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Vitiligo; stable lesion (man, 27 years old, right foot). Ultraviolet (UV) light dermoscopy (×20) delineates stable vitiligo with the sharply demarcated border (black arrow) and perifollicular depigmentation (black circle) better than polarised dermoscopy (×20).
Source publication
Background/Objective
Polarized dermoscopy, Wood's lamp, and reflectance confocal microscopy were currently commonly used auxiliary technology in vitiligo clinic diagnosis. To improve the efficiency and accuracy of different periods of lesions of vitiligo, we used a novel ultraviolet (UV)‐dermoscopy (Model CH‐UVDS30, Ultraviolet wavelength range of...
Citations
... 8 In dermatological practices, the use of ultraviolet (UV)-induced fluorescence is a prevalent technique for aiding in disease diagnosis. 9,10 The Wood's lamp, for instance, exemplifies this application, emitting This fluorescence phenomenon is frequently applied in diagnosing scalp conditions, such as tinea capitis. 12 However, the application of fluorescence detection has not yet been explored in the case of AGA. ...
Background
Ultraviolet (UV)‐induced fluorescence technology is widely used in dermatology to identify microbial infections. Our clinical observations under an ultraviolet‐induced fluorescent dermatoscope (UVFD) showed red fluorescence on the scalps of androgenetic alopecia (AGA) patients. In this study, based on the hypothesis that microbes are induced to emit red fluorescence under UV light, we aimed to explore the microbial disparities between the AGA fluorescent area (AF group) and AGA non‐fluorescent area (ANF group).
Methods
Scalp swab samples were collected from 36 AGA patients, including both fluorescent and non‐fluorescent areas. The bacterial communities on the scalp were analyzed by 16S rRNA gene sequencing and bioinformatics analysis, as well as through microbial culture methods.
Results
Significant variations were observed in microbial evenness, abundance composition, and functional predictions between fluorescent and non‐fluorescent areas. Sequencing results highlighted significant differences in Cutibacterium abundance between these areas (34.06% and 21.36%, respectively; p < 0.05). Furthermore, cultured red fluorescent colonies primarily consisted of Cutibacterium spp., Cutibacterium acnes, Staphylococcus epidermidis, and Micrococcus spp.
Conclusions
This is the first study to investigate scalp red fluorescence, highlighting microbial composition variability across different scalp regions. These findings may provide novel insights into the microbiological mechanisms of AGA.
... Some other indications for which the Wood's lamp can be used include -evaluation of Cutibacterium acnes, which can produce an orange-red colour in pilosebaceous follicles, pseudomonas infections which can produce a green fluorescence, and also porphyrias. 1 The Wood's lamp can also be used in the evaluation of premature canities and compliance regarding the use of sunscreens. 2,3 UV dermoscopy UV reflectance dermoscopy (UVRD) is a relatively new innovation, combining dermoscopy with UV light evaluation. Like the Wood's lamp, UV dermoscopy can be useful in pigmentary disorders such as vitiligo and melasma. ...
... Lesional margins, perifollicular pigmentation, and depigmentation can be better appreciated under UV dermoscopy as compared to normal dermoscopy. 2 Dermoscopy with near-UV light can highlight demarcation of the distribution of melanin in cutaneous melanoma. 4 Sebaceous gland openings can show fluorescence under UVRD -ranging from bright blue/green to yellow, orange, or red. ...
... [3,4] Newer modifications of dermoscopy include the following: a. Ultraviolet (UV) dermoscopy: It functions like an amplified Wood's lamp, emitting UV light within the 360-390 nm range and generating fluorescence in visualized structures to assist in diagnosing various disorders. [5] In cases where dermoscopy and Wood's lamp examination may not provide a definitive diagnosis, this technique can provide valuable additional information and clarity [ Figure 1]. [5] However, its higher cost compared to conventional dermoscopes currently restricts its widespread clinical use. ...
... [5] In cases where dermoscopy and Wood's lamp examination may not provide a definitive diagnosis, this technique can provide valuable additional information and clarity [ Figure 1]. [5] However, its higher cost compared to conventional dermoscopes currently restricts its widespread clinical use. The uses of UV dermoscopy are summarized in Table 1. ...
