Depigmentation patterns of nonsegmental vitiligo: a prospective study of macromorphologic changes in lesions.

Abstract:

BACKGROUND:Efforts have been recently made to investigate simple, objective, accurate, and reproducible methods of clinical/noninvasive assessment of nonsegmental vitiligo. However, studies have mostly considered quantitative or semiquantitative parameters, almost neglecting the purely qualitative appearance of vitiligo lesions at a given moment and over time. OBJECTIVE:The objective of this study was to investigate the dynamics of macromorphologic alterations taking place within vitiligo patches. STUDY DESIGN:This was a prospective study of a vitiligo cohort. PATIENT POPULATION:Consecutive patients affected by nonsegmental vitiligo. METHODS:Enrolled patients affected by nonsegmental vitiligo underwent a dermatology visit once monthly for 12 months. Vitiligo lesions were photographed at each visit under both room light and Wood's light, and analyzed via a morphometric, digitalized software capable of detecting quantitative changes of white areas. Pictures depicting changing patches were evaluated in order to assess clinical morphology. RESULTS:Ninety patients were included for the final analysis and 360 lesions were evaluated, 102 of which (28.9 %) showed changes of white areas. Subjective evaluation highlighted two distinct depigmentation patterns, which were present either alone or in combination: (1) a sharply defined band of intermediate color between the depigmented center and the surrounding normal skin, which was defined as 'marginal hypopigmentation;' and (2) pinpoint hypopigmented/depigmented macules centered by a follicle, which we named 'perifollicular depigmentation.' On the other hand, only one repigmentation pattern was detected, the already known 'perifollicular repigmentation.' CONCLUSION:The depigmentation process in vitiligo seems to follow only two specific patterns. This preliminary study represents, in our opinion, a valuable background for future research aiming to investigate the dynamics of vitiligo pathogenesis or assess depigmentation/repigmentation patterns for monitoring treatment response.

journal_name

Am J Clin Dermatol

authors

Menchini G,Comacchi C,Cappugi P,Torchia D

doi

10.1007/s40257-012-0001-9

subject

Has Abstract

pub_date

2013-02-01 00:00:00

pages

55-9

issue

1

eissn

1175-0561

issn

1179-1888

journal_volume

14

pub_type

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