Skip to main content
Top
Published in: Dermatology and Therapy 5/2020

Open Access 01-10-2020 | Phototherapy | Original Research

Dermoscopic and Clinical Response Predictor Factors in Nonsegmental Vitiligo Treated with Narrowband Ultraviolet B Phototherapy: A Prospective Observational Study

Authors: Enzo Errichetti, Enrico Zelin, Caterina Pinzani, Athanassios Kyrgidis, Aimilios Lallas, Giuseppe Stinco

Published in: Dermatology and Therapy | Issue 5/2020

Login to get access

Abstract

Introduction

Few data on possible local factors that can influence the achievement of response in nonsegmental vitiligo (NSV) treated with narrowband ultraviolet B (Nb-UVB) phototherapy are available. Our objective is to evaluate possible correlations between therapeutic outcomes and dermoscopic and local (lesional) clinical findings of vitiligous lesions undergoing Nb-UVB phototherapy to find positive and/or negative response predictor factors to such treatment.

Methods

For each target patch, we calculated the extension area using a computer-aided method and assessed dermoscopic and local (lesional) clinical findings at baseline. After 30 phototherapy sessions (twice weekly), surface area of the lesions was reevaluated to assess clinical improvement, correlating the therapeutic outcome with initial clinical and dermoscopic features.

Results

A total of 70 lesions were finally included in the study. At the end of therapy, 18 patches (25.7%) achieved improvement, and the presence of perifollicular pigmentation on baseline dermoscopic examination was found to be associated with a 12-fold higher probability of having a positive therapeutic outcome. Similarly, face localization was also correlated with clinical amelioration, with a sevenfold higher probability for improvement. No association (p > 0.05) between therapeutic outcomes (either good or poor) and other dermoscopic or local clinical variables (including leukotrichia) was observed.

