Department of Dermatology, Ghent University Hospital, Ghent, Belgium.
Faculty of Medicine and Health Science, Ghent University, Ghent, Belgium.
Exp Dermatol. 2024 Sep;33(9):e15167. doi: 10.1111/exd.15167.
The progression of vitiligo is unpredictable, emphasizing the need to identify periods of activity early for tailored treatment. Confetti-like depigmentation, hypochromic areas/borders and Koebner's phenomenon are clinical visible signs associated with disease activity in vitiligo. However, their true clinical significance requires further investigation using standardized scoring systems. In the present study, the Vitiligo Signs of Activity Score (VSAS) and the Vitiligo Disease Activity Score (VDAS) were applied to assess disease activity signs and disease progression over time, respectively. Individuals with at least one disease activity sign had a 76.9% likelihood of having active vitiligo. The simultaneous presence of multiple signs or their appearance across body locations increased the likelihood to 94% and 87.1%, respectively. Patients with no disease activity signs had a 60.3% likelihood of having stable disease. This research provides an important nuance about the disease activity signs in vitiligo, which may help guide disease management. The risk of active disease increases when at least two types of vitiligo activity signs are present, or when they are present on different body locations. However, the absence of vitiligo activity signs does not rule out active vitiligo.
白癜风的进展是不可预测的，这强调了需要早期识别活动期，以便进行针对性治疗。糠疹样脱色素、色素减退区/边界和 Koebner 现象是与白癜风活动相关的临床可见征象。然而，它们的真正临床意义需要使用标准化评分系统进一步研究。在本研究中，应用白癜风活动评分（VSAS）和白癜风疾病活动评分（VDAS）分别评估疾病活动征象和随时间推移的疾病进展。至少有一个疾病活动征象的个体有 76.9%的可能性患有活动性白癜风。同时存在多个征象或它们出现在身体不同部位的可能性分别增加到 94%和 87.1%。没有疾病活动征象的患者有 60.3%的可能性患有稳定的疾病。这项研究为白癜风的疾病活动征象提供了一个重要的细微差别，这可能有助于指导疾病管理。当至少两种类型的白癜风活动征象存在，或者当它们出现在身体不同部位时，患活动性疾病的风险会增加。然而，没有白癜风活动征象并不能排除活动性白癜风。
