一项综述白癜风文献旨在规范疾病严重程度的表述。

A Review of the Vitiligo Literature to Standardize Expression of Disease Severity.

出版信息

J Drugs Dermatol. 2024 Oct 1;23(10):842-846. doi: 10.36849/JDD.2024.8049.

DOI:10.36849/JDD.2024.8049

PMID:39361696

Abstract

BACKGROUND

The literature on vitiligo is heterogeneous with limited standardization in vitiligo disease severity reporting.

OBJECTIVES

The IDEOM Vitiligo Workgroup initiated a project to develop an improved understanding of clinical reporting of vitiligo severity.

METHODS

A medical librarian-developed literature review identified 50 clinical trials treating vitiligo topically using topical corticosteroids or topical tacrolimus that included adult and pediatric patients, with 10 or more patients, with grading by SORT criteria.

RESULTS

Grading systems used included body surface area scoring (BSA) clinically or via photography and mapping. Most studies create a grading system of repigmentation including G0- no change, G1- 1-25%, G2- 26-50%, G3- 51-75%, G4- 75-99%, and G5- 100%. Variations include reporting success as thresholds >25% (G2-G5), >50% (G3-G5), and >75% (G4-G5) repigmentation. Vitiligo Area Scoring Index (VASI), Dermatology Life Quality Index (DLQI), patient satisfaction, and the vitiligo noticeability scale are all standardized scoring systems that have been used in clinical studies. Other metrics reported include onset and maintenance of response, treatment burden, side effects, and cost-effectiveness.

CONCLUSIONS

BSA total and quartiles of improvement are the most commonly reported metrics in studies with high-level evidence. The addition of categories of no improvement, complete clearance, spontaneous improvement, and worsening appears to enhance information collection. Collection of data using photographs or computer-assisted BSA monitoring enhances data reproducibility. Thresholds of success should include 25%, 50%, 75%, and adding 90% and 100% repigmentation. VASI represents a validated collection method, which can be modified for 50%, 75%, and 90% improvement. Newer metrics including treatment burden and cost effectiveness are emerging metrics under evaluation. J Drugs Dermatol. 2024;23(10):842-846. doi:10.36849/JDD.8049.

摘要

背景

白癜风文献具有异质性，疾病严重程度报告的标准化程度有限。

目的

IDEOM 白癜风工作组启动了一个项目，以深入了解白癜风严重程度的临床报告。

方法

医学图书馆员开发的文献综述确定了 50 项治疗白癜风的临床试验，这些试验使用局部皮质类固醇或局部他克莫司进行治疗，包括成人和儿科患者，患者人数为 10 人或更多，分级采用 SORT 标准。

结果

使用的分级系统包括体表面积评分（BSA）临床或通过摄影和映射。大多数研究创建了一个复色分级系统，包括 G0-无变化，G1-1-25%，G2-26-50%，G3-51-75%，G4-75-99%，和 G5-100%。变化包括报告成功率>25%（G2-G5）、>50%（G3-G5）和>75%（G4-G5）复色。白癜风面积评分指数（VASI）、皮肤病生活质量指数（DLQI）、患者满意度和白癜风可见性量表都是已在临床研究中使用的标准化评分系统。其他报告的指标包括起效和维持反应、治疗负担、副作用和成本效益。

结论

BSA 总评分和改善四分位数是具有高级别证据的研究中最常报告的指标。增加无改善、完全清除、自发改善和恶化的类别似乎增强了信息收集。使用照片或计算机辅助 BSA 监测收集数据可提高数据可重复性。成功的阈值应包括 25%、50%、75%，并增加 90%和 100%复色。VASI 代表一种经过验证的收集方法，可以修改为 50%、75%和 90%的改善。包括治疗负担和成本效益在内的新指标是正在评估的新兴指标。J 皮肤病药物学杂志。2024；23（10）：842-846. doi：10.36849/JDD.8049.