Italian Group for the Study and Treatment of Vitiligo (GISV), Pisa, Italy.
Am J Clin Dermatol. 2013 Feb;14(1):55-9. doi: 10.1007/s40257-012-0001-9.
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.
The objective of this study was to investigate the dynamics of macromorphologic alterations taking place within vitiligo patches.
This was a prospective study of a vitiligo cohort.
Consecutive patients affected by nonsegmental vitiligo.
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.
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.'
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.
最近，人们一直在努力探索简单、客观、准确和可重复的非节段性白癜风临床/非侵入性评估方法。然而，这些研究大多只考虑了定量或半定量参数，几乎忽略了在给定时刻和随时间推移时白癜风病变的纯定性外观。
本研究旨在探讨白癜风斑块内发生的宏观形态改变的动态。
这是一项对白癜风队列进行的前瞻性研究。
连续患有非节段性白癜风的患者。
入组的患有非节段性白癜风的患者每月接受一次皮肤科就诊，共 12 个月。每次就诊时，在室内光和伍德灯下拍摄白癜风病变，并通过一种能够检测白色区域定量变化的形态计量、数字化软件进行分析。评估显示病变变化的图片，以评估临床形态。
最终有 90 名患者被纳入最终分析，共评估了 360 处病变，其中 102 处（28.9%）显示白色区域发生变化。主观评估突出了两种不同的脱色素模式，它们单独或组合存在：（1）在色素脱失中心和周围正常皮肤之间有一条清晰界定的中间色带，我们称之为“边缘性色素减退”；（2）以毛囊为中心的针尖状色素减退/脱色斑，我们称之为“毛囊周围脱色素”。另一方面，只检测到一种再色素沉着模式，即已知的“毛囊周围再色素沉着”。
白癜风的脱色素过程似乎只遵循两种特定模式。这项初步研究在我们看来，为未来旨在探讨白癜风发病机制动态或评估脱色素/再色素沉着模式以监测治疗反应的研究提供了有价值的背景。
