Clinicopathological correlation of acquired hypopigmentary disorders

Objective: To determine the pattern of drug use, adverse events (AEs), and quality of life (QOL) in hypopigmentary disorders of the skin. Methods: A prospective, observational study was conducted on 48 newly diagnosed and untreated participants with hypopigmentary disorders who attended the dermatology outpatient department (OPD) of a tertiary care hospital in Bangalore, India. The pattern of drug therapy and AEs to the therapy were analyzed using descriptive statistics. The dermatology life quality index (DLQI) score for QOL was assessed before and after treatment using analysis of variance (ANOVA). The participants were monitored every 30 d for three months to study the appropriateness and changes in prescription patterns, AEs, and QOL. Results: Male participants had a mean age of 36.69±15.58, while female participants had a mean age of 40.96±11.88. The different classes of drugs used were calcineurin inhibitors, growth factors, melanizing agents, glucocorticoids (GCs), antifungals, and anti-lepra drugs. QOL improved after treatment. The most common AEs include gastritis (16.6%) and acneiform eruption (10.41%). Conclusion: This study has helped in determining the different patterns of drugs used in hypopigmentary disorders and their positive impact on QOL. The individualized prescribing pattern could improve the clinical and psychosocial outcome of the disease in the future.

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“…Females outnumbered males (n = 25) by a factor of two. The most prevalent disorder in our study was vitiligo, similar to other studies [1].…”

Section: Discussionsupporting

confidence: 92%

“…Hypopigmentary disorders are a varied group of pigmentary disorders that are common among Indians and Asians [1]. They produce whitening of the skin due to a decrease in melanin synthesis or the partial or complete absence of melanocytes [2].…”

Section: Introductionmentioning

confidence: 99%

Drug Therapy of Hypopigmentary Disorders of the Skin: A Hospital-Based Study

Girish

GOWDA

Jyothi

et al. 2023

Int J Pharm Pharm Sci

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“…With regard to relatively high prevalence of vitiligo in the world [ 1 , 4 ], involvement of young people [ 2 , 3 ] and high disease burden [ 9 – 16 ], evaluation of disease quality of life with a specific scale in countries with various cultural values could be worthwhile. VitiQoL is originally a questionnaire in English, which recently has been suggested for estimation of quality of life in vitiligo patients.…”

Section: Discussionmentioning

confidence: 99%

Quality of life in patients with vitiligo: a cross-sectional study based on Vitiligo Quality of Life index (VitiQoL)

Hedayat

Karbakhsh

Ghiasi

et al. 2016

Health Qual Life Outcomes

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BackgroundVitiligo is a multi-factorial pigmentary skin disorder. Recently, the importance of emotional and psychological issues is proposed in incidence, progression, relapse and remission of vitiligo. There are limited studies conducted in developing countries, which assess life quality of patients with vitiligo. The aim of this study was the application and evaluation of a disease-specific quality of life index in Iranian patients, for the first time.MethodsThis cross-sectional biphasic study was conducted on 25 patients as a pilot and another 173 patients as the main study group, in Razi Hospital, Tehran, Iran, 2013–2014. Persian version of Vitiligo Quality of Life index (VitiQoL) was developed with backward-forward method. Based on the pilot study, the validity and reliability were assessed. The Vitiligo Area and Score Index (VASI), VitiQoL, and their relationship, demographic and clinical characteristic of patients were measured.ResultsThe Mean and standard deviation of the VitiQoL score was 30.5 ± 14.5 (range 0–60 in Persian version). There was a significant relationship between VASI score and VitiQoL (p = 0.015, r = 0.187). Confirmatory factor analysis revealed three important factors within VitiQoL: participation limitation, stigma, and behavior. In subscale analysis based on behavior factor, female patients had poorer quality of life (p = 0.02). Concomitant psychiatric problems, e.g. anxiety and depression, were not associated with QOL; however, they were near to being meaningful (p = 0.06, r = 0.14).ConclusionVitiQoL is a valid index in estimating life quality of vitiligo patients and has proper relation to disease severity. Focusing on patient’s life quality is an important entity in the management of vitiligo patients; relevant supportive group-based consultations and therapies are also important arms when approaching vitiligo.Electronic supplementary materialThe online version of this article (doi:10.1186/s12955-016-0490-y) contains supplementary material, which is available to authorized users.

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“…Histopathological findings in vitiligo vary according to the life of the lesion. [ 9 ] An early evolving lesion shows decreased melanin in the basal layer with few melanocytes still present at the dermoepidermal junction with a sparse perivascular lymphocytic infiltrate. As the lesion ages the epidermis flattens and there is complete loss of melanin and melanocytes.…”

Section: Discussionmentioning

confidence: 99%

Skip areas of retained melanin: A clue to the histopathological diagnosis of idiopathic guttate hypomelanosis

Joshi

2014

Indian J Dermatol

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Biopsy findings in 55 cases of idiopathic guttate hypomelanosis (IGH) are reported. Most cases had a flat epidermis with loss of the rete pattern and a thickened orthokeratotic basket weave stratum corneum. The epidermis had markedly decreased to absent melanin in the basal layer and reduced numbers of melanocytes at the dermoepidermal junction. One-third of patients had a sparse perivascular lymphocytic infiltrate, whereas the rest had no significant dermal inflammation. These findings are in concordance with current literature. However, small foci of retained melanin in the basal layer (skip areas) alternating with larger areas of melanin loss were present in almost 80% of cases. This finding has not been reported earlier and appears to be quite specific to IGH and may be used as a clue to differentiate IGH from other similar conditions such as vitiligo and guttate morphea.

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Clinicopathological correlation of acquired hypopigmentary disorders

Cited by 20 publications

References 25 publications

Drug Therapy of Hypopigmentary Disorders of the Skin: A Hospital-Based Study

Drug Therapy of Hypopigmentary Disorders of the Skin: A Hospital-Based Study

Quality of life in patients with vitiligo: a cross-sectional study based on Vitiligo Quality of Life index (VitiQoL)

Skip areas of retained melanin: A clue to the histopathological diagnosis of idiopathic guttate hypomelanosis

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