... The uses of UV dermoscopy are summarized in Table 1. [5][6][7][8][9][10] The advantages and disadvantages are summarized in Table 2. [7] b. Infrared dermoscopy: It assists in capturing cellular activity and vascular patterns of the lesion, offering valuable indicators for distinguishing a lesion as either benign or malignant. ...
Every year, the field of medicine witnesses technological advancements, leading to improved patient care and furtherment of research, which contribute to the efficient acquisition of knowledge and skill by physicians and surgeons. A discipline like dermatology, which relies heavily on the recognition of morphological patterns, gains bountifully from cutting-edge technologies for capturing images, facilitating disease diagnosis, and their monitoring and progression. These novel modalities offer the potential to bridge the gap between clinical assessment and invasive procedures, reducing the need for biopsies and enhancing diagnostic accuracy.
... Vitiligo UVFD allows for the identification of well-defined depigmented and pigmented areas, as well as perifollicular pigmentation in a series of patients with vitiligo [23]. In a study on UVFD comparing hypopigmented dermatoses of the trunk, vitiligo did not exhibit any specific fluorescence pattern, yet this study did not address border abruptness [24]. ...
... In a study on UVFD comparing hypopigmented dermatoses of the trunk, vitiligo did not exhibit any specific fluorescence pattern, yet this study did not address border abruptness [24]. It has been suggested that the character of demarcation seems to be stage dependent, with perifollicular pigmentation and poorly demarcated margins in progressive lesions, and well-demarcated borders and perifollicular depigmentation in stable lesions (Fig. S5) [23,25]. In one patient in re-pigmentation phase, telangiectasias and pigmentation reservoirs were visualized with UVFD [23]. ...
... It has been suggested that the character of demarcation seems to be stage dependent, with perifollicular pigmentation and poorly demarcated margins in progressive lesions, and well-demarcated borders and perifollicular depigmentation in stable lesions (Fig. S5) [23,25]. In one patient in re-pigmentation phase, telangiectasias and pigmentation reservoirs were visualized with UVFD [23]. Nonetheless, diagnostic accuracy with UVFD was shown to be inferior to conventional non-contact polarized dermatoscopy (well-defined borders) [24]. ...
Dermatoscopy is a non-invasive and cost-efficient imaging technique augmenting clinical examination in neoplastic and non-neoplastic dermatoses. Recently, novel dermatoscopic techniques based on principles of reflectance/absorption and excited fluorescence have been developed. However, comprehensive data on their applications are sparse, and terminology is inconsistent. In this systematic review, we addressed the principles of ultraviolet (UV) imaging and proposed categorization based on spectral characteristics and signal acquisition, as well as discussed documented and potential clinical applications, safety measures during examination, and limitations associated with reflectance and fluorescence dermatoscopy. A literature search was conducted in the PubMed medical database until 2 December 2023 according to PRISMA guidelines, and 28 papers fit the scope of this review, whereas additional relevant articles were included to provide broader context regarding the chosen terminology, chromophores described, safety of sub-UV/UV, and regulations for light-emitting devices. UV and sub-UV dermatoscopy, categorized into different methods on the basis of the emitted wavelength and signal acquisition process (reflectance versus fluorescence), augment conventional dermatoscopy by optimizing safety margins in melanoma, facilitating early detection of tumor recurrence, and enhancing visualization in non-neoplastic conditions, including pigmentation disorders, intertrigo, papulo-desquamative dermatoses, and beyond. The review highlights the limitations of these techniques, including difficulty in differentiating melanin from hemoglobin, challenges in evaluating uneven surfaces, and artifacts. Although UV dermatoscopy complements conventional dermatoscopy, clinicians should be aware of their peculiarities, artifacts, limitations, and safety concerns to optimize their diagnostic accuracy and ensure patient’s safety.
