الفهرس 
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Abstract
Vitiligoisanacquiredpigmentarydisorderoftheskinandmucousmembranes, characterized by circumscribed depigmented macules and patches.Vitiligopathogenesisentailsanautoimmuneresponsetargetingepidermalmelanocytes.NarrowbandultravioletBtherapyisaneffectiveandsafemodalityfor vitiligotreatment.
Oxidative stress is one of the main contributors to melanocyte cytotoxicity inthepathogenesisofvitiligo.Thedynamicthiol/disulfideratioisoneofbiochemical markers to define oxidative stress and inflammation. Thiols arecompounds that contain sulphur and play an important role in helping the bodydefendagainstreactive oxygenspecies.
This study aimed to evaluate total thiol/ thiol disulfide ratio in patients withvitiligo before and after narrow band ultraviolet B therapy compared to healthycontrols.Allparticipantsinvolvedinthisstudyprovidedinformedconsent.
This study included 66 subjects divided into two groups. group A included 33patients with vitiligo, 14 males and 19 females. group B included 33 healthycontrol subjects, 15 males and 18 females. Before starting NB-UVB therapysessions, patients underwent history taking and dermatological examination aswell as evaluation of vitiligo severity via VES score, and activity via VIDAscore and clinical signs of activity. Standard photography was taken for eachpatient. Blood samples were taken to assess serum level of total thiol and thiol-disulfidebeforeandafterNB-UVBtherapyusingenzyme-linkedimmunosorbent assay (ELISA). Finally total thiol / thiol disulfide ratio wascalculated.
After completing 36 sessions of NB-UVB, patients with vitiligo were assessedagainbyVES, presenceofsignsofactivity, standardphotography.
The study revealed that the pre and post treatment serum levels of total thiol inpatients with vitiligo were significantly lower than control group. On the otherhand, there was no significant difference between the pre and post-treatmentlevelsamongpatients.
Thestudyrevealedthatthepreandposttreatmentserumlevelsofthioldisulfide in patients with vitiligo were significantly higher than control group.On the other hand, there was no significant difference between the pre andpost-treatmentlevelsamongpatients.
The study revealed that the pre and post treatment serum levels of total thiol /thiol disulfide in patients with vitiligo were significantly lower than controlgroup. On the other hand, there was no significant difference between the preandpost-treatmentlevelsamongpatients.
Therewassignificantnegativecorrelationbetweenthepretreatmentserumlevelof thiollevelandage.
There was also a significant negative correlation between the pretreatmentserumlevelofthiol/thioldisulfideratiolevelanddiseaseduration.
There was also a relation between pretreatment serum levels of thiol disulfideandclinicalsignsof activity.
Clinicalimprovementwasobservedin75.8%ofpatientsintheformoffollicularrepigmention,marginalrepigmention,mixedrepigmentationandassociatedwith significantimprovementinVES.However,nostatistically