No full-text available
To read the full-text of this research,
you can request a copy directly from the authors.
Vitiligo: Clinical Findings in 1436 Patients
Abstract
We retrospectively analyzed the clinical and epidemiological profiles of patients with vitiligo attending the pigmentary dermatoses clinic. One thousand four hundred and thirty‐six patients were seen between 1989 and 1993. Males constituted 54.5% of the group and females 45.5%. Mean age of the patients was 25 years, and average disease duration at the time of hospital visit was 3.7 years.
Vitiligo vulgaris was the commonest form of the disease in 1002 (69.8%) patients followed by focal vitiligo in 214 (14.9%) and segmental vitiligo in 72 (5.0%). The sites of onset were the face, trunk, and legs in descending order of frequency. Less than 20% body area involvement was seen in 1356 (94.4%) of the patients. Leukotrichia was present in 165 (11.5%), and Koebner's phenomenon was observed in 72 (5.0%). Twenty nine (2.0%) patients had associated halo nevi. Of the various diseases associated with vitiligo, atopic/nummular eczema was seen in 20 (1.4%) patients, bronchial asthma in 10 (0.7%), diabetes mellitus in 8 (0.6%), thyroid disease in 7 (0.5%), and alopecia in 6 (0.4%). A family history of vitiligo was present in 165 (11.5%) patients.
... Similar numbers of cases were found among all occupational types. About one-third (27,34.2%) of the cases had been substance abusers giving sixteen (59.3%) alcohol users and eleven (40.7%) smokers. Details about epidemiological profile of vitiligo are found in Table 2. ...
... It was concordant with a finding given by Akrem et al. [22]. In contrary, the face was the most common site in a study done by Handa and Kaur [27]. e exact significance of this observation is difficult to appreciate. ...
... e most commonly found associated systemic disease was asthma. is was followed by diabetes mellitus, alopecia areata, and thyroid disease. Another interesting study conducted by Handa and Kaur has revealed similar finding [27]. is might be due to the fact that autoantibodies against different organ systems may also affect the melanocytes. ...
Background:
Vitiligo is not a well-studied disease in Ethiopia. Therefore, this study assessed its clinico-epidemiological profile and treatment patterns.
Methods:
An institutional-based cross-sectional study was conducted in conveniently selected dermatologic clinics of Mekelle city, Ethiopia. A two-phased study was conducted, in which the first was to determine prevalence of vitiligo while the second phase was to describe the clinico-epidemiological profile and treatment pattern of vitiligo. Four-hundred three randomly selected dermatological patients were included in the first phase study. The second phase study included vitiligo cases from the first phase study and additional vitiligo cases found in a two months period prospective study.
Results:
Of the 403 randomly selected dermatological patients who presented in the year 2017 to 2019, the prevalence of vitiligo was 13.15%. Of the 79 cases with vitiligo, nearly two-thirds (50, 63.3%) were males with five years as the median age at onset of the disease. Positive family history of vitiligo was recorded in about one-third (25, 31.6%) of the cases. Limbs (48, 44.5%) followed by the head and neck (26, 24%) were the most commonly affected parts of the body at the onset of the disease. The most prevalent clinical form of vitiligo was vulgaris (39.2%) followed by the focal type (26.6%). Emotional upset (24, 33.8%) and physical traumas (23, 32.4%) were the frequently reported triggering factors of vitiligo. Three-fourths (75.5%) of the cases had prescriptions of topical corticosteroids, and 24.5% of them had prescriptions of sun screen lotion.
Conclusion:
The prevalence of vitiligo was found to be high. The clinico-epidemiological profile of vitiligo in Ethiopia was similar with that found globally. However, treatment options of vitiligo were very limited in Ethiopia.
... [7] Some of the previous publications from India revealed the prevalence of vitiligo from 0.6% to 1.13% [mean 1.1 ± 0.68] in the population-based surveys. [2,[15][16][17] Among the hospital-based surveys, [18][19][20][21][22][23][24][25][26] the range was wider [0.43%-9.98%, mean 2.96 ± 0.99]. ...
... Mean 'age at onset' was reported to be within the first three decades in studies by Zhanget et al. [29] and Boisseau-Garsaudet et al. [30] and in two institutional surveys from India. [21,26] We found a nearly similar result [25.14 ± 7.48 years (1 month to 82.5 months)]. In one Chinese study, [31] the median age at onset was 37.6 years. ...
... Two earlier Indian studies, both from Gujarat reported much higher rates (20.4% and 78.29%). [17,21] Two earlier reports, one from India [26] and one from China [31] reported a higher prevalence of positive family history among SV cases. We, however, found significantly higher value in NSV. ...
Background: Vitiligo is an acquired, idiopathic, and common depigmentation disorder. The values of various epidemiologic parameters are often doubtful due to the methodological weaknesses of the studies. Aims: To elicit the magnitude of various epidemiological parameters and important correlates of vitiligo. Materials and Methods: Every vitiligo patient attending the outpatient department of medical colleges spread over most of the Indian states were examined over a period of 1 year. Various epidemiological and clinical variables were examined and compared with age and sex-matched controls (registered in the Clinical Trial Registry of India CTRI/2017/06/008854). Results: A total of 4,43,275 patients were assessed in 30 medical colleges from 21 Indian states. Institutional prevalence of vitiligo was 0.89% (0.86% in males and 0.93% in females, P < 0.001). The mean age at presentation and mean age at onset were 30.12 ± 17.97 years and 25.14 ± 7.48 years, respectively. Head-neck was the most common primary site (n = 1648, 41.6%) and most commonly affected site (n = 2186, 55.17%). Most cases had nonsegmental vitiligo (n = 2690, 67.89%). The disease started before 20 years of age in more than 46% of cases. About 77% of all cases had signs of instability during the last 1 year. The family history, consanguinity, hypothyroid disorders, and depressed mood were significantly (P < 0.001) higher among the cases. First, second, and third-degree family members were affected in 269 (60.04%), 111 (24.78%), and 68 (15.18%) cases, respectively. Work-related exposure to chemicals was significantly higher among cases (P < 0.008). Obesity was less common among vitiligo cases [P < 0.001, odds ratio (OR) 0.78, 95% confidence interval (CI): 0.71-0.86]. Conclusion: This is one of the largest studies done on vitiligo in India. The prevalence of vitiligo was found to be 0.89% among hospital attendees. Prevalence of vitiligo was higher among females than in males and prevalence of family history, consanguinity, hypothyroid disorders were higher in vitiligo than among controls.
... [7] Some of the previous publications from India revealed the prevalence of vitiligo from 0.6% to 1.13% [mean 1.1 ± 0.68] in the population-based surveys. [2,[15][16][17] Among the hospital-based surveys, [18][19][20][21][22][23][24][25][26] the range was wider [0.43%-9.98%, mean 2.96 ± 0.99]. ...
... Mean 'age at onset' was reported to be within the first three decades in studies by Zhanget et al. [29] and Boisseau-Garsaudet et al. [30] and in two institutional surveys from India. [21,26] We found a nearly similar result [25.14 ± 7.48 years (1 month to 82.5 months)]. In one Chinese study, [31] the median age at onset was 37.6 years. ...
... Two earlier Indian studies, both from Gujarat reported much higher rates (20.4% and 78.29%). [17,21] Two earlier reports, one from India [26] and one from China [31] reported a higher prevalence of positive family history among SV cases. We, however, found significantly higher value in NSV. ...
... [7] Some of the previous publications from India revealed the prevalence of vitiligo from 0.6% to 1.13% [mean 1.1 ± 0.68] in the population-based surveys. [2,[15][16][17] Among the hospital-based surveys, [18][19][20][21][22][23][24][25][26] the range was wider [0.43%-9.98%, mean 2.96 ± 0.99]. ...
... Mean 'age at onset' was reported to be within the first three decades in studies by Zhanget et al. [29] and Boisseau-Garsaudet et al. [30] and in two institutional surveys from India. [21,26] We found a nearly similar result [25.14 ± 7.48 years (1 month to 82.5 months)]. In one Chinese study, [31] the median age at onset was 37.6 years. ...
... Two earlier Indian studies, both from Gujarat reported much higher rates (20.4% and 78.29%). [17,21] Two earlier reports, one from India [26] and one from China [31] reported a higher prevalence of positive family history among SV cases. We, however, found significantly higher value in NSV. ...
Background:
Vitiligo is an acquired, idiopathic, and common depigmentation disorder. The values of various epidemiologic parameters are often doubtful due to the methodological weaknesses of the studies.
Aims:
To elicit the magnitude of various epidemiological parameters and important correlates of vitiligo.
Materials and methods:
Every vitiligo patient attending the outpatient department of medical colleges spread over most of the Indian states were examined over a period of 1 year. Various epidemiological and clinical variables were examined and compared with age and sex-matched controls (registered in the Clinical Trial Registry of India CTRI/2017/06/008854).
Results:
A total of 4,43,275 patients were assessed in 30 medical colleges from 21 Indian states. Institutional prevalence of vitiligo was 0.89% (0.86% in males and 0.93% in females, P < 0.001). The mean age at presentation and mean age at onset were 30.12 ± 17.97 years and 25.14 ± 7.48 years, respectively. Head-neck was the most common primary site (n = 1648, 41.6%) and most commonly affected site (n = 2186, 55.17%). Most cases had nonsegmental vitiligo (n = 2690, 67.89%). The disease started before 20 years of age in more than 46% of cases. About 77% of all cases had signs of instability during the last 1 year. The family history, consanguinity, hypothyroid disorders, and depressed mood were significantly (P < 0.001) higher among the cases. First, second, and third-degree family members were affected in 269 (60.04%), 111 (24.78%), and 68 (15.18%) cases, respectively. Work-related exposure to chemicals was significantly higher among cases (P < 0.008). Obesity was less common among vitiligo cases [P < 0.001, odds ratio (OR) 0.78, 95% confidence interval (CI): 0.71-0.86].
