Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India.
Department of Dermatology and STD, Safdurjung Hospital, New Delhi, India.
Indian J Dermatol Venereol Leprol. 2020 Nov-Dec;86(6):656-662. doi: 10.4103/ijdvl.IJDVL_704_18.
Segmental vitiligo has a different clinical course and prognosis as compared to nonsegmental vitiligo, which necessitates its correct diagnosis. It may be difficult to distinguish segmental vitiligo from the limited or focal types of nonsegmental vitiligo.
To validate the previously proposed diagnostic criteria for segmental vitiligo.
This was a cross-sectional validation study involving patients with limited vitiligo. The diagnostic criteria were used to classify vitiligo lesions as segmental or nonsegmental, and was compared with the experts' diagnosis, which was considered as the "gold standard".
The study included 200 patients with 225 vitiligo lesions. As per the diagnostic criteria, 146 vitiligo lesions were classified as segmental and 79 as nonsegmental. The experts classified 147 vitiligo lesions as segmental and 39 as nonsegmental, while the diagnosis either was labeled "unsure" or could not be agreed upon for 39 lesions. As compared with the experts' opinions ("for sure" cases, n = 186), the sensitivity and specificity of the diagnostic criteria was 91.8% (95% confidence interval [CI]: 86.2%-95.7%) and 100% (95% CI: 91%-100%), respectively. The positive predictive value was 100% (95% CI: 97.3-100%), while the negative predictive value was 76.5% (95% CI: 62.5%-87.2%). There was a 93.5% agreement between the clinical criteria and experts' opinions (k = 0.83, P < 0.001).
The diagnostic criteria were compared with the experts' opinion in the absence of an established diagnostic "gold standard".
The proposed diagnostic criteria for segmental vitiligo performed well, and can be used in clinical practice, as well as in research settings.
节段性白癜风与非节段性白癜风的临床表现和预后不同，因此需要正确诊断。区分节段性白癜风与非节段性白癜风的局限性或局灶性类型可能具有挑战性。
验证先前提出的节段性白癜风诊断标准。
这是一项涉及局限性白癜风患者的横断面验证研究。使用诊断标准将白癜风皮损分类为节段性或非节段性，并与专家诊断进行比较，专家诊断被认为是“金标准”。
该研究纳入了 200 名患者的 225 处白癜风皮损。根据诊断标准，146 处皮损被归类为节段性，79 处为非节段性。专家将 147 处皮损归类为节段性，39 处为非节段性，而 39 处皮损的诊断或无法达成一致意见。与专家意见（“确定”病例，n = 186）相比，诊断标准的敏感性和特异性分别为 91.8%（95%置信区间[CI]：86.2%-95.7%）和 100%（95%CI：91%-100%）。阳性预测值为 100%（95%CI：97.3%-100%），而阴性预测值为 76.5%（95%CI：62.5%-87.2%）。临床标准与专家意见之间的一致性为 93.5%（k = 0.83，P < 0.001）。
诊断标准是在缺乏既定诊断“金标准”的情况下与专家意见进行比较的。
提出的节段性白癜风诊断标准表现良好，可在临床实践和研究中使用。
