Abstract

Background: Vitiligo is a skin disorder characterized by hypopigmentation due to destruction of melanocytes. Conventionally thought to be an epidermal disease, the role of dermal compartment has not been adequately explored. It has been proposed that due to oxidative stress, dermal fibroblasts in vitiliginous skin undergo premature senescence leading to melanocyte loss. This study aimed to assess these processes in the dermal fibroblasts with the help of immunohistochemical markers p16 and p53, which indicate senescence and oxidative stress respectively. Design: Skin punch biopsies were taken from the lesional and perilesional areas from 30 adult vitiligo patients and were histologically scored for stability. Immunohistochemistry was done to assess senescence and oxidative stress in the dermal fibroblasts with p16 and p53 respectively. Percentage positivity of p16 and p53 expression was assessed in dermal fibroblasts in lesional and perilesional skin and was correlated with vitiligo histological score. Results and Discussion: Higher p16 expression was observed in the dermal fibroblasts of lesional skin compared to perilesional skin. There was a significant association of p16 positivity in lesional skin with histological score, dermal melanophages and presence of dermal lymphocytes>100/5HPF. Expression of p53 was also higher in dermal fibroblasts in lesional skin compared to perilesional skin. Conclusion: Role of dermal compartment in vitiligo pathogenesis is presently not clear. The current study highlights the role of the immunohistochemical markers p16 and p53 which indicates senescence and oxidative stress in the dermal fibroblasts respectively in the pathogenesis of vitiligo. A better understanding of these abnormalities can lead to expansion of treatment options in the management of vitiligo.

Financial Disclosure:
No current or relevant financial relationships exist.