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Vitiligo is a common autoimmune pigmentary disorder characterized by destruction of functional melanocytes resulting in the appearance of depigmented patches on the skin and mucosa. These lesions pose a cosmetic challenge. The involvement of the mucosa is less, but may be the first symptom of this pathology. Depigmentation in the lips can be more easily observed and patients can be counseled regarding the condition and guided for treatment. Aims: The study describes the various clinic-epidemiological factors associated with lip vitiligo. Materials and Methods: The study sample included 100 patients of lip vitiligo of all age groups and gender. Patients with a history of herpes labialis, and history suggestive of post inflammatory depigmentation of lips secondary to various causes were excluded from this study. Also, patient vitiligo patients without lip involvement were excluded. The frequency, site, extension, association with vitiligo elsewhere, and systemic association were noted and tabulated. Results: Among 100 patients, 57 were males and 43 were females. Majority of our study subjects (63%) had onset of vitiligo between 11 and 30 years and 24% between 31 and 50 years. In the present study, 41 patients had only lip vitiligo, 55 patients had lip and vitiligo in other parts, four had involvement of lip and genital mucosa. Out of 100 patients, 71 complained that the lips were the initial lesion. The most type of vitiligo seen in our study subjects was the isolated lip vitiligo (41) and the least common was universal vitiligo (2). Leukotrichia was seen in three patients. In our study six patients had exclusive upper lip vitiligo and 40 patients had lower lip vitiligo. The remaining patients had both lower lip and upper lip involvement. Angle of the mouth was involved in 31 patients and five had marginal extension onto the skin. Of 100 patients with vitiligo nearly 19% had atleast one co-morbid condition. The most common autoimmune disease was thyroid dysfunction seen in 17% of patients. Conclusion: Though rare, lip vitiligo could be one of the earliest presentations of vitiligo and will aid in counseling the patients regarding the chronicity and thereby reduce the psychological morbidity. The data on lip vitiligo is sparse and to the best of our knowledge, there is no study on the demographic characteristics and clinical patterns of lip vitiligo. [ABSTRACT FROM AUTHOR]

Background and Aim: In celiac disease (CD), abnormalities of brush border enzyme activities have been detected in the course of the disease activity. There are conflicting results on intestinal mucosal enzyme activities and its correlation to mucosal injury in CD. The aim of the present study was to evaluate the brush border enzyme activities (disaccharidases and alkaline phosphatase) in the duodenal mucosa of North Indian children with CD and to examine their correlation to duodenal mucosal morphological alterations. Methods: This prospective study included 71 children with CD and 29 controls (patients with gastroesophageal reflux disease) in whom upper gastrointestinal endoscopy was performed and distal duodenal biopsies were taken for histological assessment, and estimation of disaccharidases and alkaline phosphatase activities. Each biopsy sample was classified according to the modified Oberhuber classification. Lactase, sucrase, maltase and alkaline phosphatase activities were estimated in duodenal biopsy homogenates from patients with CD and from controls. The association between enzyme activities and duodenal morphology was examined. Results: The mean age of the 71 patients with CD (M:F, 43:28) was 6.0 ± 0.3 years and mean age of onset of symptoms was 2.7 ± 0.4 years. Sixty-four of 71 (90.1%) CD patients showed type 3 (destructive) lesion, whereas it was grade 0 in all patients with gastroesophageal reflux disease. In CD and patients with gastroesophageal reflux disease, the mean level (IU/g protein) of lactase was 12.1 ± 0.9 versus 24.4 ± 1.0 ( P < 0.001), mean level of sucrase was 25.9 ± 1.9 versus 42.5 ± 1.9 ( P < 0.001), mean level of maltase was 56.6 ± 3.5 versus 76.1 ± 13.0 (NS), and mean level of alkaline phosphatase was 602.8 ± 56.2 versus 1359.3 ± 51.2 ( P < 0.001), respectively. The mean disaccharidases and alkaline phosphatase levels were not significantly different in patients with milder lesions (type 2 and type 3a) compared with those of control. However, mean lactase, sucrase and alkaline phosphatase levels were significantly lower ( P < 0.001) in CD patients with moderate (type 3b) and severe (type 3c) lesions compared with control. Conclusions: A generalized decrease of disaccharidases and alkaline phosphatase activity was seen in the duodenal mucosa of children with CD. The depressed activities of lactase, sucrase and alkaline phosphatase were well correlated with the histological grade of duodenal mucosal lesions in children with CD. [ABSTRACT FROM AUTHOR]

Objective: Lactate dehydrogenase (LDH) is a critical intracellular enzyme responsible for anaerobic respiration in pyruvate metabolism which becomes detectable in extracellular spaces after cellular breakdown. This clinical investigation examined the effects of brushing with a test toothpaste containing natural ingredients, i.e., clove (Syzygium aromaticum), aloe vera (Aloe barbadensis), amla (Emblica officinalis), neem (Azadirachta indica), tulsi (Ocimum basillicum), and honey (from Apis mellifera), and 0.96% zinc (zinc oxide, zinc citrate) and 0.76% SMFP (1000 ppm F) in a calcium carbonate base formulated with natural ingredients (Ved Shakti, Colgate Palmolive India) and a fluoride toothpaste containing 0.76% SMFP (1000 ppm F) in a calcium carbonate base (Colgate Cavity Protection, Colgate Palmolive; henceforth control) on salivary LDH in conjunction with the assessments of dental plaque and gingivitis representing oral hygiene parameters., Materials and Methods: This double-blind, two-cell study enrolled 70 adults (age range 20-59 years). Subjects completed a washout and provided baseline saliva samples for LDH analysis and clinical assessments of dental plaque and gingivitis using the Turesky Modification of Quigley-Hein and Loe-Silness methods respectively. Subjects were randomly assigned to brush their teeth with either the test or control. Post-treatment sample collection and clinical evaluations were conducted after 3 weeks, 6 weeks, and 12 week sof brushing with all assessments conducted 12 h after hygiene. Statistical analyses were conducted independently for each parameter by t-test for within treatment evaluation and analysis of covariance (ANCOVA) for between treatment comparisons., Results: At baseline, treatment groups demonstrated no significant differences for LDH or dental plaque and gingival index scores. Brushing with the test demonstrated progressive reductions in salivary LDH, plaque and gingival index scores over the study duration in comparison to the control. The test demonstrated reductions in LDH of 9.5-15.4% over the study period in comparison to the control representing statistically significant effects (p < 0.05). The test also demonstrated reductions in dental plaque that ranged between 6.4 and 16.2% over the study period and gingivitis reductions that ranged between 8.2 and 23.8% representing statistically significant results (p < 0.05)., Conclusions: Brushing with a novel herbal toothpaste demonstrated significant reductions in salivary LDH representing improvements in cellular integrity with concurrent reductions in dental plaque and gingivitis as compared to the control dentifrice., Clinical Relevance: Salivary LDH measurements offer a non-invasive and objective measurement of mucosal cellular integrity complementing other evaluations and clinical assessments such as plaque and gingival index scores.