Assessment methods for the evaluation of vitiligo

Abstract

There is no standardized method for assessing vitiligo. In this article, we review the literature from 1981 to 2011 on different vitiligo assessment methods. We aim to classify the techniques available for vitiligo assessment as subjective, semi-objective or objective; microscopic or macroscopic; and as based on morphometry or colorimetry. Macroscopic morphological measurements include visual assessment, photography in natural or ultraviolet light, photography with computerized image analysis and tristimulus colorimetry or spectrophotometry. Non-invasive micromorphological methods include confocal laser microscopy (CLM). Subjective methods include clinical evaluation by a dermatologist and a vitiligo disease activity score. Semi-objective methods include the Vitiligo Area Scoring Index (VASI) and point-counting methods. Objective methods include software-based image analysis, tristimulus colorimetry, spectrophotometry and CLM. Morphometry is the measurement of the vitiliginous surface area, whereas colorimetry quantitatively analyses skin colour changes caused by erythema or pigment. Most methods involve morphometry, except for the chromameter method, which assesses colorimetry. Some image analysis software programs can assess both morphometry and colorimetry. The details of these programs (Corel Draw, Image Pro Plus, AutoCad and Photoshop) are discussed in the review. Reflectance confocal microscopy provides real-time images and has great potential for the non-invasive assessment of pigmentary lesions. In conclusion, there is no single best method for assessing vitiligo. This review revealed that VASI, the rule of nine and Wood's lamp are likely to be the best techniques available for assessing the degree of pigmentary lesions and measuring the extent and progression of vitiligo in the clinic and in clinical trials.

Comparison of two kinds of skin imaging analysis software: VISIA® from Canfield and IPP® from Media Cybernetics

“…By integrating the RBX technology, cross‐polarized‐mode processing of subsurface red and brown features enables visualization of conditions such as rosacea, spider veins, melasma, and acne. Image‐Pro Plus (IPP ® ) is an image analysis software that has been widely used in many fields such as oral science, ophthalmology, pathology, and dermatology . Recently, IPP ® has been introduced into the field of beauty and cosmetics.…”

Distinct temperament and character profiles in first onset vitiligo but not in alopecia areata

“…The Rule of Nine assessment calculates as the head and neck, each arm, leg, and the four trunk quadrants each composing 9% and genitalia 1% of the total body surface area. According to Wood's lamp examination of the depigmentation of patients with V, the severity of the disease is assessed with the Rule of Nine, which is subjective and based on visual assessments …”

Comparison of the efficacy of 308‐nm excimer lamp monotherapy with topical tacrolimus or clobetasol 17‐propionate combination therapies in localized vitiligo

“…In vitiligo, there is a need for a sensitive assessment method, as repigmentation occurs rather slowly . However, there is not any standardized method to evaluate the efficacy of the treatment .…”