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Systemic Steroids Suppress Antimelanocyte Antibodies in Vitiligo

Background: Vitiligo is associated with autoantibodies to melanocytes. The role of these antibodies in the pathogenesis of the disease is still unknown. Objective: The purpose of this study was to examine the role of vitiligo antibodies in the pathogenesis of the disease by studying whether or not there is a correlation between changes in their level and response to therapy with systemic steroid. Methods: Antibodies to the 40 to 45 kD, 75 kD, and 90 kD vitiligo antigens were measured prior to and following systemic steroid therapy in 10 patients with active vitiligo. Results: Four months following initiation of therapy, seven (78%) of nine patients with good clinical response to steroid treatment had a significant decrease in the level of vitiligo antibodies. By contrast, one patient who had no response to treatment had a slight increase in antibody levels. Conclusion: These findings suggest that one mechanism by which corticosteroids can cause repigmentation in vitiligo is by decreasing the level of vitiligo antibodies, and support the notion that vitiligo antibodies are involved in the pathogenesis of this disease.