Association of Clinical Markers With Disease Progression in Patients With Vitiligo From China

Zhang, Li; Chen, Shujun; Kang, Yuli; Wang, Xiuxiu; Fang, Yan; Jiang, Min; Wang, Qianqian; Liu, Ziqi; Zhang, Chengfeng; Xiang, Leihong

doi:10.1001/jamadermatol.2019.4483

Cited by 27 publications

(36 citation statements)

References 22 publications

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“…The typical lesion of vitiligo is well-demarcated, nonscaly milky white macules. Some clinical signs and dermoscopy may be useful to assess disease activity and prognosis and to guide personalized management [52,53]. Koebner's phenomenon, confetti depigmentation (substantial 1-to 5-mm depigmented spots in clusters at the lesions' borders), poorly defined borders, or inflammatory lesions (erythema and raised borders) could be surrogate markers that link to disease progression [52,54] (Fig.…”

Section: Clinical and Histological Features Of Vitiligomentioning

confidence: 99%

“…2). Alternatively, patients with a trichrome sign (three different hues result from the hypopigmentation zone between normal and depigmented skin) require intensive therapies [53,55] (Fig. 2e).…”

Section: Clinical and Histological Features Of Vitiligomentioning

confidence: 99%

“…2e). The presence of more than two phenotypic markers may suggest unfavorable prognosis [53]. Recently, the Vitiligo Signs of Activity Score was created to quantify these clinical signs that linked to vitiligo activity [56].…”

Section: Clinical and Histological Features Of Vitiligomentioning

confidence: 99%

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Clinical Features, Immunopathogenesis, and Therapeutic Strategies in Vitiligo

Wang

2021

Clinic Rev Allerg Immunol

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

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Section: Clinical and Histological Features Of Vitiligomentioning

confidence: 99%

Section: Clinical and Histological Features Of Vitiligomentioning

confidence: 99%

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Clinical Features, Immunopathogenesis, and Therapeutic Strategies in Vitiligo

Wang

2021

Clinic Rev Allerg Immunol

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“…We further followed and analyzed the disease activity, progression, and prognosis for repigmentation in the patients at active stage. Serum CXCL10 and clinical markers were used to assess the disease activity at first visit as described previously (Abdallah et al, 2018; Wang et al, 2016; Zhang et al, 2020). The disease progression was assessed by the percentage of patients at active stage at 3 and 6 months.…”

Section: Methodsmentioning

confidence: 99%

New insights into segmental vitiligo: A clinical and immunological comparison with nonsegmental vitiligo

Jiang

Zhang

et al. 2021

Pigment Cell Melanoma Res

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The overlaps between segmental vitiligo (SV) and nonsegmental vitiligo (NSV) suggest the underlying features of SV, which may be helpful for treating SV. In this study, 379 vitiligo patients were recruited and divided into SV (33.2%), mild‐to‐moderate NSV (M‐NSV, affected body affected area [BSA] ≤10%, 34.0%), and severe NSV (S‐NSV, affected BSA >10%, 32.7%) groups. Demographics and clinical data were collected through in‐person interviews. The disease activity, progression, and prognosis were assessed through 6 months’ follow‐up. Serum cytokines profile and tissue‐infiltrating immune cells were measured by ELISA assay and immunofluorescence, respectively. The SV exhibited lower rates of autoimmune comorbidities and recurrence than the S‐NSV, but performed similar to the M‐NSV. Moreover, the disease activity, progression, serum cytokines profile, and tissue‐infiltrating Th/c1 cells in the active SV and M‐NSV were comparable, but differed significantly from those of the active S‐NSV. The clinical and immunological similarities between SV and M‐NSV presented a deeper autoimmune understanding of SV. Additionally, a classification of active vitiligo according to disease extent may be more clinically meaningful than subtypes for guiding immunomodulatory treatment.

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“…According to the definition of the Vitiligo Global Consensus, analysis of vitiligo stability or instability should include a combination of history, series of photographs, and clinical scores such as VASI or VETF; vitiligo is considered stable if no new lesions, enlargement of old macules, Köbner phenomenon, or perifollicular (confetti) depigmentation is observed. 7 , 8 …”

Section: Introductionmentioning

confidence: 99%

Consensus on the treatment of vitiligo – Brazilian Society of Dermatology

Dellatorre¹,

Antelo

Bedrikow

et al. 2020

Anais Brasileiros de Dermatologia

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Background Vitiligo is a muco-cutaneous, autoimmune, localized, or disseminated disease, which manifests through hypochromic or achromic macules, with loss in quality of life. The prevalence of vitiligo in Brazil was determined to be 0.54%. There is no on-label medication for its treatment. To date, no Brazilian consensus on the treatment of vitiligo had been written. Objectives The objective of this group of Brazilian dermatologists with experience in the treatment of this disease was to reach a consensus on the clinical and surgical treatment of vitiligo, based on articles with the best scientific evidence. Methods Seven dermatologists were invited, and each was assigned two treatment modalities to review. Each treatment (topical, systemic, and phototherapy) was reviewed by three experts. Two experts reviewed the surgical treatment. Subsequently, the coordinator compiled the different versions and drafted a text about each type of treatment. The new version was returned to all experts, who expressed their opinions and made suggestions for clarity. The final text was written by the coordinator and sent to all participants to prepare the final consensus. Results/Conclusion The experts defined the following as standard treatments of vitiligo: the use of topical corticosteroids and calcineurin inhibitors for localized and unstable cases; corticosteroid minipulse in progressive generalized vitiligo; narrowband UVB phototherapy for extensive forms of the disease. Surgical modalities should be indicated for segmental and stable generalized vitiligo. Topical and systemic anti-JAK drugs are being tested, with promising results.

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Association of Clinical Markers With Disease Progression in Patients With Vitiligo From China

Cited by 27 publications

References 22 publications

Clinical Features, Immunopathogenesis, and Therapeutic Strategies in Vitiligo

Clinical Features, Immunopathogenesis, and Therapeutic Strategies in Vitiligo

New insights into segmental vitiligo: A clinical and immunological comparison with nonsegmental vitiligo

Consensus on the treatment of vitiligo – Brazilian Society of Dermatology

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