Addition of oral minipulse dexamethasone to narrowband ultraviolet B phototherapy and topical steroids helps arrest disease activity in patients with vitiligo

Tovar‐Garza, Andrea; Hinojosa, Jorge A.; Hynan, Linda S.; Pandya, Amit G.

doi:10.1111/bjd.17150

Cited by 25 publications

(31 citation statements)

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“…selecting specific treatments). 1,2,8 The main strength of the VSAS is that a reproducible quantification of signs linked to disease activity in vitiligo can be proposed. The conversion into a numerical output might improve the monitoring of patients and communication between physicians.…”

Section: Discussionmentioning

confidence: 99%

“…The median overall VSAS (first round) was 4 [range 0-13, interquartile range (IQR) [1][2][3][4][5][6][7][8]. Figure 3 shows a scatter plot illustrating the distribution of the overall VSAS in mean rank order of all cases.…”

Section: Reliabilitymentioning

confidence: 99%

“…start a treatment to halt progression) but it does not allow quantification of disease activity. 8 Currently, available outcome measures for disease activity in vitiligo are scarce. So far, the Vitiligo Disease Activity Index (VIDA) score is the most frequently cited measurement instrument by researchers, although it is constructed as a recallbased patient-reported outcome measure.…”

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confidence: 99%

“…This information can be relevant for clinical trials and clinical practice (e.g. start a treatment to halt progression) but it does not allow quantification of disease activity 8…”

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confidence: 99%

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Reliability and validity of the Vitiligo Signs of Activity Score (VSAS)

et al. 2020

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Summary Background The associations between disease activity and several clinical signs in vitiligo have been described, but a widely accepted and validated scoring system is lacking. Objectives To validate the Vitiligo Signs of Activity Score (VSAS) for physicians. Methods Three visible clinical signs were scored on 15 body locations: confetti‐like depigmentation (c), Koebner phenomenon (k) and hypochromic areas/borders (h). The inter‐ and intrarater reliability of the global VSAS and VSAS subscores (c‐VSAS, k‐VSAS and h‐VSAS) were tested by four and three raters (physicians), respectively. Construct validity and feasibility were evaluated. Results The VSAS demonstrated good inter‐rater reliability, with an intraclass correlation coefficient (ICC) of 0·87 in the first round and 0·90 in the second round. The intrarater reliability ICCs were all ≥ 0·86. The inter‐rater reliabilities of the subscores were excellent for c‐VSAS and fair for k‐VSAS and h‐VSAS (ICC 0·83, 0·51 and 0·53, respectively, in the first round). Evidence for construct validity was provided. The completion time by the raters (median 2·18 min per patient) improved during the second round (median 1·33 min per patient). A limitation of the study is the low number of patients, mainly of skin phototypes II–III, from a single tertiary centre. Conclusions The VSAS appears to be a valid and reliable instrument to score visible clinical signs linked to disease activity in a standardized way. What is already known about this topic? Evidence exists for a possible link between several visible clinical signs in vitiligo and disease activity. A widely accepted and validated scoring system to quantify these clinical signs is lacking. What does this study add? The Vitiligo Signs of Activity Score (VSAS) underwent preliminary validation and may assist quantification of visible clinical signs linked to disease activity in a standardized way in clinical practice and trials. What are the clinical implications of this work? VSAS may be used for future trials that aim to establish the clinical significance of the specific visible clinical signs in vitiligo in a more controlled setting. Linked Comment: Eleftheriadou. Br J Dermatol 2020; 183:801–802.

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Section: Discussionmentioning

confidence: 99%

Section: Reliabilitymentioning

confidence: 99%

mentioning

confidence: 99%

“…This information can be relevant for clinical trials and clinical practice (e.g. start a treatment to halt progression) but it does not allow quantification of disease activity 8…”

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confidence: 99%

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Reliability and validity of the Vitiligo Signs of Activity Score (VSAS)

et al. 2020

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“…Therefore, suggesting that short-term physical examinations are useful in the treatment of vitiligo is of great clinical significance. The confetti type is known to be an active sign of vitiligo [10] and was found in 3 out of 4 cases with exacerbated lesions, which suggests that early detection of lesions using a Wood's lamp can be considered for the early introduction of immunosuppressive agents, such as systemic immunosuppressants with half-pulse or oral steroids [11].…”

Section: Discussionmentioning

confidence: 99%