Conclusion:
This is one of the largest studies done on vitiligo in India. The prevalence of vitiligo was found to be 0.89% among hospital attendees. Prevalence of vitiligo was higher among females than in males and prevalence of family history, consanguinity, hypothyroid disorders were higher in vitiligo than among controls.
... The lower percentage of Acrofacial in this study than Singh et al (2011) 9 might be due to different environmental conditions in the studies. Similarly, Kovacs (1998) 12 ; Handa & Kaur (1999) 21 reported vulgaris to be most common type. In this study, family history of disease was present among more than one third of patients (46.2%). ...
... The lower percentage of Acrofacial in this study than Singh et al (2011) 9 might be due to different environmental conditions in the studies. Similarly, Kovacs (1998) 12 ; Handa & Kaur (1999) 21 reported vulgaris to be most common type. In this study, family history of disease was present among more than one third of patients (46.2%). ...
... Singh et al (2011) 9 found family of disease among 28% patients. Handa & Kaur et al (1999) 21 reported 11.5% family history while Al Mutairi& Sharma (2006) 13 reported 18.9%. This is attributed to the role of genetic factors in the pathogenesis of vitiligo. ...
Background: Vitiligo, also called leukoderma, is either an acquired or familial, but highly complex pigmentation disorder in which melanocytes, the principle pigment-producing cells in humans, are destroyed. Affecting 0.5%-1% of population worldwide, vitiligo can be a highly disfiguring disorder that is characterized by the development of smooth and porcelain-white patches of skin devoid of protective melanin pigmentation. Methods: This was an cross-sectional study during a period from 2017 to 2018 including 52 clinically diagnosed vitiligo patients. Patient were clinically evaluated and a proper history was taken including patient's age, sex, site, duration, family history, area of community, itching, associated endocrine disorder, associated skin disorder, and clinically examined for the morphological distribution, pattern, and border of the lesion, and looked for signs such as erythema, koebner phenomenon, leukotrichia. Results: More than one third of patients were between 20-30 years of age (38.5%). More than half of patients were females (57.7%). The duration of disease was 12-60 months (Sub acute phase/Intermediate lesion) among more than half of patients (57.7%). Vitiligo vulgaris clinical diagnosis was among more than half of patients (55.8%) followed by Generalised & Segmental (17.3%) and Acrofacial vitiligo (9.6%).Diabetes mellitus was among 11.5% patients and Thyroid disorder was in 7.7% patients. On histological aspect Hypomelanosis and Monodermal cells infiltrate was among majority of patients 86.5% and 76.9% respectively followed by Suprabasal vacuolization was 53.8%. Conclusion: This study indicates the correlation of various pathological alterations with clinical features of vitiligo patients.
... Thus, males and females were affected almost equally. This was found to be similar in studies reported by Handa and Kaur, [3] Sarin and Kumar, [4] Koranne et al. [5] Although few studies showed female preponderance such as in Mutairi and Sharma, [6] Shajil et al., [7] and Martis et al., [8] it may be presumably explained by more awareness of the women to cosmetic disfigurement, and therefore more likely to seek treatment. ...
... Positive family history was reported in 25.4% of the patients in our study. Handa and Kaur [3] reported 11.5%, Mutairi and Sharma [6] reported 18.9%, and Shajil et al. [7] reported 21.93% of cases with a positive family history. Vitiligo has a polygenic or autosomal-dominant inheritance pattern with incomplete penetrance and variable expression. ...
... Our findings were found to be similar as reported by Shajil et al., [7] Singh et al., [14] and Handa and Kaur. [3] In a few studies reported by Singh et al. [14] and Agarwal et al., [15] acrofacial vitiligo was the most common type found. Most patients begin with focal vitiligo and progress to different phenotypes of vitiligo as the disease progresses. ...
Introduction: Vitiligo is a common, acquired, pigmentary disorder of the skin, mucous membrane, and hair, resulting from the destruction of functional melanocytes. Objective: The objective of this study was to describe the cutaneous and systemic manifestations of vitiligo. Materials and Methods: The study comprised 130 patients attending the outpatient department (OPD) of dermatology, MGM Medical College and Hospital, Aurangabad, India. Clinical details were noted in the pro formas, and cutaneous examination was done in relation to the size and type of lesions of vitiligo and other lesions if present. Pure-tone audiometry (PTA) and ophthalmological examinations were also performed to rule out audiometric and ocular changes. Further, lab investigations were conducted. Results: Of 130 patients, the female-to-male ratio was found to be 1.06:1. The most common age-group for the disease onset was 21–30 years. Vitiligo vulgaris and focal vitiligo were found to be the most common types, followed by generalized, acrofacial, segmental, poliosis in 3.8% patients, alopecia in 4.6% cases, hypoacusis was observed in 3.1%, halo nevi in 0.8%, thyroid disease in 7.7%, diabetes mellitus in 3.1%, and psoriasis in 0.8% of cases. Conclusion: Vitiligo vulgaris and focal vitiligo were the most common types found with associated cutaneous and systemic abnormalities such as thyroid disease, diabetes mellitus, and alopecia areata.
... Leucotrichia has been reported in 9-48.4% of the patients with vitiligo. 10,[25][26][27][28][29] Significance is attached to this finding as these cases also showed resistance to therapy. It may also be considered as poor prognostic factor. ...
... 30 It was seen in 26.3% of our vitiligo patients similar to other studies. However, it was less prevalent in the studies done by Handa et al. 26 and Akay et al. 31 (5% and 7.3%, respectively). Lower limbs were the most common sites for the onset in 257 (33.7%) patients. ...
This study was carried out with an objective to document clinico-epidemiological features of vitiligo from this part of the country having varied geo-climatic conditions, rural and semi-urban communities of diverse ethnic backgrounds.
The diagnosis of vitiligo was essentially clinical, confirmed by at least three senior dermatologists. Clinically ambiguous cases and lesions not accentuating under Woods’ light were excluded. The vitiligo patients were classified according to recent Bordeaux vitiligo global issues consensus conference classification and consensus nomenclatureinto three groups, viz. non-segmental, segmental, and unclassified vitligo.
There were 390 men and 460 women (m:f 1:1.1) aged between 2 and 80 years (mean 23.5 years) at presentation. The patients were distributed across all age groups and the majority 450 (52.9%) patients were aged ≤20 years and also comprised 230 (27.5%) children aged up to 12 years.
The patients with an affected first‑degree family member may have more chances of onset at an early age compared with others but without a significant difference.
... 5 Two hospital-based studies mentioned spontaneous repigmentation in 19.5% and 7.2% of patients. 6,7 However, information on the extent, color match, and persistence of pigmentation is lacking. We carried out this study to assess the frequency and extent of spontaneous repigmentation in vitiligo and to study the factors which determine spontaneous repigmentation. ...
... 13 A retrospective analysis of vitiligo clinic data in a hospital-based study by Handa and Kaur mentioned spontaneous repigmentation in 280 (19.5%) of 1436 patients. 6 Similarly, a clinico-epidemiologic hospital-based study from Gujarat mentioned spontaneous regression in 72 (7.2%) of 1010 patients with vitiligo. 7 One textbook mentions that spontaneous repigmentation occurs in 15%-25% of individuals with vitiligo. ...
Background:
Spontaneous regression is well documented in several chronic skin diseases such as psoriasis, alopecia areata, and atopic dermatitis. However, information on vitiligo is scarce.
Aims:
We studied the frequency, extent, and factors affecting spontaneous repigmentation in vitiligo.
Methods:
A cross-sectional descriptive study was undertaken in 167 patients with vitiligo with an emphasis on history of spontaneous repigmentation. Where available, photographs documenting spontaneous repigmentation were also obtained. Repigmentation was defined as spontaneous if it occurred when the patient was off treatment for at least 3 consecutive months.
Results:
Spontaneous repigmentation occurred in 36 (21.5%) patients with complete repigmentation in 6 (3.6%) patients. The extent varied from 0.5% to 100% (mean, 35.4 ± 37.9%) of vitiliginous skin. It occurred after 3 months to 47 years (mean, 8.7 ± 9.5 years) of onset of vitiligo and persisted for 2 months to 27 years (mean, 4.4 ± 6.2 years). Diffuse repigmentation was the most common pattern observed in 20 (55.6%) patients and there was a good color match in 26 (72.2%) patients. Likelihood of spontaneous repigmentation was 3.5 times greater in patients with more than 3 years of stable disease (P = 0.001).
Limitations:
The chief limitation was the dependence on patient recall for the data, except when documented by images.
Conclusion:
Spontaneous repigmentation occurs in one-fifth of patients with vitiligo. In some patients, the repigmentation is clinically significant and long-lasting. Considering its frequency and extent, spontaneous repigmentation should be taken into account both when evaluating novel interventions and counselling patients about the course of the disease.
... Vitiligo is a chronic, acquired depigmentation disorder of the skin resulting in an episodically progressive loss of functional melanocytes causing pigment dilution in the affected areas of the skin (Picardo et al. 2015). Affecting 0.5-1% of the world population (Boisseau-Garsaud et al. 2000;tHowitz et al. 1977) and with a prevalence rate of 0. 5-2.5% in India (Handa and Kaur 1999), vitiligo can develop at any age irrespective of the type of skin, gender, race, or geographical location underlying both genetic and non-genetic factors in a complex interactive manner. We, therefore, investigated the role of specific miRNAs and SNPs reported to be associated with vitiligo in the human genome to identify their plausible effect on vitiligo susceptibility using computational platforms. ...
... The exact mechanisms behind vitiligo are still not fully understood, but several risk factors have been identified, including an autoimmune association, heredity, and trigger events, such as stress, severe sunburn, and exposure to certain chemicals [6][7][8][9][10][11][12][13]. The prevalence of vitiligo varies among different populations, but it is estimated to affect approximately 0.5-1% of the global general population [14][15][16]. In some populations, this number can be as high as 2-3% [17,18]. ...
