Dermatoscopic assessment of treatment response in patients undergoing autologous non‐cultured epidermal cell suspension for the treatment of stable vitiligo: A prospective study

Abstract

There is lack of literature on serial dermatoscopic assessment in patients undergoing non‐cultured epidermal cell suspension (NCES) for treatment of stable vitiligo. This prospective study was conducted to evaluate the role of serial dermatoscopy in assessing disease stability and predicting repigmentation rates in vitiligo patients undergoing NCES. Dermatoscopic assessment of target lesions were done at baseline and post‐NCES at week 4, 8, 12, 16, and 24. Patches obtaining >90% repigmentation at 24 weeks were categorized to have obtained excellent repigmentation. The dermatoscopic features of target lesions that showed clinical signs of disease activity anytime during the follow‐up period were compared to those maintaining clinical stability throughout. Twenty‐six vitiligo patients with 52 patches, clinically stable for atleast 1 year were recruited. At follow‐up, six patches showed clinical signs of instability. Five patches in the unstable group developed satellite lesions by week 16, compared to none in the stable group (p < 0.05). Excellent repigmentation was achieved in 29 out of 52 patches. Appearance of normal reticular pigment network at 8 weeks was a positive predictor of excellent response (OR = 10.5, CI 1.2–89.7), whereas, altered pigment network at 12, 16, and 24 weeks and telangiectasias at 12 and 16 weeks significantly reduced the odds of excellent repigmentation.

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

“…The early lesions often are hypopigmented (rather than complete that pigment network changes are seen in evolving vitiligo while these changes are seen less frequently in stabilized or repigmenting vitiligo (Dev et al, 2021;Jha et al, 2018;Kumar Jha et al, 2018;Nirmal et al, 2019;Thatte & Khopkar, 2014). The study conducted by Benzekri et al also found that the hypomelanotic with poorly defined borders lesions are associated with disease activity (Benzekri & Gauthier, 2017).…”

“…Regarding intralesional telangiectasia, previous studies have suggested it to be the marker of repigmenting disease (Jha et al, 2018; RuSong et al, 2009). However, the study by Dev et al (2021) suggested that appearance of telangiectasia significantly reduces the odds of excellent repigmentation after surgical management. As this study included lesions, which were already stable and evaluated after administration of surgical treatment, the findings of this study are difficult to generalize for active lesions on medical treatment.…”

“…Few prior reports have described the dermoscopic features of vitiligo in a cross‐sectional manner (Chuh & Zawar, 2004; Jha et al, 2018; Kumar Jha et al, 2018; Nirmal et al, 2019; Thatte & Khopkar, 2014). Some of these studies have also tried to correlate the observed dermoscopic features with disease activity (Chuh & Zawar, 2004; Dev et al, 2021; Errichetti et al, 2020; Jha et al, 2018; Kumar Jha et al, 2018; Nirmal et al, 2019; RuSong et al, 2009; Thatte & Khopkar, 2014; Wang et al, 2018). However, results were non‐homogenous and even contradictory, as far as association with disease activity/stability was concerned, and same dermoscopic features were being reported to be associated with both stable and progressive disease (Chuh & Zawar, 2004; Dev et al, 2021; Errichetti et al, 2020; Jha et al, 2018; Kumar Jha et al, 2018; Nirmal et al, 2019; RuSong et al, 2009; Thatte & Khopkar, 2014; Wang et al, 2018).…”

“…Some of these studies have also tried to correlate the observed dermoscopic features with disease activity (Chuh & Zawar, 2004; Dev et al, 2021; Errichetti et al, 2020; Jha et al, 2018; Kumar Jha et al, 2018; Nirmal et al, 2019; RuSong et al, 2009; Thatte & Khopkar, 2014; Wang et al, 2018). However, results were non‐homogenous and even contradictory, as far as association with disease activity/stability was concerned, and same dermoscopic features were being reported to be associated with both stable and progressive disease (Chuh & Zawar, 2004; Dev et al, 2021; Errichetti et al, 2020; Jha et al, 2018; Kumar Jha et al, 2018; Nirmal et al, 2019; RuSong et al, 2009; Thatte & Khopkar, 2014; Wang et al, 2018). This discrepancy was mainly due to retrospective and cross‐sectional nature of the studies and therefore a reliance on patient‐provided history to categorize the lesions as active or stable, thereby carry a degree of recall bias (Chuh & Zawar, 2004; Jha et al, 2018; Kumar Jha et al, 2018; Nirmal et al, 2019; RuSong et al, 2009; Thatte & Khopkar, 2014).…”

A New Assessment Method of Vitiligo by Combination of Dermoscopy and Reflectance Confocal Microscopy

“…Additionally, dermoscopy and RCM have been reported to be reliable techniques to evaluate initial treatment response as they can show increases in perilesional and intralesional pigmentation that are not visible to the naked eye. [34][35][36] In our study, the clinical, dermoscopic and RCM changes of 92 patients before and after treatment were compared and the following conclusions were found. Before the skin lesions recovered clinically, dermoscopy had observed increased pigmentation in the skin lesions.…”