Validation of a physician global assessment tool for vitiligo extent: Results of an international vitiligo expert meeting

Geel, Nanja van; Wolkerstorfer, Albert; Ezzedine, Khaled; Pandya, Amit G.; Bekkenk, Marcel W.; Grine, Lynda; Belle, Sarah van; Lommerts, Janny E; Hamzavi, Iltefat; Harris, John E.; Eleftheriadou, Viktoria; Esmat, Samia; Kang, Hyun-Woo; Kumarasinghe, Prasad; Lan, Cheng‐Che E.; Parsad, Davinder; Raboobee, Noufal; Xiang, Leihong; Suzuki, Tamio; Prinsen, Cecilia A.C.; Taı̈eb, Alain; Picardo, Mauro; Speeckaert, Reinhart

doi:10.1111/pcmr.12784

Cited by 11 publications

(18 citation statements)

References 11 publications

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“…Up till now, there are no standardized methods. VASI is the most cited and conducted scoring tools [77], but VES has been validated as a clear, time-saving, and user-friendly score for vitiligo evaluation in adults [77,83]. Experts have recommended the use of VES for clinical trial as outcome measure [83,84].…”

Section: Diagnosis Differential Diagnosis and Disease Assessmentmentioning

confidence: 99%

“…VASI is the most cited and conducted scoring tools [77], but VES has been validated as a clear, time-saving, and user-friendly score for vitiligo evaluation in adults [77,83]. Experts have recommended the use of VES for clinical trial as outcome measure [83,84]. Several promising noninvasive tools may evaluate disease activity and be used as early indicators of therapy efficacy, such as clinical signs, dermoscopy, and Wood's light examination.…”

Section: Diagnosis Differential Diagnosis and Disease Assessmentmentioning

confidence: 99%

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Clinical Features, Immunopathogenesis, and Therapeutic Strategies in Vitiligo

Wang

2021

Clinic Rev Allerg Immunol

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Vitiligo is an autoimmune disease of the skin characterized by epidermal melanocyte loss resulting in white patches, with an approximate prevalence of 0.5-2% worldwide. Several precipitating factors by chemical exposure and skin injury present commonly in patients with vitiligo. Although the diagnosis appears to be straightforward for the distinct clinical phenotype and specific histological features, vitiligo provides many challenges including chronicity, treatment resistance, frequent relapse, associated profound psychosocial effect, and negative impact on quality of life. Multiple mechanisms are involved in melanocyte disappearance, including genetics, environmental factors, and immune-mediated inflammation. Compelling evidence supports the melanocyte intrinsic abnormalities with poor adaptation to stressors leading to instability and release of danger signals, which will activate dendritic cells, natural killer cells, and innate lymphoid cells to initiate innate immunity, ultimately resulting in T-cell mediated adaptive immune response and melanocyte destruction. Importantly, the cross-talk between keratinocytes, melanocytes, and immune cells, such as interferon (IFN)-γ signaling pathway, builds inflammatory loops that give rise to the disease deterioration. Improved understanding of the immune pathogenesis of vitiligo has led to the development of new therapeutic options including Janus kinase (JAK) inhibitors targeting IFN-γ signaling pathways, which can effectively reverse depigmentation. Furthermore, definition of treatment goals and integration of comorbid diseases into vitiligo management have revolutionized the way vitiligo is treated. In this review, we highlight recent developments in vitiligo clinical aspects and immune pathogenesis. Our key objective is to raise awareness of the complexity of this disease, the potential of prospective therapy strategies, and the need for early and comprehensive management.

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Section: Diagnosis Differential Diagnosis and Disease Assessmentmentioning

confidence: 99%

Section: Diagnosis Differential Diagnosis and Disease Assessmentmentioning

confidence: 99%

Clinical Features, Immunopathogenesis, and Therapeutic Strategies in Vitiligo

Wang

2021

Clinic Rev Allerg Immunol

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“…It is possible that the accumulated damage favors the variability observed in the evolution, activity, and even in the response to treatment. It was recently recog- nized that a limited extension measured with VES is between 0.21 and 1.67% and a moderate extension between 1.75 and 6.21% BSA [35]. Item 1 adequately discriminates these patients and is consistent with the assessment of BSA by the doctor (p < 0.001), giving congruence to the theory that led to the inclusion of this item in the questionnaire (BSA in patients who perceive the lesions as quantifiable: 0.42% [0.12-1.15]; not quantifiable: 2.9% [0.52-6.9]).…”