This study aimed to investigate the effects and safety of 308 nm excimer laser (308 nm EL) and tacrolimus ointment (TO) in the treatment of facial vitiligo (FV). We searched Cochrane Library, PUBMED, EMBASE, CNKI, and WANGFANG from inception to June 1, 2023. Outcomes included overall response rate (ORR), total adverse reaction rate (TARR), recurrence rate at 3-month (RR-3) and recurrence rate at 6-month (RR-6). The outcome data were presented as odds ratios (OR) with 95% confidence intervals (CI). The risk of bias was assessed by Cochrane risk-of-bias tool and data analysis was performed by RevMan 5.4 software. This study included a total of 19 trials involving 2085 patients. When comparing 308 nm EL monotherapy with 308 nm EL plus TO, significant differences in the ORR (OR = 4.29, 95% CI [2.97, 6.19], I² = 0%, P < 0.001), RR-3 (OR = 0.18, 95% CI [0.05, 0.69], I² = 0%, P = 0.01), and RR-6 (OR = 0.38, 95% CI [0.14, 1.03], I² = 39%, P = 0.06) were found between the two managements. When comparing TO monotherapy with TO plus 308 nm EL, its results showed significant differences in the ORR (OR = 4.21, 95% CI [2.90, 6.11], I² = 0%, P < 0.001), TARR (OR = 0.42, 95% CI [0.22, 0.81], I² = 4%, P = 0.009), and RR-3 (OR = 0.32, 95% CI [0.01, 8.03], P = 0.49) between the two modalities. The results of this study suggest that the combination of 308 nm EL and TO is more effective than either treatment alone for the treatment of FV.
... [17]- [20] There are also studies in which the male-female ratio is reported to be higher in favor of males. [21], [22] Of the 327 patients in our study, male patients were 169, and female were 158 (M/F=1.1:1). ...
Objective: It was aimed to evaluate retrospectively the epidemiological and clinical data of patients who applied to our clinic and were diagnosed with vitiligo. Epidemiological and clinical evaluation guide the progression, choice of treatment, and diagnosis of the comorbidities of the disease. Methods: 327 patients evaluated as non-segmental vitiligo were included in the study. Demographic characteristics of the patients (age and gender), age at onset of vitiligo, treatments used for vitiligo, clinical type of vitiligo, location of lesions, and accompanying autoimmune thyroid disease data were evaluated. Results: Of 327 patients, 169 (51.7%) were male and 158 (48.3%) were female. The male/female ratio was found to be 1,1:1. The mean age of the patients was 37.26±18.07 years, and the mean age according to gender was 37.44±18.19 years in females and 37.08±18 years in males. The mean age of onset of the disease was 29.17±15.79 years, and the mean age of onset by gender was 29.13±16.46 years in females and 29.2±15.15 years in males. Regarding onset of the disease, 54% of the patients were <30 years old, and 46% of the patients were 30 years or older. Generalized vitiligo (58.8%) and acrofacial vitiligo (29.9%) were the most common clinical types. Head and neck (68.9%) and extremities (64%) were the most common locations of the lesions. Concomitant autoimmune thyroid disease was seen in 13.5% of the patients. Accompanying autoimmune thyroid disease according to gender was 19.5% in females and 7.4% in males, and there was a statistically significant difference between the groups. It was observed that 89.5% of the patients received treatment for vitiligo, and 10.5% did not receive any treatment. The most commonly used treatments were found to be topical treatment (76.1%) and topical treatment+phototherapy (14.6%). Conclusion: The epidemiological and clinical characteristics of the patients in our study were similar to other studies in the literature. Concerning the highest prevalence of generalized vitiligo in our study, phototherapy and/or systemic therapy use should have been considered when their use was indicated, and factors precluding their more widespread use could be investigated in other studies.
... There was a higher prevalence of vitiligo among women (78.5%), a finding compatible with the meta-analysis carried out by Zhang et al. 23 ; however, that was different from other previous studies, in which the prevalence between men and women was shown to be equal. 24,25 This result is probably due to the greater cultural concern with skin depigmentation in females. The mean age found in the present study, 43 years, differs from this same meta-analysis, in which the prevalence was more common in patients over 60 years. ...
Background
Vitiligo is the most common pigmentary disorder and is considered a chronic, cumulative, multifactorial disease. The crucial role of cytotoxic CD8+ T lymphocytes and the IFNγ/CXCL10 axis has been demonstrated in its pathogenesis.
Objective
To evaluate the clinical profile and immuno-inflammatory markers in patients with vitiligo in a reference medical center.
Methods
Cross-sectional study in which all patients with vitiligo seen at the medical center the from 2019 to 2022 were evaluated, to outline the clinical profile. Moreover, cardiovascular risk biomarkers (neutrophil/lymphocyte ratio and C-reactive protein levels) were measured, as well as cytokines and chemokines (TNFα, IFNγ, IL10, IL15 and CXCL10) in the serum of a subgroup of 30 patients.
Results
There was a predominance of females, with a mean age of 43 years. Most were phototypes IV or V (71.3%), without comorbidities (77.55%), and without a family history of vitiligo (70.41%). Higher levels of neutrophil/lymphocyte ratio, C-reactive protein, and inflammatory cytokines/chemokines were documented in vitiligo patients when compared to the control group (non-significant). As relevant data, the highest values of CXCL10 were detected in patients with vitiligo versus controls, as well as in patients with disease of shorter duration (p < 0.05).
Study limitations
The number of assessed patients was small due to recruitment difficulties caused by the COVID-19 pandemic.
Conclusion
The present data contribute to confirming the relevant role of the IFNγ/CXCL10 axis in the pathogenesis of vitiligo, highlighting CXCL10 as a possible activity marker.
... The incidence in India is roughly estimated to be 0.25% to 2.5%. 2,3 Vitiligo is mostly seen in skin type III and IV. 4 Onset varies from birth to 81 years of age. 5 Indian studies also showed peak age of onset between 11 to 20 years. 6,7 It affects either sex with heritable constitutional predilection. ...
Vitiligo is an acquired depigmenting disease of the skin and mucosa caused due to the destruction of the melanocytes. The white patch leads to social stigma in society and psychological stress in vitiligo patients. The etiopathogenesis of vitiligo is complex interplay of multiple genetic risk factors, environmental factors, neural factors, auto cytotoxicity, oxidative stress by reactive oxygen species, immunological factors, anti-melanocytes and organ-specific auto-antibodies mediated by autoreactive T lymphocytes in a genetically susceptible person. Hence, it is termed polygenic and multifactorial. All these factors, either alone or mixed leads to melanocytes death in a susceptible person leading to formation of depigmented patch. This review is an overview of the different pathomechanism involved in vitiligo.
... [1] The incidence of the disease ranges between 0.1-4% of the world population. [2] Vitiligo usually arises in childhood or young age, approximately half to one third of them progresses this condition by 20 years of age and around 25% of them develop before 8 years with a mean age of outbreak varying between 4 and 5 years. [3] It spares no age, sex, or race. ...
Patients of vitiligo are hated and neglected lot in the society. Great researches in the world have done lot of studies and experiments but no medicine has proved satisfactory in total eradication of the disease. Objective: To see the effect of multi-modality Ayurveda regime in the management of Childhood vitiligo/Shwitra. Methodology: Female patient 07yrs old had been experiencing symptoms of white Patches around the b/l eye and elbow since 5months. Ayurvedic medicines were used in the study for one year and six months. Discussion: The major goal of the multi-modality regime is to help to eliminate white patches. Bakuchi Ghanvati, Mahamanjishtadi kadha, Panchtikta ghruta guggul, Krumikuthar rasa were given orally. Bakuchi tail for local application and daily Hanuman chalisa path advised to patient. This treatment for one half year continued which showed excellent result in the patient. Conclusion: The effect of Dravya and Adravya shaman chikitsa has shown encouraging results in the repigmentation of the affected skin. Not many complications were observed in the patients at the end of the study. Ayurveda has distinctive concepts with all disease called as Chikitsa siddhanta, which work and stand for a long period of time. Since the therapy for Vitiligo has limitation in other pathies, Ayurvedic management of vitiligo is one of the most effective therapy and which have less chances of recurrence.
... A research in Uttarakhand indicated that the frequency was 2.64% [10]. The sociocultural effects of the disease and the varied ethnic origins in each place are likely to be to blame for this regional diversity [11]. In 7% to 36% of cases, a favorable family history is observed. ...
Vitiligo, is a skin disorder, in which the skin loses its pigment due to the loss of melanocytes. The exact cause is still under research but the disorder is linked to autoimmune disease, oxidative stress, genetics and environmental variables. The disease being progressive in nature often spreads all over the body. Globally, Vitiligo affects nearly about 0.5% to 1% of people. In 2012, the most recent and approved classification for Vitiligo was given at Vitiligo Global Issues Consensus Conference (VGICC). Understanding the biological mediators and molecular mechanisms that result in metabolic problems, melanocyte degradation, and autoimmunity is crucial in order to identify innovative therapy targets and drugs that may be able to stop the progression of the condition or even cure vitiligo. Treatment options range from oral antibiotics, topical immunosuppressants, melanocyte promoters, oral immunosuppressants, JAK kinase inhibitors, physical therapy, to surgical intervention. Systemic biological therapies that target cytokines have shown promising results in the treatment of diseases like vitiligo and psoriasis.
... It is noteworthy that prevalence of SV in our study (6.7%) was comparable to previous studies estimating the prevalence of different subtypes of vitiligo. [12][13][14] In a prior study, Ezzedine et al. 7 Our study was the first study regarding treatment response to different modalities among segmental and non-segmental components of MV patients ( Table 2). The topical modalities and systemic immunosuppressive agents were found to have a significantly better treatment response in the non-segmental component as compared to SC. ...
