A prospective observational study to sequentially determine the dermoscopic features of vitiligo and its association with disease activity in patients on medical treatment

Gupta, Priyansh; Vinay, Keshavamurthy; Bishnoi, Anuradha; Parsad, Davinder

doi:10.1111/pcmr.13069

Cited by 7 publications

(15 citation statements)

References 19 publications

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“…Prior studies have linked dermoscopic signs like perifollicular depigmentation and micro-Koebner phenomenon to disease activity. 14,15 However, in the present study our focus was on visible clinical signs of disease activity because a standardised scoring instrument is already available and validated (VSAS). Further elaboration of the dermoscopic signs and their connection to disease activity would be an interesting topic.…”

Section: Discussion/con Clus Ionmentioning

confidence: 99%

“…Further research focusing on the impact of treatment on the disease activity sign would be valuable. Prior studies have linked dermoscopic signs like perifollicular depigmentation and micro‐Koebner phenomenon to disease activity 14,15 . However, in the present study our focus was on visible clinical signs of disease activity because a standardised scoring instrument is already available and validated (VSAS).…”

Section: Discussion/conclusionmentioning

confidence: 99%

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Hot spots for clinical signs of disease activity in vitiligo

Delbaere,

van Causenbroeck,

Duponselle

et al. 2023

Experimental Dermatology

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There is evidence of a link between disease activity in vitiligo and clinical visible signs such as confetti‐like depigmentation, Koebner phenomenon and hypochromic areas/borders. Despite its established value, dermatologists and researchers continue to have a limited understanding of the vitiligo disease activity signs. The primary goal of this study was to identify ‘hot spots’ of disease activity signs in vitiligo patients in order to improve detection in clinical practice. Furthermore, the prevalence, clinical profiles of predisposed patients, interrelationship between the disease activity signs and potential pitfalls in the recognition of the signs were evaluated. The Vitiligo Signs of Activity Score (VSAS) was used to score the presence of the disease activity signs in 441 non‐segmental and 57 segmental vitiligo patients. More detailed predilection areas were scored in a subset of patients, using 65 predefined body locations. At least one disease activity sign was observed in 51.0% and 8.8% of the non‐segmental and segmental vitiligo patients, respectively. Confetti‐like depigmentation was most observed on the elbows, Koebner phenomenon on the back of the hands, and hypochromic areas/borders in the armpits. The three signs were significantly more observed in patients with more involved body locations. Moreover, hypochromic areas/borders were more common in younger patients. Confetti‐like depigmentation had the highest interrelationship with the other signs and was the easiest to recognise. Knowledge around hot spots of the disease activity signs will enhance and simplify their detection in clinical practice. Based on the results, confetti‐like depigmentation appears to be the most straightforward sign to evaluate.

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Section: Discussion/con Clus Ionmentioning

confidence: 99%

Section: Discussion/conclusionmentioning

confidence: 99%

Hot spots for clinical signs of disease activity in vitiligo

Delbaere,

van Causenbroeck,

Duponselle

et al. 2023

Experimental Dermatology

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“…Pigment network changes, such as altered, reduced, and reversed pigment network, could be a marker of disease activity, as they are observed more in active disease than in stable or repigmenting vitiligo. 34,36,37 Reticulate pigment network, on the other hand, has been associated with stable vitiligo. 35 Conflicting results have been reported on perifollicular pigmentation and perifollicular depigmentation.…”

Section: Part 2: Dermoscopic Markersmentioning

confidence: 99%

“…Perifollicular pigmentation is linked to active vitiligo in a case series and retrospective analysis by the same author, while an observational study observed perifollicular repigmentation as a marker of lesional stability or repigmentation. 34,36,37 Perifollicular depigmentation has been associated with stable disease; however, another study linked this feature to active disease. 34,36,37 Other features such as starbust appearance, comet tail appearance, tiny pearly white globules, and tapioca sago were exclusively observed in active disease.…”

Section: Part 2: Dermoscopic Markersmentioning

confidence: 99%

“…34,36,37 Perifollicular depigmentation has been associated with stable disease; however, another study linked this feature to active disease. 34,36,37 Other features such as starbust appearance, comet tail appearance, tiny pearly white globules, and tapioca sago were exclusively observed in active disease. 34,36 Leukotrichia was described most frequently, but not exclusively, in stable vitiligo.…”

Section: Part 2: Dermoscopic Markersmentioning

confidence: 99%

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Biomarkers and clinical indicators of disease activity in vitiligo

Delbaere

Speeckaert

Herbelet

et al. 2022

Dermatological Reviews

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Background:The management of vitiligo is guided by the assessment of disease activity. However, this assessment is hampered by the absence of a highly feasible and reliable single marker to evaluate activity. Furthermore, the need for an objective, easy, preferably noninvasive marker is further stressed by the increased amount of research performed on new treatment strategies for vitiligo.Objectives: In this review, the available research on clinical signs linked to disease activity, and biomarkers in tissues and blood are summarized.Results: In the group of clinical signs, the Koebner phenomenon has the strongest evidence of an association with disease activity, while confetti-like depigmentation is gaining importance and seems to outweigh this role. For the tissue markers, the most evidence is available for histopathological findings, such as epidermal spongiosis with vacuolar degeneration in the basal cells and inflammatory infiltrate. Circulating biomarkers such as interleukin-1β (IL-1β), IL-17, interferon-γ, tumor growth factor-β, soluble cluster of differentiation 25, autoantibodies, and oxidative stress markers show the most promising results. Nevertheless, none of them are currently regarded as the gold standard.Discussion: In conclusion, we encourage researchers to investigate various biomarkers and clinical signs in their trials in a standardized manner to get insight into their exact value, so they can be used to optimize treatment selection, gain insight into the disease, and predict future disease progression.

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Dermoscopy in vitiligo, diagnostic clues and markers of disease activity: a review of the literature

Yang,

Morriss,

Rodrigues

2024

Clinical and Experimental Dermatology

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Dermoscopy is a noninvasive, efficient and inexpensive tool used to aid diagnosis of skin conditions such as vitiligo. Furthermore, it aids in tracking patient progress, treatment response and disease activity. Vitiligo can be diagnosed on dermoscopy by the presence of white structureless areas signifying hypopigmentation with a typical glowing appearance. Other typical features are perilesional and perifollicular hyperpigmentation, pigmentation networks and leucotrichia. In total, 15 studies were reviewed to determine the dermoscopic signs of the three main stages of disease activity: active, stable and repigmenting vitiligo. Features that differentiate active, stable and repigmenting vitiligo are reviewed and discussed in this article. Notably, there is a conflict in the literature between various dermoscopic features and which type of vitiligo they are truly indicative of. However, dermoscopy can be coupled with other clinical, biological and physiological markers to strengthen diagnostic accuracy.

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A prospective observational study to sequentially determine the dermoscopic features of vitiligo and its association with disease activity in patients on medical treatment

Cited by 7 publications

References 19 publications

Hot spots for clinical signs of disease activity in vitiligo

Hot spots for clinical signs of disease activity in vitiligo

Biomarkers and clinical indicators of disease activity in vitiligo

Dermoscopy in vitiligo, diagnostic clues and markers of disease activity: a review of the literature

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