Classification of segmental vitiligo on the face: clues for prognosis

Authors

  • D-Y. Kim,

    1. Department of Dermatology and Cutaneous Biology Research Institute, Yonsei University College of Medicine, 134 Sinchon-dong, Seodaemun-gu, Seoul 120-752, Korea
      *Korea Institute of Vitiligo Research, Drs Woo and Hann’s Skin Center, 15-3 Garwol-dong, Yongsan-gu, Seoul 140-801, Korea.
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  • S.H. Oh,

    1. Department of Dermatology and Cutaneous Biology Research Institute, Yonsei University College of Medicine, 134 Sinchon-dong, Seodaemun-gu, Seoul 120-752, Korea
      *Korea Institute of Vitiligo Research, Drs Woo and Hann’s Skin Center, 15-3 Garwol-dong, Yongsan-gu, Seoul 140-801, Korea.
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  • S-K. Hann

    1. Department of Dermatology and Cutaneous Biology Research Institute, Yonsei University College of Medicine, 134 Sinchon-dong, Seodaemun-gu, Seoul 120-752, Korea
      *Korea Institute of Vitiligo Research, Drs Woo and Hann’s Skin Center, 15-3 Garwol-dong, Yongsan-gu, Seoul 140-801, Korea.
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  • Funding sources
    None.

  • Conflicts of interest
    None declared.

  • S-K.H. and S.H.O. contributed equally to this work as co-corresponding authors. This study was presented at the first Vitiligo World Congress, 23–25 November 2010, Milan, Italy (invited lecture).

Seung-Kyung Hann.
E-mail: skhann@paran.com

Summary

Background  The origin of the distribution of segmental vitiligo (SV) has not yet been clearly elucidated. Segmental configurations of cutaneous disorders have been explained using two main interpretations, i.e. following either dermatomal or blaschkolinear distributions. However, facial SV does not always correspond to either of these distributions.

Objectives  We classified facial SV into several distinctive subtypes according to specific distributions based on long-term observations.

Methods  In total, 257 patients with facial SV were included, all of whom were closely observed for more than 1 year. The distribution patterns of facial SV were classified according to morphological similarities based on clinical observations.

Results  The lesions of facial SV were categorized into six subtypes: types I-a and I-b, and types II–V. Type I-a and type IV broadly involved the mid-level face from the forehead to the lower cheek, but type IV lesions selectively appeared on the right side of the face and did not cross the midline. Type I-b lesions chiefly involved the forehead and scalp hair. Types II and III involved the lower face and, frequently, the neck area, and type V lesions were distributed mostly around the right orbital area. The most frequent type of lesion in this study was type I-a (28·8%), followed by types II (16·0%), III (14·4%), IV (10·9%), I-b (10·5%) and V (8·6%).

Conclusions  Newly established patterns of facial SV may be valuable for certain aspects of prognosis, such as the likely degree and path of lesion spreading.

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