... It is noteworthy that prevalence of SV in our study (6.7%) was comparable to previous studies estimating the prevalence of different subtypes of vitiligo. [12][13][14] In a prior study, Ezzedine et al. 7 Our study was the first study regarding treatment response to different modalities among segmental and non-segmental components of MV patients ( Table 2). The topical modalities and systemic immunosuppressive agents were found to have a significantly better treatment response in the non-segmental component as compared to SC. ...
Background Mixed vitiligo (MV) is the coexistence of segmental vitiligo (SV) and nonsegmental
vitiligo (NSV). The literature on MV is sparse.
Objective To assess the clinicodemographic and treatment parameters in MV and
compare them with SV.
Methods Clinical data of MV and SV patients enrolled in our pigmentary clinic from July
2015 to December 2019 were reviewed retrospectively and compared.
Results Out of a total of 4,371 vitiligo patients, 293 (6.7%) were SV while 74 (1.69%) were
MV. As compared to SV, MV had significantly lower mean age of onset of segmental
component (SC) (13.33 9.01 vs. 15.70 8.60 years, P = 0.03) and significantly higher
proportion of patients with more than 1% body surface involvement by SC (66.2% vs.
51.5%, P = 0.03) and presence of leukotrichia in the SC (66.2% vs. 51.5%, P = 0.03).
Topical agents and systemic immunosuppressive agents were significantly more effective
in non-segmental component (NSC) as compared to SC of MV. Surgical modalities were
the only effective treatment modality for SC.
Limitations Retrospective design, heterogeneity of treatment regimens.
Conclusion Early age of onset, larger (>1%) body surface area involvement, and
leukotrichia in SV predict its progression into MV with time. Treatment response to different
modalities varies significantly between SC and NSC of MV.
... patients were females. This was similar to the study done by Sehgal et al. [7,8]. ...
Vitiligo commonly begins in childhood or young adulthood with peak onset between 10 to 30 years. From this study results it was found that females 83(55.3%)were more commonly affected with vitiligo than males 67(44.7%) and the most common affected age group is 31-50 (35.33%) and the most common site of onset of vitiligo was equal in upper limb and face seen in 71(47.33%) patients each, followed by lower limb sseenin50(33.33%) patients. The most common site involved in males was upper limb 32(47. 76%)and females was face 42(50.6%)were observed. The common type was common clinical type of vitiligo documented was vitiligo vulgaris, seen in 69(46%) patients. This was followed by mucosal vitiligo 36(24%), acrofacial22 (14.67%), segmental17 (11.33%) and vitiligo are ata6 (4%) and reported to be more common in B positive patients.
... In India, the prevalence varies in available literature from 0.46 to 8.8%. [1] Vitiligo has also been classified on the basis of natural course of disease; as active and stable disease. However, the notion of stability is too rigid and sometimes difficult to ascertain alone clinically. ...
Introduction:
Narrow-band (NB) ultraviolet B (UVB) phototherapy has been shown to halt disease progression in vitiligo, but whether there is any difference in the response to NB-UVB seen in patients with progressive vitiligo versus non-progressive vitiligo has not been evaluated.
Objectives:
To evaluate the effect of NB-UVB on progressive versus non-progressive non-segmental vitiligo.
Study design:
Prospective observational comparative study.
Duration:
April 2016-November 2017.
Methods:
Adult patients having non-segmental vitiligo involving 2-50% body surface area were divided into two subsets; patients developing >5 lesions in the last 1 month or >15 lesions in the last 3 months (progressive vitiligo, Group I) and patients with static disease for the last 6 months (non-progressive vitiligo, Group II). Both groups were treated with NB-UVB for 6 months (26 weeks) cumulatively and its efficacy in halting disease progression, re-pigmentation, side effects and psychosocial impact were evaluated.
Results:
Nineteen out of 24 patients with progressive vitiligo had arrest of disease progression. Rest five patients developed lesions at a slower pace. Group II had earlier onset of re-pigmentation, while Group I had more NB-UVB fluence (34.73 J/cm2 vs 25.2 J/cm2, P value = 0.034), more time for the fluence to be fixed (P value = 0.001) and more pruritus (P value = 0.001).
Conclusions:
NB-UVB has the potential to halt disease progression in some patients with progressive vitiligo; but is associated with more total NB-UVB fluence and time taken for fixing it. Progressive vitiligo patients have more pruritus as compared to patients with non-progressive vitiligo.
... Vitiligo is the most common skin pigmentation disorder, affecting 0.1-2% of the population worldwide (4,5), with no sex bias (6)(7)(8)(9). While it can affect people at all ages, vitiligo appears more frequently before 20 years of age and its early onset (during childhood) is associated with hereditary disease (5,7,(9)(10)(11). Vitiligo is characterized by white lesions on the skin, and the associated psychological and social effects make patients more prone to depression and low self-esteem (12). ...
Vitiligo is an acquired multifactorial disease that affects melanocytes and results in skin depigmentation. In this review, we examine the role of cells stress and self-reactive T cells responses. Given the canonical and non-canonical functions of NKG2D, such as authenticating stressed target and enhance TCR signaling, we examine how melanocyte stress leads to the expression of ligands that are recognized by the activating receptor NKG2D, and how its signaling results in the turning of T cells against self (melanocyte suicide by proxy). We also discuss how this initiation phase is followed by T cell perpetuation, as NKG2D signaling results in self-sustained long-lasting T cells, with improved cytolytic properties.
... 4,5 Strong associa�on of specific HLA haplotypes with family history of vi�ligo, severity of disease, age of onset, and popula�on geography has been reported from several interna�onal studies. [6][7][8] The incidences of vi�ligo ranges from 0.1 to over 8.8% wereshown in different studies [9][10][11][12][13] Like other countries,vi�ligo is quite prevalent also in Bangladesh and cons�tutes a major psycho-social problem reflected in few socio-demographic study reports from Bangladesh. 14,15 It is an ancient polygenic autoimmune disease of unknown e�ology. ...
Vitiligo is a common depigmenting and disfiguring skin disease. Association of Human Leukocyte Antigen (HLA) and vitiligo is well known and several HLA studies across the population worldwide are done and found to be important in prediction of disease susceptibility.
... The highest incidence of the condition has been reported in India, followed by Mexico and Japan. [1,2] Although vitiligo does not cause direct physical impairment, it can produce an important psychosocial burden in the form of poor body image, low self-esteem, and experience a considerable level of disability. [3] Various therapeutic options for repigmentation of vitiligo are available, including medical therapy (topical and oral) and phototherapy. ...
Background:
Vitiligo surgery has evolved a long way from punch skin grafts to the epidermal cell suspension and latest to the extracted hair follicle outer root sheath cell suspension transplantation (EHFORSCS). In the latest development, the novel technique autologous negative pressure epidermal harvesting system (ANPEHS) seems to be a good addition to the prevailing therapy in vitiligo.
Aims and objectives:
The aim of this work was to study and compare novel ANPEHS and suction blister grafting (SBG) in the treatment of stable vitiligo.
Materials and methods:
This was a prospective, single-centered, observational, open-labeled comparative study of the rate and final extent of repigmentation in ANPEHS or EHS and SBG in the management of stable vitiligo. The patients in this study were drawn from the outpatient Department of Dermatology of a Tertiary Care Hospital of the Armed Forces from July 1 2015 to December 31, 2016. A total of 40 patients with at least two comparable depigmented patches of 6 months' stability were recruited. Both procedures were performed in the same patient on the same day. Informed consents were taken from all the patients. Each patient in the study had undergone a detailed clinical, general physical, systemic, and a dermatological examination. Clinical photographs had been taken before and after grafting, monthly for the first 6 months then bimonthly for the next 6 months. Donor site was preferably inner aspect of thigh.
Statistical analysis used:
"Chi-square test" and "statistical significance" (P value) methods.
Results:
Of total 80 patches, excellent results were seen in 82.9% patches by using the EHS method and 80% excellent results by using the SBG method. Similarly, very good results were seen in 2.9% patches and good results in 5.7% patches by using both methods. 11.4% patches showed poor results by using the SBG method and 8.6% patches showed poor results by using the EHS method.
Conclusions:
The EHS method is a simple, painless, less time-consuming, expensive but effective technique to produce homogeneous repigmentation without any donor site anesthesia and complication.
... Vitiligo is a disease of loss of skin pigmentation that affects 1-4% of the population worldwide [1][2][3][4]. The psychological effect of vitiligo on patients is greatly influenced by their original background color [5,6]. ...
Background Depigmentation represents a final alternative for patients with widespread vitiligo, failing to attain satisfactory pigmentation and having a compromised quality of life. Monobenzyl ether of hydroquinone (MBEH) is the most widely used depigmenting agent, but little is known regarding specific features of its utilization.
Objective To evaluate and compare two concentrations of MBEH cream (20 and 40%) regarding their effectiveness, tolerability, and effect on patients’ quality of life.
Patients and methods In a double-blind randomized study, 40 patients indicated for depigmentation were equally divided into MBEH 20 and 40% groups. Patients’ responses were assessed bimonthly over 1 year or till complete depigmentation was attained through photography, point counting, and colorimetric assessment. Baseline and final evaluations by dermatology life quality index and visual analog scale were performed. Patients were followed up for 6 months. The study was registered under number ‘PACTR201808699550182.’
Results A total of 39 patients completed the study. Significant color dilution, reduction of point counting and melanin indices, and improvement of dermatology life quality index and visual analog scale scores were obtained in both groups. The number of patients who achieved complete depigmentation and the degree of skin irritation was higher in MBEH 40% group, but no significant difference was found regarding the efficacy, adverse effects, or relapse between groups.
Conclusion MBEH 20 and 40% concentrations proved to be effective in depigmentation; however, MBEH 20% is more suitable for face in terms of safety profile, whereas MBEH 40% can be employed for resistant cases as well as for hands and areas of thick skin.
