaimani Polytechnic University, Sulaymaniyah, Iraq; Email: dralihattem@yahoo.com

^♦Corresponding author
PhD candidate at the University of Sulaimani, College of Medicine, Department of Medicine, Dermatology Unit, Sulaymaniyah, Iraq; Email: dr-ronaksa@hotmail.com

ABSTRACT

Background: Vitiligo is a chronic depigmenting disorder of the skin that results from immunological distraction of functioning melanocyte. Various studies found alteration in the epidermal level of TNF-α, while only few studies determine the role of serum TNF-α in vitiligo pathogenesis. Objectives: To measure serum level of TNF-α among Iraqi patients with subtypes of generalized vitiligo and to correlate it with duration of presentation, activity of vitiligo and extent of skin involvement. Material and methods: A case control study includes 80 patients with generalized vitiligo and 40 clinically healthy control subjects, serum concentration of TNF-α was measured by Enzyme Linked Immunosorbent Assay (ELISA) technique. Patients were divided in to those presented with vitiligo ≤ 2 years and patients with> 2 years duration of vitiligo. Activity of vitiligo was assessed based on Vitiligo Disease Activity (VIDA) score and Vitiligo Extent Score (VES) was used for measuring extent of skin surface involvements. Results: Statistically significant elevation of serum level of TNF-α found among patient group compared with controls (P value 0.01). No correlation was found between serum level of TNF-α and duration of vitiligo presentation (P value 0.27). Patients with active generalized vitiligo have a higher serum level of TNF-α (P value 0.01). Extent of skin involvement is not correlated with the serum level of TNF-α (P value 0.98). Conclusion: Our study shows that TNF-α in the serum is increased in active generalized vitiligo; hence it could be a biomarker for identifying patients with aggressive vitiligo.

Keywords: Vitiligo, Enzyme Linked Immunosorbent Assay, Vitiligo Disease Activity (VIDA) score, Vitiligo Extent Score (VES)

Medical Science, 2020, 24(106), 4295-4302

PDF