Classification of segmental vitiligo on the trunk

Geel, Nanja van; Bosma, Sarah; Boone, Barbara; Speeckaert, Reinhart

doi:10.1111/bjd.12652

Cited by 15 publications

(8 citation statements)

References 17 publications

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“…In a recent study on the classification of the truncal SV lesion, authors reported that SV was more frequently seen on the ventral side (85.8%) than the lateral side or the back of the trunk. This was explained by the dorsoventral embryological migration pattern of the melanocyte precursors . In our study, the tendency of the medial location of SV lesions may also be due to this.…”

Section: Discussionsupporting

confidence: 51%

“…This was explained by the dorsoventral embryological migration pattern of the melanocyte precursors. 13 In our study, the tendency of the medial location of SV lesions may also be due to this. When analyzing the dermatomal distribution, cervical dermatome was the most commonly involved dermatome in SND versus trigeminal dermatome in patients with SV.…”

Section: Discussionmentioning

confidence: 48%

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Clinical differences between segmental nevus depigmentosus and segmental vitiligo

Roh¹,

Shin²,

Kim³

et al. 2019

The Journal of Dermatology

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Segmental nevus depigmentosus and segmental vitiligo can be difficult to differentiate from each other. Differential diagnosis of these two diseases is important because they have significantly different prognoses and psychological effects. The purpose of this study is to identify clinical clues that may be helpful in differentiating these two diseases. We enrolled 63 patients with segmental nevus depigmentosus and 149 patients with segmental vitiligo. Sex, age of onset, sites involved, dermatomal distribution, margin of lesion and presence of poliosis were evaluated in both groups. The age of onset was less than 10 years in 96.8% of segmental nevus depigmentosus and 28.9% of segmental vitiligo cases. Trunk (36.5%) and cervical (38.1%) dermatomes were the most commonly involved in segmental nevus depigmentosus and face (67.1%) and trigeminal (64.4%) dermatomes in segmental vitiligo. The average number of dermatomes involved in truncal lesions was different in segmental nevus depigmentosus and segmental vitiligo (2.71 vs 1.62, P = 0.001). Segmental vitiligo on the face, neck and trunk appeared closer to the axis than segmental nevus depigmentosus (P < 0.001). Segmental nevus depigmentosus and segmental vitiligo showed significantly different margins (90.5% and 41.6% serrated, respectively; P < 0.001). We observed clinical differences between patients with segmental nevus depigmentosus and those with segmental vitiligo. Distribution (site, distance to axis, dermatome), vertical width, margin of lesion and presence of poliosis can be helpful in differentiating segmental nevus depigmentosus and segmental vitiligo.

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Section: Discussionsupporting

confidence: 51%

Section: Discussionmentioning

confidence: 48%

Clinical differences between segmental nevus depigmentosus and segmental vitiligo

Roh¹,

Shin²,

Kim³

et al. 2019

The Journal of Dermatology

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“…The characteristic distribution patterns of SV suggest a genetically mutated population of melanocytes which is targeted by a cytotoxic cell response. Different patterns of segmental vitiligo in the face and on the trunk have been detected and can easily be recognized in clinical practice (74,75). By comparing different unilateral and localized skin disorders, we found that the SV pattern does not follow a dermatomal distribution but displays a unique distribution pattern that shares the largest similarity with segmental lentiginosis, followed by epidermal naevus verrucosus (76).…”

Section: Evidence Of Somatic Mosaicismmentioning

confidence: 90%

Autoimmunity in Segmental Vitiligo

et al. 2020

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The autoimmune basis of segmental vitiligo (SV) has only recently been recognized. Systemic autoimmune diseases are less frequently associated compared to non-segmental vitiligo (NSV), but localized skin disordersin particular linear morpheahave been repeatedly observed in patients with SV. The inflammatory response is documented on a clinical level with cases displaying erythematous borders or a hypochromic stage, on a histopathological level with predominantly CD8 lymphocytes migrating toward the basal layer and by flow cytometry demonstrating the antimelanocyte specificity of these cytotoxic T cells. The increased risk for halo naevi and NSV in these patients further underline the immunemediated mechanisms of SV. Nonetheless, the localized and unique distribution pattern points to somatic mosaicism. This places SV in a category of similar diseases such as lichen striatus, blaschkitis, linear lupus erythematosus, and linear scleroderma where an immune reaction against genetically mutated skin cells is believed to be the underlying cause. All these disorders are characterized by a young age of onset, a temporary disease activity with spontaneous resolution, limited response to treatment, and often long-term sequelae. Although challenging, genetic research proving this genetic mosaicism could offer crucial insights into the pathogenesis of both segmental and non-segmental vitiligo.

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“…The maximum expected boundary for classification was established as a black line by using these vitiligo lesions. Classification was designated through a consensus of five vitiligo experts based on classifications previously suggested for the face 5 and trunk 6 …”

Section: Figurementioning

confidence: 99%