... 6,8,9 In general, childhood vitiligo differs from the adult vitiligo in the following aspects: a female preponderance is observed, segmental presentation is more commonly seen and associated autoimmune disorders are rare. 10 The aim of this study is to know the clinico epidemiological pattern of vitiligo in children. And to study the epidemiological aspects and clinical profile of children with vitiligo. ...
Vitiligo is a common acquired pigmentary disorder characterized by well defined hypopigmented or depigmented macules due to absence or decrease in melanocytes.
To study the clinico epidemiological pattern of vitiligo in children.
A group of 50 consecutive children attending out patient in the department of DVL at Shadan Institute of Medical Sciences will be included. All the patients meeting the inclusion criteria were taken into the study. A designed, coded proforma was used for recording all the findings.
Almost half of the children taken for study belongs to age group of 9-11 years. Majority of the study population were females. The most common pattern of vitiligo was vitiligo vulgaris. Common site of involvement was lower limbs. The most common associated feature was leukotrichia. The most common associated condition was photosensitivity. Family history was positive in only 4% of cases. Most of them were in the active stage of disease.
The female predominance was high in prevalence of vitiligo in children and an earlier age of onset seen among children with family history of vitiligo or autoimmune disorders. Vitiligo vulgaris is the most common presentation, and lower limbs being the most common site of involvement in children
... Widespread prejudices, ignorance, taboos, lack of scientific appraisal, and confusion of vitiligo with leprosy -all make it a social embarrassment for the patient, although the patient's life expectancy remains unaffected. [8][9] Out of 40 patients, majority were females which is different from that reported by Handa and Kaur, Koranne et al. 10,11 Age of onset of vitiligo in this study ranged from 20-30 yrs, while Howtiz et al, showed the age of onset to be between 40 and 60 years. 12 Positive family history which is considered to be a poor prognostic factor for vitiligo was seen in 4 patients in this study. ...
p class="abstract"> Background: Vitiligo, an acquired pigmentary disorder of skin and mucous membrane characterized by well circumscribed depigmented macules that occur secondary to selective destruction of melanocytes. Fractional CO<sub>2</sub> laser system is a recent advancement in the treatment of vitiligo which works on the concept of fractional photo-thermolysis, in which microscopic treatment zones are created which help in increasing the penetration of topically applied agent which indirectly improves drug efficacy.
Methods: A comparative study was conducted on 40 patients of stable vitiligo attending OPD, Dept of DVL with fractional CO<sub>2</sub> laser, narrowband ultraviolet B (NBUVB) and topical tacrolimus 0.1% vs NBUVB, topical tacrolimus 0.1% for a duration of 4 months and patients were followed up for 12 weeks post treatment.
Results: Patients on Fractional CO<sub>2</sub> laser in combination with NBUVB and topical tacrolimus 0.1% ointment showed >50% improvement compared with other group, with duration for initiation of pigmentation being comparatively less.
Conclusions: The treatment protocol with CO<sub>2</sub> laser in combination with topical tacrolimus 0.1% cream and NBUVB for stable vitiligo was more effective than NBUVB and topical tacrolimus 0.1% alone and this study demonstrates that adding fractional CO<sub>2</sub> laser improves repigmentation rate of vitiliginous lesions.</p
... 1. Clinical patterns of vitiligo [20] • Focal vitiligo: lesions confined to one or a few patches localized in a particular area. • Segmental vitiligo: lesions distributed in a segmental/dermatomal pattern. ...
ABSTRACTBackground: Vitiligo is an idiopathic acquired depigmentary skin/mucous membrane disorder. Main objective of this study was to find out demographic data, clinical patterns, and comorbidities associated with vitiligo in Kandahar, Afghanistan. Material and Methods: This was a case-control study conducted in Kandahar University Teaching Hospital between July 2017–June 2018. Descriptive statistics, Chi-square test, and logistic regression were used for data analysis.Results: A total of 400 patients (200 cases and 200 controls) were recruited. Mean age ± standard deviation (SD) of cases were 21.7±13.8 with most of the patients (77/200 [38.5%]) in age group 11–20 years. Female cases were more (107/200 [53.5%]) than males. Family history of vitiligo, accompanying altered immunity and autoimmunity disorders, psychological stress, premature graying of hair, halo nevus, vitamin D deficiency, vitamin B12 deficiency, and folate deficiency were present in 60/200 (30%), 26/195 (13.3%), 95/200 (47.5%), 31/200 (15.5%), 24/200 (12%), 22/200 (11%), 16/200 (8%), and 14/200 (7%) of the cases, respectively. Most of the patients (148/200 [74%]) had vulgaris, followed by focal (30/200 [15%]) and segmental (11/200 [5.5%]) types of vitiligo. Logistic regression analysis showed that family history, accompanying altered immunity and autoimmunity disorders, premature graying of hair, halo nevus, and atopic diathesis were the possible risk factors of vitiligo with odds ratios of 37.1, 9.0, 6.0, 13.9, and 3.9 respectively.Conclusions: Vitiligo affects women more than men, observed mostly in second decade of life. Vitiligo vulgaris is the most prevalent type.
(3) (PDF) Clinical patterns and associated comorbidities of Clinical patterns and associated comorbidities of vitiligo in Kandahar, Afghanistan. A case-control vitiligo in Kandahar, Afghanistan. A case-control study study. Available from: https://www.researchgate.net/publication/338343398_Clinical_patterns_and_associated_comorbidities_of_Clinical_patterns_and_associated_comorbidities_of_vitiligo_in_Kandahar_Afghanistan_A_case-control_vitiligo_in_Kandahar_Afghanistan_A_case-control_stud [accessed Sep 14 2020].
... These often enlarge and coalesce to form extensive areas of leukoderma [1][2][3]. It equally affects both sexes with a worldwide prevalence of 0.1-2% [4]. It is a psychologically devastating and frequently resistant to treatment [5,6]. ...
... Vitiligo occurs worldwide with an estimated prevalence of 0.5-1% in most populations, 0.5-2.5% in India (Handa et al) and the states of Gujarat and Rajasthan have the highest prevalence i.e. ~8.8% (Valia et al). 1,2 In almost half of patients, vitiligo starts before the age of 20 year and males and females are affected with approximately equal frequency (Taïeb et al). 3 Out of various methods of treatment of vitiligo, there are many cases of vitiligo who either fail to respond or only partially respond to medical line of treatment indicating that melanocyte reservoir is no more available for repigmentation in these areas. ...
p class="abstract"> Background: Vitiligo is a common acquired idiopathic and often, familial hypomelanosis, which is characterized by pale white macules that enlarges centrifugally over time. In India, vitiligo is associated with marked social stigma, thus demanding its effective management. Stable vitiligo lesions known to be relatively refractory medical therapy require surgical therapies like skin grafting or grafting of invitro cultured and non-cultured melanocytes or follicular unit excision (FUE) grafting.
Methods: A prospective observational study was done on patients of stable vitiligo. A total of 20 patients were enrolled and underwent FUE grafting for study of effectiveness and complication.
Results: A total of 20 patients of stable vitiligo were studied with or without leukotrichia in which good to excellent response was seen in 13 (65%), fair in 6 (30%) and poor in 1 (5%) patients.
Conclusions: FUE is a superior and upcoming methodology which is cost effective, reliable, less disfiguring, very low morbidity and results in good color match in patients with stable vitiligo.</p
... [1] Vitiligo affects 1% of the world's population, with highest incidence of the condition has been reported in India, followed by Mexico and Japan. [2,3] Many medical treatment modalities are currently used for vitiligo, such as psoralen plus ultraviolet A (PUVA), narrowband ultraviolet B (NB-UVB), excimer lasers, topical steroids, topical immunomodulators and calcipotriol, which may also be used in combination. Mode of therapy is based on decreasing the activity, thereby achieving stability and later inducing pigmentation. ...
Background and aims:
Present study aimed to determine the clinical outcome for non-cultured melanocyte transfer in the management of stable vitiligo.
Methods:
A hospital based prospective study was conducted including 50 stable unresponsive patients of vitiligo undergoing non-cultured melanocyte transplant. Re-pigmentation was analyzed on the basis of baseline photographs after 6 months post procedure. Degree of re-pigmentation was estimated to the nearest of one of the following percentages and the final outcome of re-pigmentation for statistical analysis was graded as: >70% re-pigmentation: Good; 30-69% re-pigmentation: Fair and; <30% re-pigmentation: Poor.
Results:
The mean age of study group was 29.79 ± 13.8 with 52% males and 48% females. Out of total 50 patients, 31 (62%) patients showed good re-pigmentation, 10 (20%) showed fair re-pigmentation while 9 (18%) patients showed poor re-pigmentation. Patches over face, lips, trunk and legs showed good re-pigmentation, however patches over acral areas and bony prominences had poor re-pigmentation.
Conclusion:
Autologous non-cultured melanocyte transfer have an edge over the other modalities, however, proper patient selection, proper technique and good laboratory set up is required. It has an advantage over conventional split skin thickness grafting as it requires very little donor site skin.
Background
Suction blister epidermal grafting (SBEG) is currently one of the most prevalent surgical methods for stable vitiligo.
Objective
To investigate the long-term outcomes of vitiligo patients who underwent SBEG and to explore risk factors associated with postoperative relapse.
Methods
A retrospective cohort study was conducted in patients who underwent SBEG in our department between January 2016 and December 2022. Treatment outcomes, including repigmentation rate, adverse events, and postoperative relapse, were surveyed via telephone interview or out-=patient visit. Multivariate logistic regression models were used to assess the potential risk factors for postoperative relapse. Statistical significance was assumed at P < .05.
