The Efficacy and Psychoneuroimmunology Mechanism of Camouflage Combined With Psychotherapy in Vitiligo Treatment

Yuqian Chang, Shaolong Zhang, Weigang Zhang, Shuli Li, Chunying Li, Yuqian Chang, Shaolong Zhang, Weigang Zhang, Shuli Li, Chunying Li

Abstract

Background and objectives: The efficacy of camouflage combined with psychotherapy and the underlying mechanisms are poorly understood in vitiligo management. This study aimed to investigate the joint efficacy and further explore psycho-neuro-endocrine-immune-skin interactions.

Patients and methods: In a prospective, non-randomized and concurrent controlled trial, patients were divided into two groups. Quality of life (QOL) was evaluated using the Chinese version of the Vitiligo Life Quality Index (VLQI-C). Serum levels of neuropeptides and cytokines were detected by enzyme-linked immunosorbent assay.

Results: A total of 149 patients were included for final evaluation. After treatment for 4 weeks, total and subcategory quality of life scores in the intervention group were much lower than in the control group. Serum levels of neuropeptide-Y (NPY) and melanin-concentrating hormone (MCH) significantly decreased, and serum level of adrenocorticotropic hormone (ACTH) increased in both active and stable patients of the intervention group, but not in the control group. In addition, the serum levels of interferon-γ (IFN-γ), CXC chemokine ligand 10 (CXCL10), and interleukin-1β (IL-1β) decreased in both the active and stable patients of the intervention group and only in the active patients of the control group.

Conclusions: The combination of camouflage and psychotherapy provided a clinically meaningful improvement in quality of life and ameliorated the outcome by likely modulating the psycho-neuro-endocrine-immuno-skin system during vitiligo management.

Clinical trial registration: www.clinicaltrials.gov/ct2/show/NCT03540966, identifier: NCT03540966.

Keywords: camouflage; psychoneuroimmunology; psychotherapy; quality of life; vitiligo.

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Copyright © 2022 Chang, Zhang, Zhang, Li and Li.

Figures

Figure 1
Figure 1
Overview of trial design.
Figure 2
Figure 2
Flow chart to show cohort recruitment.
Figure 3
Figure 3
Quality of life (QoL) score at baseline (before) and 4 weeks later (after). (A) Total VLQI-C scores before and after camouflage and psychotherapy in the IG. (B) PSA, SP, DM, and SRS scores before and after camouflage and psychotherapy in the IG. (C) Total VLQI-C scores before and after 4 weeks in the CG. (D) PSA, SP, DM, and SRS scores before and after camouflage and psychotherapy in the CG. IG, intervention group; CG, control group; PSA, psychosomatic and social affect; SP, self perception; DM, disease management; SRS, self-reported severity. **P < 0.01, ****P < 0.0001, ns, nonsignificant.
Figure 4
Figure 4
Serum levels of neuropeptides and cytokines before and after 4 weeks in the two groups. (A) NPY, (B) MCH, (C) ACTH, (D) IFN-γ, (E) CXCL10, and (F) IL-1β. A-IG, active phase of intervention group; S-IG, stable phase of intervention group; A-CG, active phase of control group; S-IG, stable phase of control group. *P < 0.05, **P < 0.01, ***P < 0.001, ****P < 0.0001, ns, nonsignificant.

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