Role of In vivo reflectance confocal microscopy in determining stability in vitiligo: A preliminary study

Abstract

Background:Vitiligo is an acquired pigmentary disorder. In vivo reflectance confocal microscopy (RCM) reproducible imaging technique has already been reported to be useful in the diagnosis of other skin diseases.Objective:To define RCM features of vitiligo on different clinical stages.Materials and Methods:A total of 125 patients with a clinical diagnosis of vitiligo were included in this study. After informed consent, lesional skins of those vitiligo patients were characterized by using RCM. Five patients with inflammatory cell infiltration observed at the edge of skin lesions and another 5 patients without inflammatory cell infiltration were selected. Biopsies were performed at same sites of the RCM examination areas for histological and immune-histological analysis.Results:In the active stage of vitiligo, the RCM examination revealed that the bright dermal papillary rings presented at the dermoepidermal junction level in normal skin lost their integrity or totally disappeared, border between vitiligo lesion and normal skin became unclear, and highly refractile cells that referred to infiltrated inflammatory cells could be seen within the papillary dermis at the edge of the lesions. In the stable stage of vitiligo, the RCM showed a complete loss of melanin in lesional skin and a clear border between lesional and normal skin.Conclusion:A simple clinical examination with RCM may reliably and efficiently allow evaluation of the stability status of vitiligo lesions.

Vitiligo with Progressive Repigmentation during Secukinumab Treatment in a Patient with Psoriatic Arthritis: A Case Report

“…As demonstrated in our case and in previous studies, RCM is an important instrument for the evaluation of vitiligo and repigmentation [8-10]. The absence of bright dermal papillary rings at the dermo-epidermal junction level is indicative of vitiligo, and the presence of dendritic melanocytes is a sign of repigmentation [9, 10], both of which were observed in our patient.…”

“…Our patient's vitiligo lesions were examined using RCM, which is a noninvasive diagnostic tool providing real-time images that approach cellular histological resolution. Use of RCM to diagnose and monitor inflammatory skin disease represents a relatively new field of interest [ 8 , 9 , 10 ]. Compared with the surrounding skin structures, melanin has a high reflectance index, allowing melanocytes, which are progressively lost in vitiligo lesions, to be clearly visualized with RCM [ 9 , 10 ].…”

“…Use of RCM to diagnose and monitor inflammatory skin disease represents a relatively new field of interest [ 8 , 9 , 10 ]. Compared with the surrounding skin structures, melanin has a high reflectance index, allowing melanocytes, which are progressively lost in vitiligo lesions, to be clearly visualized with RCM [ 9 , 10 ]. As demonstrated in our case and in previous studies, RCM is an important instrument for the evaluation of vitiligo and repigmentation [ 8 , 9 , 10 ].…”

“…Compared with the surrounding skin structures, melanin has a high reflectance index, allowing melanocytes, which are progressively lost in vitiligo lesions, to be clearly visualized with RCM [ 9 , 10 ]. As demonstrated in our case and in previous studies, RCM is an important instrument for the evaluation of vitiligo and repigmentation [ 8 , 9 , 10 ]. The absence of bright dermal papillary rings at the dermo-epidermal junction level is indicative of vitiligo, and the presence of dendritic melanocytes is a sign of repigmentation [ 9 , 10 ], both of which were observed in our patient.…”