Results
A total of 253 patients were included with a repigmentation rate of 96% (243/253) after grafting. Common adverse events included cobblestone-like appearance (73.1%, 185/253) in the donor site, perigraft halo (46.2%, 117/253), and cobblestone-like appearance (26.1%, 66/253) in the recipient site. Postoperative relapse occurred in 20.1% of patients over a mean time of 29.7 months after grafting. Nonsegmental type of vitiligo and coexistence of autoimmune diseases were risk factors for postoperative relapse.
Conclusion
SBEG is an effective surgical treatment for vitiligo with high repigmentation rate and good safety profile. Nonsegmental vitiligo and comorbid autoimmune diseases may increase the risk of postoperative relapse.
Background
Vitiligo is a common depigmenting dermatosis characterized by milky-white macules or patches. Any pathological discoloration of the skin has been linked to an impact on the body image of an individual, and vitiligo has been linked to decreased self-esteem and poor socialization of the affected people. In Indian society, vitiligo is labeled as Shweta-Kushta (i.e., white-colored leprosy) and is compared to leprosy—a more stigmatizing skin condition.
Aim
This study aims to study gender-related differences in the quality of life of Indian vitiligo patients.
Methodology
In this hospital-based cross-sectional study, a total of 55 vitiligo patients (females 25 and males 30) were enrolled using the purposive sampling technique. The sample was assessed on Dermatology Life Quality Index (DLQI) questionnaire, Rosenberg Self-Esteem Scale (RSS), and General Health Questionnaire-12 (GHQ-12) to assess their quality of life, self-esteem, and psychological well-being, respectively. The gender differences in sociodemographic and clinical details as well as their relationship with the quality of life of the patients were sought with the help of appropriate statistical measures.
Results
The patients of both genders were comparable in terms of all sociodemographic and clinical variables except the females being less educated and employed than the males. There was a statistically significant trend of higher mean DLQI total score in females than males (6.6 ± 3.55 vs 4.8 ± 2.71, Mann–Whitney U = 263.5, P =0.058). Significantly, the average DLQI score in female vitiligo patients was negatively related to family income (r s = -.659, P <.001) and it was significantly higher for the patients from a rural background than those from an urban background (8.55 ± 3.30 vs 5.07 ± 3.03, Mann–Whitney U = 33.5, P <.05). The average DLQI score was negatively correlated to RSS score but positively correlated to GHQ-12 score in patients of both genders.
Conclusion
The quality of life of female patients with vitiligo is poorer than the same in male patients. The poor financial condition of families and rural living are two factors related to the poorer quality of life of female patients. A poorer quality of life in vitiligo patients of both genders is linked with decreased self-esteem and decreased psychological well-being. Gender-related issues in the quality of life and the overall well-being of such patients are important in their management and policy-making.
Background: Vitiligo denotes an acquired primary, usually progressive, melanocytopenia of unknown etiology, and clinically manifested by circumscribed achromic macules often associated with leukotrichia. Objective: The objective was to assess the prevalence and various clinical patterns of vitiligo and to study the efficacy of narrow-band ultraviolet B (NB-UVB) radiation. Materials and Methods: A prospective case series study was carried out at dermatology outpatient department (OPD), of tertiary care center in Central India on 50 patients of Vitiligo, who were diagnosed clinically, age ranging from 5 to 70 years of age. A thorough history and clinical examination as per institutional protocol was done for all the patients included in the study. Patients were exposed to NB-UVB rays in a phototherapy unit (Dermaindia Spiegel Series) with a standard protocol. Two scores designed for the assessment of vitiligo are Vitiligo Area Severity Index and Wallace Rule of Nines. Results: During the period of two years, 6638 patients were seen in dermatology OPD, out of which 129 patients were having vitiligo clinically. Thus, the prevalence of vitiligo was 1.9% in our study. The mean age in male was 40.4 years and that of female was 30.85 years. The female-to-male ratio was 2:3. 6% had a positive family history of vitiligo. The most common site affected was leg (pretibial region) (48%). Two patients (4%) were in Category– 0, 12 patients (24%) were in Category– I, 24 patients (48%) were in Category-II, and 12 patients (24%) were in Category– III, when graded according to their improvement. Forty-five patients (90%) had vitiligo vulgaris, two patients (4%) had segmental vitiligo, and one patient (2%) each of acrofacial vitiligo, lip-tip vitiligo, and focal vitiligo. On comparing the level of significance before treatment and after 2 months of treatment, after 4 and 6 months of treatment, and before treatment and at the end of treatment, it was found that the results were statistically highly significant. Thus, indicating that the improvement in the disease after NB-UVB therapy is statically significant. Conclusion: Our study found 1.9% prevalence of vitiligo among patients attending OPD. On comparing the level of significance, before treatment and at the end of treatment, it was found that the results were statistically highly significant with respect to improvement. Side effects were minimal in our participants. Thus, our study concludes that NB-UVB radiation is an effective and safe therapy for vitiligo.
Background: Vitiligo is characterized depigmented macules and patches over the skin. It has a major impact on the quality of life (QoL) of patients, many of whom feel distressed and stigmatized by their condition. Aim: To assess QoL in vitiligo patients in terms of clinical severity and psychological burden. Materials and Methods: An observational study on 60 patients with age ≥16 years was conducted at an outpatient department of a tertiary care hospital. Data were collected in a predesigned pro forma. The QoL of patients and family members was assessed using Dermatology Life Quality Index (DLQI) and Family DLQI (FDLQI), respectively. The clinical severity was measured using Vitiligo Area Severity Index (VASI) and psychological burden by Vitiligo Impact Score-22 (VIS-22) questionnaire. Results: Sixty patients were included in the study. The mean age was 35.27 ± 2.24. Male-to-female ratio was 1.1:1. About 51.7% of patients were married. Majority of patients were students (30%). The time of presentation after disease onset was 5 years. About 20% of subjects had positive family history. The common sites were face (75%), lower limb (71.67%), and upper limb (60%), with leukotrichia in 11.7% of patients. The mean VASI score at baseline and at 1-month of follow-up after starting treatment was 4.11 ± 0.38 and 3.59 ± 0.58, respectively. The mean DLQI, FDLQI and VIS-22 score were 11.73 ± 0.80, 10.58 ± 0.71, and 37.32 ± 1.53, respectively. VIS-22 and VASI score correlated with changes in DLQI (P < 0.059). Conclusion: Vitiligo largely impairs the QoL of patients. The more the clinical severity (high VASI score), the higher the psychological burden, impairing QoL of patients, and family members.
Purpose of Review
Vitiligo is an acquired condition resulting from melanocyte disappearance and clinically manifests as explicit white patches. Limited research exists on its distribution patterns, specifically, its predisposition for certain anatomic sites, such as the face and extensor surfaces, and any unique structure and function of these sites. Therefore, the aim of this systematic review is to summarize the existing literature on vitiligo’s main sites of involvement and give insight into vitiligo’s susceptibility.
Recent Findings
Nineteen observational studies were included after the Scopus and MEDLINE databases were systematically searched in accordance with the PRISMA guidelines. Particularly vulnerable anatomic sites such as the face display increased melanocyte density, melanocyte:keratinocyte ratio, cholesterol, and AH ceramides. Additionally, anatomic regions experiencing chronic friction, including the bearded area for men and axilla for women, are more vulnerable to depigmentation. These findings allude to the multidimensional pathogenesis of vitiligo and contribute partially to the explanation of anatomic susceptibility.
Summary
This data provides rationale into why vitiligo is rarely universal and may suggest the development of related biological testing, such as measurement of cholesterol levels, for early vitiligo detection and future research explaining depigmentation patterns. Furthermore, these observations are pertinent for future vitiligo management, specifically that treatments might be specifically directed to match the affected body site’s unique structure and function.
This chapter consists of piebaldism, oculocutaneous albinism, unilateral hypomelanosis of Ito, tuberous sclerosis, phylloid hypomelanosis, acral speckled hypomelanosis, nevus depigmentosus, leukoderma punctata confined in nevus depigmentosus, nevus depigmentosus in the twins, hypomelanosis with punctate keratosis of the palms and soles, focal dermal hypoplasia, homocystinuria, trichrome vitiligo, pentachrome vitiligo in a segmental pattern, inflammatory vitiligo, a figurate papulosquamous variant of inflammatory vitiligo, hypochromic vitiligo, follicular vitiligo, palmoplantar vitiligo, confetti-like depigmentation: a potential sign of rapidly progressing vitiligo, bilateral symmetrical areolar vitiligo, perifollicular pigment retention in vitiligo, follicular repigmentation in vitiligo, eczematous lesion spares vitiligo skin, eczema confined in vitiligo, vitiligo colocalized with melasma, vitiligo overlapped with psoriasis, vitiligo appearing in striae distensae, post-herpetic vitiligo, Malassezia related vitiligo, acrylic acid-induced vitiligo, atrophic scar after injection of steroids in the treatment of vitiligo, supravenous hypopigmentation following intralesional triamcinolone injection, Darier-white disease, clear cell papulosis, pili annulati and hereditary generalized punctate leukoderma.
Hintergrund und ziele:
Ziel dieser Studie war die Untersuchung des Zusammenhangs zwischen Vitiligo und dem metabolischen Syndrom (MetS) sowie dessen relevanten Komponenten.
Material und methoden:
Die Datenbanken PubMed, Web of Science, Cochrane Library und Embase wurden von deren Beginn bis zum 30. März 2021 nach relevanten Studien durchsucht. Querschnitts- und Fall-Kontroll-Studien, die entweder die Prävalenz oder die Odds-Ratio [OR] des MetS oder seiner Komponenten bei Vitiligo-Patienten berichteten, wurden eingeschlossen. Die Daten wurden entsprechend der Heterogenität entweder mit einem Zufallseffektmodell oder einem Modell mit festen Effekten gepoolt.
