Development and validation of the Vitiligo Extent Score for a Target Area (VESTA) to assess the treatment response of a target lesion

Abstract

Since localized treatment for vitiligo is as essential as systemic treatment, a reliable instrument for target evaluation is needed besides those for whole body evaluation. We developed the Vitiligo Extent Score for a Target Area (VESTA) using reference images of both marginal and perifollicular repigmentation to measure the repigmentation rate (%) in a target lesion. In the validation study, a total of 65 dermatologists in 10 institutes evaluated 17 pairs of vitiligo images (pre- and post-treatment) using both a rough estimate and the VESTA. The VESTA (concordance correlation coefficient: 0.949, 95% confidence interval [CI] 0.942-0.955) was significantly more accurate than the rough estimate (0.896, 95% CI: 0.883-0.908). It was also associated with better inter-rater reliability over the rough estimate, albeit not significant. The VESTA can afford intuitive, convenient, and reliable assessment of the treatment response in a target area, and would be useful in clinical practice as well as retrospective studies.

Effect of platelet‐rich plasma on the outcome of mini‐punch grafting procedure in localized stable vitiligo: Clinical evaluation and relation to lesional basic fibroblast growth factor

“…The re‐pigmentation response was assessed via vitiligo extent score for a target area (VESTA) score, 15 and the grades for percent of re‐pigmentation were adopted according to Vinay et al, 2015 as follows: minimal repigmentation (≤25%), mild repigmentation (26%‐50%), moderate repigmentation (51%‐75%), marked repigmentation (76%‐90%), and excellent repigmentation (91%‐100%) 16 . The treated site was considered to have ideal re‐pigmentation response if re‐pigmentation occurred by more than 75% 16 .…”

“…The re-pigmentation response was assessed via vitiligo extent score for a target area (VESTA) score, 15 and the grades for percent of repigmentation were adopted according to Vinay et al, 2015 as follows:…”

Skin seeding technique with 0.5‐mm micropunch grafting for vitiligo irrespective of the epidermal–dermal orientation: Animal and clinical studies

“…Treatment success was defined as 75% or more repigmentation of the surgery site using VESTA. 13 A partial response was defined as 50-74% repigmentation, and insufficient repigmentation was defined as less than 50% repigmentation.…”

“…The treatment response was rated by two dermatologists based on clinical photographs obtained at baseline and 3 months postoperatively. Treatment success was defined as 75% or more repigmentation of the surgery site using VESTA 13 . A partial response was defined as 50–74% repigmentation, and insufficient repigmentation was defined as less than 50% repigmentation.…”

Efficacy and safety of combined fractional ablative CO2 laser and 5 fluorouracil in the treatment of acral vitiligo: An open, uncontrolled study

“…It involves three main parts: reference images of marginal repigmentation, reference images of perifollicular repigmentation and a formula used to calculate the total percent of repigmentation. 18 • High-resolution digital photographs were taken from the patient's lesions on the dorsal side of both hands at baseline, before each treatment session, and 12 weeks after the final treatment using a single standard camera (Nikon, 20.1 mega pixel resolution) in a fixed time of the day under the same standard settings. Two independent dermatologists then blindly reviewed the photographs to assess the degree of repigmentation using a 5-point scale: grade 0 (no repigmentation), grade 1 (1%-5%), grade 2 (6%-25%), grade 3 (26%-50%), grade 4 (51%-75%), and grade 5 (76%-100%).…”