... Two separate certified dermatologists were responsible for the clinical evaluation through confocal dermascopy and follow-up of the patients. 8 Repigmentation was evaluated at 2, 3, 6, and 12 months after transplantation. Photographs were taken both before and 12 months after the transplant. ...
Purpose
To compare the efficacy and safety of autologous cultured melanocytes transplantation (CMT) and non‐cultured epidermal cell suspension transplantation (NCES) in the treatment of piebaldism.
Patients and methods
A retrospective study was conducted on 30 anatomically based lesions from nine piebaldism patients who underwent either CMT (n = 7) or NCES (n = 23) between 2018 and 2020. The extent of repigmentation and colour matching was evaluated in all recipient sites using a digital imaging analysis system. In addition, adverse effects have also been assessed by follow‐up results.
Results
More than 75% repigmentation was achieved in 100% (7/7) and 60.9% (14/23) of the 30 lesions with the CMT and NCES, respectively. There were significant differences between the two methods in terms of repigmentation. The majority of patients had colour mismatches, and there was no discernible difference between the two surgical techniques. Adverse reactions rarely occurred.
Conclusion
The present study suggested that autologous CMT may provide better repigmentation in piebaldism patients than NCES with no significant side effects.
... [5][6][7] Therefore, it is essential to establish an objective and effective method to evaluate vitiligo stability and treatment response. Dermoscopy and reflectance confocal microscopy (RCM), as important auxiliary examination tools in dermatology, 8,9 have been gradually recognized in evaluating vitiligo stability and treatment efficacy, [10][11][12][13] though there are some limitations in the clinical application. 14 The dermoscopy is easy to operate, with high acceptance of patients, but it lacks information on deep structures of lesions. ...
... [5][6][7] With the development of skin imaging technology, research shows that UV-dermoscopy can also be used in active/progress judgment in vitiligo and the depigmented and pigmented junctional zone and perifollicular pigmentation areas could be easier and simultaneously identified via UV-dermoscopy. 11 So far, the VIDA score is the most frequently cited measurement instrument. With the application of skin imaging technology clinically, dermoscopy and RCM have been shown to be promising tools in assessing vitiligo activity and monitoring therapeutic effects. ...
Purpose
The aim is to investigate the application value of dermoscopy combined with reflectance confocal microscopy (RCM) in assessing vitiligo disease activity and treatment response.
Patients and Methods
We enrolled 279 patients with vitiligo and evaluated the disease activity by Vitiligo Disease Activity (VIDA) score, dermoscopy, RCM and dermoscopy combined with RCM respectively. The sensitivity and specificity of different assessment techniques were compared with VIDA score by the differences and consistency. The different characteristics of dermoscopy and RCM with different treatment responses were also analyzed.
Results
The results showed that the sensitivity and specificity of dermoscopy combined RCM were higher than RCM or dermoscopy alone (P values less than 0.05). In the repigmentation process, leukotrichia, pigment network absent and perilesional hyperpigmentation under dermoscopy at the baseline suggested a poor treatment response, while the incompletely disappearing pigment rings under RCM and perifollicular hyperpigmentation under dermoscopy indicated a good treatment response. We also found the proportion of patients with telangiectasia, increased pigment at the lesions and around the hair follicles was significantly higher in the good treatment response group than that in the poor one by dermoscopy (χ2 = 4.423, 32.471, 4.348, P = 0.035 0.000, 0.037) and by RCM the proportion of patients with both increased pigment granules and dendritic melanocytes in the good treatment response group was higher than that in the poor one (χ2 = 38.215, 5.283, P = 0.000, 0.022, respectively).
Conclusion
With the higher sensitivity and specificity than dermoscopy or RCM alone, a combination of dermoscopy and RCM may be a new more accurate measure to assess the vitiligo disease activity and the treatment response.
... Ultraviolet (UV) light serves as a standard and extensively employed diagnostic tool for evaluating vitiligo. Among the reviewed studies, UV light was utilized as a diagnostic technique in seven studies, with Wood's lamp being the preferred choice in six of them (46)(47)(48)(49)(50)(51)55). The theory behind UV light photography suggests that UV rays are selectively absorbed by melanin in the epidermis compared to visible light. ...