Ergebnisse:
Es wurden 30 Studien mit insgesamt 28.325 Vitiligo-Patienten eingeschlossen. Signifikante Zusammenhänge wurden zwischen Vitiligo und Diabetes mellitus (gepoolte OR, 3,30; 95 %-Konfidenzintervall [KI], 2,10-5,17) sowie zwischen Vitiligo und Adipositas (gepoolte OR, 2,08; 95 %-KI, 1,40-3,11) ermittelt. Die Gesamtprävalenz der Hypertonie bei Patienten mit Vitiligo betrug 19,0 % (95 %-KI, 2,0 %-36,0 %).
Schlussfolgerungen:
Unserer Ergebnisse lassen auf einen Zusammenhang zwischen Vitiligo und Diabetes mellitus sowie Hypertonie schließen. Dermatologen wird empfohlen diese Zusammenhänge zu berücksichtigen, um potenzielle Begleiterkrankungen bei Vitiligo-Patienten zeitnah zu identifizieren. Zudem wird Vitiligo-Patienten empfohlen, Parameter wie BMI, Blutzuckerspiegel und Blutdruck zu überwachen und bei auffälligen Veränderungen dieser Parameter unverzüglich einen Spezialisten zu konsultieren.
Background and objectives:
This study aimed to investigate the association of vitiligo with metabolic syndrome (MetS) and its relevant components.
Material and methods:
We searched PubMed, Web of Science, Cochrane Library and Embase databases from inception to March 30, 2021, for relevant studies. Cross-sectional and case-control studies that reported either the prevalence or odds ratio [OR] of MetS or its components in vitiligo patients were included. Data were pooled using either random-effects model or fixed-effects model according to the heterogeneity.
Results:
Thirty studies with a total of 28,325 vitiligo patients were included. Significant associations were found between vitiligo and diabetes mellitus (pooled OR, 3.30; 95 % confidence interval [CI], 2.10-5.17) and between vitiligo and obesity (pooled OR, 2.08; 95 % CI, 1.40-3.11). The overall prevalence of hypertension in the patients with vitiligo was 19.0 % (95 % CI, 2.0 %-36.0 %).
Conclusions:
Our findings suggest the association of vitiligo with diabetes mellitus, obesity, and hypertension. It is recommended for dermatologists to take these associations into account so as to identify potential comorbidities promptly in vitiligo patients. Additionally, vitiligo patients are advised to monitor the indexes including BMI, blood glucose, and blood pressure levels and the consultation with specialists is necessary upon abnormal changes of these indexes.
Vitiligo is an idiopathic acquired chronic stigmatizing disease. It is a pigmentary disorder that affects the skin and the mucous membranes, and it is characterized by well-circumscribed, depigmented milky white macules and patches. It has an estimated prevalence of 0.5-2% of the population worldwide. In the previous studies, several mechanisms such as autoimmune, oxidative stress, genetic factors, melanocytorrhagy, and neural hypothesis have been suggested for vitiligo pathogenesis.We aimed to assess the morphological changes of epidermal melanocytes and keratinocytes in patients with vitiligo. This aim will be fulfilled by histological, ultrastructural, and immunohistochemical analysis of skin biopsies from lesioned and non-lesioned sites in vitiligo patients.The study was carried out on 15 selected patients with stable vitiligo vulgaris but not receiving treatment in the last year and they fulfilled our inclusion criteria.Biopsies were taken from lesioned and non-lesioned sites in the same vitiligo patients, and they are processed for examinations by LM (using Hx & E, and Masson Fontana stain), immunohistochemical analysis (using Melan-A, E-cadherin, and caspase-3), and TEM (to demonstrate the ultra-structures).By LM, staining with Hx & E, lesioned skin in vitiligo patients showed hyperkeratosis, basal vacuolization, acanthosis with an increase in the epidermal thickness, ballooning of keratinocytes, and spongiosis. Regarding melanocytes, we observed a few numbers of melanocytes, also we detected some basal epidermal cells contain brown melanin granules. Using Fontana-Masson stain, we found that the melanin pigment is present in both lesioned and non-lesioned skin of vitiligo patients. We confirmed the presence of melanocytes in the lesioned skin by the immunohistochemical staining with Melan-A. The epidermal cells in lesioned skin of vitiligo patients showed weak positive expression of E-cadherin between them and an increase in the number of apoptotic Caspase-3 positive cells. BY TEM, the lesioned skin in vitiligo patients showed that the keratinocytes and melanocytes had various degenerative changes, disturbance of desmosomes in between keratinocytes, and absence of melanosomes in the keratinocytes. The detected melanocytes were degenerated and contained some melanosomes, melanin granules, and autophagosomes.We concluded that vitiligo pathogenesis is a combination of several factors and cannot be explained by only one mechanism. The pathology in the lesioned vitiliginous skin is a combination of several degenerative changes in keratinocytes, and melanocytes.
Background:
The prevalence of vitiligo has been reported to range from 0.1% to 8% worldwide, and vitiligo has been linked to some autoimmune and non-autoimmune diseases. This study aimed to estimate the prevalence of vitiligo and associated comorbidities in adults in Shanghai.
Methods:
A community-based cross-sectional survey was conducted among 9,114 adults (4,288 males) in a community of Shanghai between October 2009 and January 2010. Face-to-face interviews were conducted at the home of each participant, and all respondents had their skin examined by dermatologists. The risks of comorbidities associated with vitiligo were evaluated by multiple logistic regression analysis.
Results:
The estimated prevalence of vitiligo was 0.91%, and the standardized (age-adjusted) prevalence was 0.67%. Prevalence increased with age from 0.20% in 18-30 years to 1.59% in the 71-80 years age group. The presence of vitiligo was associated with increased risks of atopic dermatitis [adjusted odds ratio (aOR) =2.49; 95% confidence interval (95% CI): 1.46-4.23], urticaria (aOR =1.83; 95% CI: 1.11-3.04). and coronary heart disease (aOR =1.88; 95% CI: 1.03-3.41), although the association with coronary heart disease was only identified in subjects who were aged ≥60 years or overweight.
Conclusions:
The prevalence of vitiligo in Shanghai was comparable to that seen in previous studies and increased with age. Vitiligo was associated with increased risks of atopic dermatitis, urticaria, and coronary heart disease in adults.
Shwitra is considered in dreadful and hating state. One to four percent population is suffering in world. It produces mental discomfort. A 3½ years old boy had suffering white patches over arm and shoulder. Bakuchi Churna 500 mg twice in a day with warm water and area in morning sunlight for one year by follow up every month. The assessment criteria were size and color of the patches. The effect of drug is to enhance the proliferation of melanocyte.The use of Bakuchi along with sunlight is very effective. The color of lesion becomes red and sizes of lesion also diminishes.
Vitiligo is a relatively common, acquired hypopigmentary disorder caused by the loss of epidermal melanocytes. It is characterized by asymptomatic, well-circumscribed round to oval-shaped whitish patches that vary in size. Depending on various clinical features, vitiligo is classified into several types, that is, non-segmental, segmental, and undetermined/unclassified vitiligo. The uniform classification of vitiligo is very important in predicting its clinical course and prognosis and communication among researchers. In particular, segmental vitiligo is a highly distinctive subtype of vitiligo considering its clinical features and prognosis. It usually has an onset early in life and spreads rapidly within the affected area limited to one segment of the integument. Signs of vitiligo activity such as Koebnerʼs phenomenon, trichrome vitiligo, inflammatory vitiligo, and confetti-like lesions give useful information to start treatments to block the progression of the disease. Lastly, other hypopigmentary disorders should be distinguished from vitiligo to make the correct diagnosis and prescribe the right treatment. In this report, I review the clinical features of vitiligo, various subtypes according to classification, and the importance for differential diagnosis of hypopigmentary disorders from vitiligo.
Vitiligo is a common polygenic autoimmune disease in which the foci of depigmentation are formed on the skin and/or mucous membranes as a result of the death of melanocytes. There are several hypotheses for the pathogenesis of the disease, the leading role among them is played the autoimmune hypothesis. This review summarizes the available literature data on the prevalence and structure of comorbid endocrine autoimmune pathology in vitiligo patients. In most studies conducted in Europe, America and Asia the prevalence of autoimmune thyroid diseases (including autoimmune thyroiditis and Graves disease), diabetes mellitus and autoimmune adrenal insufficiency was higher in vitiligo patients than in the general population. The results of some studies indicate a frequent association of vitiligo with autoimmune polyglandular syndromes. In the structure of comorbid pathology the highest prevalence was in autoimmune thyroid diseases. A number of studies have established a higher prevalence of autoimmune endocrine diseases in women, as well as in nonsegmental vitiligo patients and in cases of family history of vitiligo and/or other autoimmune diseases. In addition, it was shown that the prevalence of endocrine diseases increases with increasing area of depigmentation. The data obtained justify the advisability of conducting a timely examination of vitiligo patients with the aim of early detection of comorbid diseases and the appointment of appropriate treatment. Further studies are needed to investigate the effect of the identified associations on the course of vitiligo and comorbid endocrinopathies, as well as the effectiveness of therapy and the quality of life of patients.
Background
Childhood vitiligo is commonly encountered. Pattern and distribution of childhood vitiligo were not clearly described in past.
Aims
To study clinical characteristics of vitiligo among Egyptian children in relation to epidemiological data and compare them with those of adolescents and adults.
Patients and Methods
Recruited clinically diagnosed vitiligo patients were categorized into three groups; I (children): < 12 years old (yo), II (adolescents): 12‐18 yo and III (adults): 18‐30 yo. Patients were subjected to history taking, general and dermatological examination to determine skin photo‐type, type, presentation and distribution of vitiligo, percentage of body area involved using vitiligo extent score (VES), associated mucosal involvement, presence of leukotrichia, koebnerization and halo nevi.