Section: Discussionmentioning

confidence: 99%

Development and Validation of a New Scoring Tool to Evaluate the Clinical Evolution of Adult Patients with Nonsegmental Vitiligo

Peralta‐Pedrero¹,

Herrera-Bringas²,

Torres-González³

et al. 2021

Dermatology

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Background: Vitiligo has an unpredictable course and a variable response to treatment. Furthermore, the improvement of some vitiligo lesions cannot be considered a guarantee of a similar response to the other lesions. Instruments for patient-reported outcome measures (PROM) can be an alternative to measure complex constructions such as clinical evolution. Objective: The aim of this study was to validate a PROM that allows to measure the clinical evolution of patients with nonsegmental vitiligo in a simple but standardized way that serves to gather information for a better understanding of the disease. Methods: The instrument was created through expert consensus and patient participation. For the validation study, a prospective cohort design was performed. The body surface area affected was measured with the Vitiligo Extension Score (VES), the extension, the stage, and the spread by the evaluation of the Vitiligo European Task Force assessment (VETFa). Reliability was determined with test-retest, construct validity through hypothesis testing, discriminative capacity with extreme groups, and response capacity by comparing initial and final measurements. Results: Eighteen semi-structured interviews and 7 cognitive interviews were conducted, and 4 dermatologists were consulted. The instrument Clinical Evolution-Vitiligo (CV-6) was answered by 119 patients with a minimum of primary schooling. A wide range was observed in the affected body surface; incident and prevalent cases were included. The average time to answer the CV-6 was 3.08 ± 0.58 min. In the test-retest (n = 53), an intraclass correlation coefficient was obtained: 0.896 (95% CI 0.82–0.94; p < 0.001). In extreme groups, the mean score was 2 (2–3) and 5 (4–6); p < 0.001. The initial CV-6 score was different from the final one and the change was verified with VES and VETFa (p < 0.05, n = 92). Conclusions: The CV-6 instrument allows patient collaboration, it is simple and brief, and it makes it easier for the doctor to focus attention on injuries that present changes at the time of medical consultation.

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“… 22 Although VASI and VES are two validated and useful scores, an international vitiligo expert meeting in 2019 validated the VES as the gold standard score for assessing the vitiligo extent. 23 Evaluations were performed by two physicians, blinded to the treatment received, on standardised pictures taken at baseline, week 12 (W12) and W24. If the two scores differed by more than 20%, a joint assessment was performed to reach an agreement.…”

Section: Methodsmentioning

confidence: 99%

Oral gliadin‐protected superoxide dismutase in addition to phototherapy for treating non‐segmental vitiligo: A 24‐week prospective randomized placebo‐controlled study

Fontas

Montaudié

Passeron

2021

Acad Dermatol Venereol

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Background Despite a solid rationale, the usefulness of antioxidants in treating vitiligo has not been clearly demonstrated. Combining superoxide dismutase (SOD) with a wheat gliadin biopolymer protects it during the passage through the gastrointestinal tract. Objective To evaluate the efficacy of gliadin-protected SOD (GP-SOD), associated with narrowband ultraviolet B(NB-UVB), for treating vitiligo.Methods We conducted a 24-week monocentric interventional prospective randomized placebo-controlled trial in the tertiary center for vitiligo care in the

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Validation of a physician global assessment tool for vitiligo extent: Results of an international vitiligo expert meeting

Cited by 11 publications

References 11 publications

Clinical Features, Immunopathogenesis, and Therapeutic Strategies in Vitiligo

Clinical Features, Immunopathogenesis, and Therapeutic Strategies in Vitiligo

Development and Validation of a New Scoring Tool to Evaluate the Clinical Evolution of Adult Patients with Nonsegmental Vitiligo

Oral gliadin‐protected superoxide dismutase in addition to phototherapy for treating non‐segmental vitiligo: A 24‐week prospective randomized placebo‐controlled study

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