... Dermoscopy can provide valuable information about the structure and appearance of affected vitiligo skin lesions, allowing for improved diagnostic accuracy. Dermoscopy was utilized in eleven different studies (46,49,(55)(56)(57)(58)(59)(60)(61)(62)(63), of which two studies used ultraviolet light (46,49), and one used high dynamic range conversion of images for diagnostic and monitoring purposes (55). Perifollicular changes and interfollicular pigmentation constituted the most common dermoscopic observations seen by Al-Refu et al. and Jha et al. (56,57). ...
... Dermoscopy can provide valuable information about the structure and appearance of affected vitiligo skin lesions, allowing for improved diagnostic accuracy. Dermoscopy was utilized in eleven different studies (46,49,(55)(56)(57)(58)(59)(60)(61)(62)(63), of which two studies used ultraviolet light (46,49), and one used high dynamic range conversion of images for diagnostic and monitoring purposes (55). Perifollicular changes and interfollicular pigmentation constituted the most common dermoscopic observations seen by Al-Refu et al. and Jha et al. (56,57). ...
Background: Vitiligo is a multifaceted autoimmune depigmenting disorder affecting around 0.5 to 2.0% of individuals globally. Standardizing diagnosis and therapy tracking can be arduous, as numerous clinical evaluation methods are subject to interobserver variability and may not be validated. Therefore, there is a need for diagnostic tools that are objective, dependable, and preferably non-invasive.
Aims: This systematic review provides a comprehensive overview of the non-invasive objective skin measurement methods that are currently used to evaluate the diagnosis, severity, and progression of vitiligo, as well as the advantages and limitations of each technique.
Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist was used for the systematic review. Scopus, Embase, Cochrane Library, and Web of Science databases were comprehensively searched for non-invasive imaging and biophysical skin measuring methods to diagnose, evaluate the severity of, or monitor the effects of vitiligo treatment. The risk of bias in included articles was assessed using the QUADAS-2 quality assessment scale.
Results: An extensive literature search resulted in 64 studies for analysis, describing eight imaging techniques (reflectance confocal microscopy, computer-aided imaging analysis, optical coherence tomography, infrared photography, third-harmonic generation microscopy, multiphoton microscopy, ultraviolet light photography, and visible light/digital photograph), and three biophysical approaches (dermoscopy, colorimetry, spectrometry) used in diagnosing and assessing vitiligo. Pertinent information about functionality, mechanisms of action, sensitivity, and specificity was obtained for all studies, and insights into the strengths and limitations of each diagnostic technique were addressed. Methodological study quality was adequate; however, statistical analysis was not achievable because of the variety of methods evaluated and the non-standardized reporting of diagnostic accuracy results.
Conclusions: The results of this systematic review can enhance clinical practice and research by providing a comprehensive overview of the spectrum of non-invasive imaging and biophysical techniques in vitiligo assessment. Studies with larger sample sizes and sound methodology are required to develop verified methods for use in future practice and research.
... It is stated in the literature that it can be used in the early diagnosis of vitiligo. 5 Although there are publications showing better visualization of tunnels in patients with scabies, there is no publication yet that shows the parasite clearly. ...
Dermoscopy is a noninvasive, efficient and inexpensive tool used to aid diagnosis of skin conditions such as vitiligo. Furthermore, it aids in tracking patient progress, treatment response and disease activity. Vitiligo can be diagnosed on dermoscopy by the presence of white structureless areas signifying hypopigmentation with a typical glowing appearance. Other typical features are perilesional and perifollicular hyperpigmentation, pigmentation networks and leucotrichia. In total, 15 studies were reviewed to determine the dermoscopic signs of the three main stages of disease activity: active, stable and repigmenting vitiligo. Features that differentiate active, stable and repigmenting vitiligo are reviewed and discussed in this article. Notably, there is a conflict in the literature between various dermoscopic features and which type of vitiligo they are truly indicative of. However, dermoscopy can be coupled with other clinical, biological and physiological markers to strengthen diagnostic accuracy.
