Kamath Chitra, Dhurat Rachita, Shah Bhavika, Sharma Richa, Kowe Priyanka Arun, Chamle Sachin
Department of Dermatology, Venerology and Leprosy, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, India.
Dermatol Pract Concept. 2023 Oct 1;13(4):e2023277. doi: 10.5826/dpc.1304a277.
Previously laid down criteria for lesional stability of vitiligo are inconsistent. Longitudinal data on correlation between dermoscopic features of vitiligo and disease activity is limited.
To sequentially determine the dermoscopic features of vitiligo and to assess their association with the dynamic nature of the vitiligo patch.
Sixty patients with 200 vitiligo patches fulfilling the inclusion criteria on medical therapy were subjected to sequential clinical and dermoscopic examination for 6 months. Baseline lesional photographs, dermoscopy and tracing of the patch was made and repeated at 6 months. The follow up tracing was superimposed onto the baseline tracing. Based on the increase or decrease in size, their outcomes were grouped as responsive, progressive and quiescent. Paired analysis of dermoscopic features was done between baseline, and their follow up after 6 months.
Well defined border was associated with static nature of the vitiligo patch and ill-defined borders and trichrome pattern depicted its dynamic nature. Statistically significant increase in leukotrichia and satellite lesions amongst progressive patches and a decrease amongst responsive patches was observed. Pigment network changes were statistically significant for both responsive and progressive patches. Satellite lesions and micro-Koebner's phenomena was suggestive of progressive disease, while perifollicular pigmentation and perilesional hyperpigmentation was suggestive of re-pigmenting disease and proved to be an early marker for response to therapy.
Repeated dermoscopic evaluation of lesions in a serial manner to assess disease activity helps understand their evolving nature and is a valuable tool in planning appropriate further treatment.
先前制定的白癜风皮损稳定性标准并不一致。关于白癜风皮肤镜特征与疾病活动度之间相关性的纵向数据有限。
依次确定白癜风的皮肤镜特征，并评估它们与白癜风斑块动态性质的关联。
60例患有200处白癜风斑块且符合药物治疗纳入标准的患者接受了为期6个月的序贯临床和皮肤镜检查。拍摄基线皮损照片、进行皮肤镜检查并对斑块进行描记，6个月时重复上述操作。将随访描记叠加在基线描记上。根据大小的增加或减少，将其结果分为反应性、进展性和静止性。对基线时的皮肤镜特征与其6个月后的随访结果进行配对分析。
边界清晰与白癜风斑块的静止性质相关，边界不清和三色模式则描绘了其动态性质。观察到进展性斑块中白发和卫星病灶在统计学上显著增加，而反应性斑块中则减少。色素网变化在反应性和进展性斑块中均具有统计学意义。卫星病灶和微科布内现象提示疾病进展，而毛囊周色素沉着和皮损周围色素沉着提示色素再生性疾病，并且被证明是治疗反应的早期标志物。
通过连续多次对皮损进行皮肤镜评估以评估疾病活动度，有助于了解其演变性质，并且是规划适当进一步治疗的宝贵工具。