Results
483 vitiligo patients were included; 220 children, 123 adolescents and 140 adults. The most common form of vitiligo was non‐segmental vitiligo (NSV). Segmental and active vitiligo were more common in children than adolescents and adults. The most common site of distribution of NSV in children was the face (periocular) versus arms & forearms in adults followed by thighs & legs in both. The mean age of onset of vitiligo in children was 6.18 (SD 2.93) yo while mean duration of disease was 2.12 (SD 2.21) y. Face was the most common site of onset of vitiligo in children and adolescents versus arms & forearms in adults.
Conclusions
Childhood vitiligo differs from adult onset vitiligo regarding several features as type, site of onset, distribution, extent and activity of disease
Large-scale epidemiological surveys have shown that most cases of vitiligo occur sporadically, though about 15–20% of patients report one or more affected relatives. The rationale for genetic studies of vitiligo susceptibility is that underlying genes are involved in mediating disease causation, either increasing or decreasing risk (protective). Three different general approaches have been used to identify genes that mediate vitiligo susceptibility: the candidate gene approach, the genome-wide approach, and the gene expression approach. Extensive experience has proven that the only analytic approach that produces verified discovery of bona fide disease genes is the genome-wide approach. Retrospective analyses of candidate gene studies have shown that the vast majority of claimed candidate gene associations represent false-positives. Accordingly, the candidate gene approach is no longer considered valid for de novo disease gene discovery and is reserved for confirmatory studies only. Similarly, almost all genes that exhibit major expression differences between disease and non-disease states turn out to not correspond to causal genes, but instead represent secondary effects, and thus likewise gene expression studies have generally not led to the discovery of genes that are causal for complex diseases. Indeed, none of the genes initially suggested on the basis of the expression approach now appear to be involved in vitiligo causation at all. In contrast, genome-wide genetic analyses, particularly genome-wide association studies (GWAS), have proven a remarkably robust approach to disease gene discovery, yielding findings that are highly reproducible and which, in aggregate, have provided dramatic advances in understanding the biological basis of many different complex diseases, including vitiligo. Reported candidate gene associations and expression difference findings that are not observed in well-powered GWAS of the same population are not now considered to be valid indications of disease-causal genes and thus will not be discussed here.
Vitiligo treatment has to be tailored to every individual after considering several individual features, including age, gender, and ethnic skin type as well as the specific location of patches. Vitiligo affects people of all age groups though the highest incidence is seen in the second and third decades of life. Treatment options are limited in childhood vitiligo because some systemic therapies are contraindicated, phototherapy is difficult to administer, there are age-specific adverse effects of different medicines, and, finally, there are difficulties in undertaking surgical treatment in children. In spite of all these limitations, response to medical as well as surgical treatments is generally stated to be better in children compared to adults. Vitiligo in older patients does not usually produce as much distress as in young people since the psychosocial burden is considerably less at this stage of life when getting married and securing employment are not of concern. The social stigma and cosmetic disfigurement of vitiligo affect both men and women, but the burden is significantly heavier in women, particularly in communities where marriages are arranged by families. Treatment options and response are similar in men and women. Vitiligo in subjects with darker skin poses particular problems because of the greater visibility and disfigurement along with the widespread prejudices and taboos associated with the disease in these communities. The location of patches is an important determinant of response with vitiligo on the hands and feet, knees and elbows, and the mucosae responding poorly to all current treatment modalities. Choice of surgical technique, dressing, and postoperative care and instructions are guided by the site affected.
This article presents the summary of observations and conclusions of a monogram based on a study of Vitiligo patients by the author. This article has been sent for publication by the author in response to a request from the Editorial Board.
A series of 202 cases of vitiligo was studied. The incidence of the disease in the dermatologic population was discovered to be 2.9%. The age at onset of the disease in the majority of the cases was in the second and third decades. A similar pattern was observed in the reporting age, indicating that the disease starts at a younger age. The duration of the disease in both sexes is brought out and its importance in prognosis is emphasized. A modified classification is proposed and its role in evaluation of prognosis is highlighted. Vitiligo and its association with other diseases is recorded.
A clinical analysis of L50 patients having vitiligo revealed the incidence among new patients to be 1.25%. The male /female ratio was 1.3:1. Patients below the age of 30 years constituted 85%. Family history of vitiligo was available in 240/o. The different morphologic, Patterns consisted of vitiligo vulgaris (90 cases), vitiligo areata (22 cases), vitiligo acro-facialis (11 cases), vitiligo univers (11 cases , vitiligo mucoaae (9 cases),and vitiligo zosteriformis (7 cases). Association with diabetes meffitus (5 cases), alopecia areata (4 cases), Hashimoto's thyroiditis (1 case) and pemphigus vulgaris ( 1 case ) was observed.
• The prevalence of vitiligo was 0.38% in 47,033 people in a representative region in Denmark. Both sexes were equally affected. No significant difference was found in the distribution of 179 patients with vitiligo among five municipalities or between urban and rural districts. The age-specific prevalence increased from 0.09% under the age of 10 years to 0.90% in the age group 60 to 69 years. After the age of 70, the prevalence declined. This fall might reflect an increased incidence of vitiligo during the past few decades. The number of new cases of vitiligo increased steadily with advancing age, its onset being most often between the ages of 40 and 60 years. It is assumed that the prevalence of vitiligo in Denmark applies also to the northwestern part of Europe.
(Arch Dermatol 113:47-52, 1977)
The Journal of Investigative Dermatology publishes basic and clinical research in cutaneous biology and skin disease.
Twenty five patients with halo nevi were studied clinically and histopathologically. All except one were seen in the first four decades of life, one patient being 76 years old. ln two-thirds of the patients the lesions were of one year′s duration and in the rest the duration was upto 4 years.87.5% halo nevi were associated with vitiligo while in the rest there was no associated vitiligo. ln the majority of these cases, halo nevi and vitiligo occurred simultaneously. Halo nevi occurring without vitiligo were confined to face and upper trunk only. The central nevus in all except two was intradermal. Histopathologically halo nevi showed similar changes at the margins as seen in vitiligo, 12 halo nevi showed large dendritic melanocytes and 13 had non-dendritic melanocytes. No inflammatory infiltrate was seen in 15 halo nevi. Ten showed histiocytes and lymphocytes. From this study it appears that cell-mediated immunity may not be the sole factor involved in the pathogenesis of halo nevi.
A review of the basics of pigment cell biology is followed by a discussion of the characteristics of several disorders of hypopigmentation. By determining such features as inheritance pattern, time of onset (congenital, childhood, adulthood), natural history (stable vs progressive), type of pigment loss (diffuse or circumscribed), distribution of lesions (generalized vs localized), degree of pigment loss (incomplete or complete), number of melanocytes, if any, in biopsy specimens of affected areas, type of melanocytic dysfunction, and associated inflammation or infection, one can classify the disorders of hypopigmentation. The proposed pathophysiology for each disorder of hypomelanosis is presented.
An epidemiological profile of vitiligo in Calcutta is presented. Prevalence data were gathered from 15,685 individuals drawn from the general population; pedigree data were collected through 293 vitiligo patients. The overall prevalence of vitiligo is about 5 per 1,000 individuals. There are no significant sex or age differences in prevalence rates. About a 4.5-fold increase in prevalence is observed among close biological relatives of affected individuals. There is, however, no clearcut correspondence between relative risks and kinship coefficients. There are no significant differences in the frequencies of various types of vitiligo between probands with and without positive family history. The overall mean and modal ages of onset are about 22 years and 15 years, respectively. The mean ages among males (24.8 years) and females (19.3 years) are significantly different.
The genetics of vitiligo has been studied in 150 probands and their families. A familial concentration of the disease has been demonstrated which supports the concept that hereditary factors contribute to the etiology of vitiligo. Segregation analysis was not consistent with inheritance at a single autosomal or x-linked locus. Further analysis suggested that vitiligo is determined by multifactorial inheritance. An estimate of heritability of liability was found to be 72.4%, indicating that genetic factors play a significant role in the etiology.
Vitiligo affects approximately 1% of the general population without racial, sexual, or regional differences. However, studies of segmental vitiligo have been few and the number of patients limited.
The aim of this study was to analyze the clinical features of patients with segmental vitiligo.
We evaluated sex, age at onset, age at initial visit, character of the initial lesion, status of progression, precipitating factors, involved sites, dermatomal distribution, family history, Koebner phenomenon, presence of poliosis, dominant hand, and associated diseases.
Segmental vitiligo had an early onset, rapid progression, no specific precipitating factors, and linear spreading in the affected dermatomal area. The most commonly involved dermatome was the trigeminal. Only a few patients had an associated autoimmune disease.
The clinical features of segmental vitiligo differ from those of nonsegmental vitiligo; pathogenesis may also differ.
Introduction
Vitiligo is a disorder of pigmentation which has baffled the medical world for centuries. It should be differentiated from the more inclusive descriptive term leukoderma, which may also include depigmentations due to obvious local causes, such as burns or wounds, chronic eczematous conditions, psoriasis, leprosy, or syphilitic leukomelanoderma. Although there is no restriction of physical endurance, work capacity, or life expectancy, vitiligo patients frequently suffer from severe psychological trauma because of the disfiguration of unsightly white patches, especially if these occur on exposed areas of the face or extremities.
From my observations on 410 cases of vitiligo seen over a period of three years in the Dermatology Clinic, Christian Medical College Hospital, Vellore, South India, I have been impressed by the variability in distribution of lesions, type of lesions, course of the disease, and particularly in response to treatment. Although the pso
Vitiligo. What is it?, Is it important?
- Lerner AB
Segmental vitiligo: Clinical findings in 208 patients
- Hann
Epidemiological study of vitiligo in Surat area, South Gujarat
- Mehta NR
- Shah KC
- Theodore C
- Vyas V
- Patel A
Disorders of skin color
- Bleehen SS
- Ebling FJG
- Champion RH
Disorders of skin color
- Bleehen
Epidemiological study of vitiligo in Surat area, South Gujarat
- Mehta NR