Conclusions

Therapeutic response of vitiligo to Nb-UVB phototherapy may be positively affected by local features of the lesions, i.e., face localization and presence of perifollicular pigmentation on baseline dermoscopic examination, which might be considered as positive response predictor factors to optimize treatment of vitiligo.
Literature
1.
go back to reference Krüger C, Schallreuter KU. A review of the worldwide prevalence of vitiligo in children/adolescents and adults. Int J Dermatol. 2012;51:1206–12.CrossRef Krüger C, Schallreuter KU. A review of the worldwide prevalence of vitiligo in children/adolescents and adults. Int J Dermatol. 2012;51:1206–12.CrossRef
3.
4.
go back to reference Njoo MD, Westerhof W. Vitiligo: pathogenesis and treatment. Am J Clin Dermatol. 2001;2:167–81.CrossRef Njoo MD, Westerhof W. Vitiligo: pathogenesis and treatment. Am J Clin Dermatol. 2001;2:167–81.CrossRef
5.
go back to reference Stinco G, Trevisan G, Buligan C, Gregoraci G, De Marchi S, di Meo N, Patrone P. Narrow band-ultraviolet B versus clobetasol propionate foam in the treatment of vitiligo: a retrospective study. Dermatol Ther (Heidelb). 2013;3:95–105.CrossRef Stinco G, Trevisan G, Buligan C, Gregoraci G, De Marchi S, di Meo N, Patrone P. Narrow band-ultraviolet B versus clobetasol propionate foam in the treatment of vitiligo: a retrospective study. Dermatol Ther (Heidelb). 2013;3:95–105.CrossRef
6.
go back to reference Stinco G, Buligan C, Grimaldi F, Valent F, Patrone P. Serological screening for autoimmune polyendocrine syndromes in patients with vitiligo. J Eur Acad Dermatol Venereol. 2012;26:1041–2.CrossRef Stinco G, Buligan C, Grimaldi F, Valent F, Patrone P. Serological screening for autoimmune polyendocrine syndromes in patients with vitiligo. J Eur Acad Dermatol Venereol. 2012;26:1041–2.CrossRef
7.
go back to reference Bae JM, Jung HM, Hong BY, et al. Phototherapy for vitiligo, a systematic review and meta-analysis. JAMA Dermatol. 2017;153:666–74.CrossRef Bae JM, Jung HM, Hong BY, et al. Phototherapy for vitiligo, a systematic review and meta-analysis. JAMA Dermatol. 2017;153:666–74.CrossRef
8.
go back to reference Alkhateeb A, Fain PR, Thody A, Bennett DC, Spritz RA. Epidemiology of vitiligo and associated autoimmune diseases in Caucasian probands and their families. Pigment Cell Res. 2003;16:208–14.CrossRef Alkhateeb A, Fain PR, Thody A, Bennett DC, Spritz RA. Epidemiology of vitiligo and associated autoimmune diseases in Caucasian probands and their families. Pigment Cell Res. 2003;16:208–14.CrossRef
9.
go back to reference Nicolaidou E, Antoniou C, Stratigos AJ, Stefanaki C, Katsambas AD. Efficacy, predictors of response, and long-term follow-up in patients with vitiligo treated with narrowband UVB phototherapy. J Am Acad Dermatol. 2007;56:274–8.CrossRef Nicolaidou E, Antoniou C, Stratigos AJ, Stefanaki C, Katsambas AD. Efficacy, predictors of response, and long-term follow-up in patients with vitiligo treated with narrowband UVB phototherapy. J Am Acad Dermatol. 2007;56:274–8.CrossRef
10.
go back to reference Errichetti E, Lallas A, Apalla Z, Di Stefani A, Stinco G. Dermoscopy of granuloma annulare: a clinical and histological correlation study. Dermatology. 2017;233:74–9.CrossRef Errichetti E, Lallas A, Apalla Z, Di Stefani A, Stinco G. Dermoscopy of granuloma annulare: a clinical and histological correlation study. Dermatology. 2017;233:74–9.CrossRef
11.
go back to reference Errichetti E, Piccirillo A, Stinco G. Dermoscopy as an auxiliary tool in the differentiation of the main types of erythroderma due to dermatological disorders. Int J Dermatol. 2016;55:e616–e618618.CrossRef Errichetti E, Piccirillo A, Stinco G. Dermoscopy as an auxiliary tool in the differentiation of the main types of erythroderma due to dermatological disorders. Int J Dermatol. 2016;55:e616–e618618.CrossRef
12.
go back to reference Errichetti E, Piccirillo A, Viola L, Stinco G. Dermoscopy of subacute cutaneous lupus erythematosus. Int J Dermatol. 2016;55:e605–e607607.CrossRef Errichetti E, Piccirillo A, Viola L, Stinco G. Dermoscopy of subacute cutaneous lupus erythematosus. Int J Dermatol. 2016;55:e605–e607607.CrossRef
13.
go back to reference Errichetti E, De Francesco V, Pegolo E, Stinco G. Dermoscopy of Grover's disease: variability according to histological subtype. J Dermatol. 2016;43:937–9.CrossRef Errichetti E, De Francesco V, Pegolo E, Stinco G. Dermoscopy of Grover's disease: variability according to histological subtype. J Dermatol. 2016;43:937–9.CrossRef
14.
go back to reference Errichetti E, Stinco G. Dermatoscopy of granulomatous disorders. Dermatol Clin. 2018;36:369–75.CrossRef Errichetti E, Stinco G. Dermatoscopy of granulomatous disorders. Dermatol Clin. 2018;36:369–75.CrossRef
15.
go back to reference Errichetti E, Stinco G. Dermoscopy in differentiating palmar syphiloderm from palmar papular psoriasis. Int J STD AIDS. 2017;28:1461–3.CrossRef Errichetti E, Stinco G. Dermoscopy in differentiating palmar syphiloderm from palmar papular psoriasis. Int J STD AIDS. 2017;28:1461–3.CrossRef
16.
go back to reference Errichetti E. Dermoscopy of inflammatory dermatoses (inflammoscopy): an up-to-date overview. Dermatol Pract Concept. 2019;9:169–80.CrossRef Errichetti E. Dermoscopy of inflammatory dermatoses (inflammoscopy): an up-to-date overview. Dermatol Pract Concept. 2019;9:169–80.CrossRef
17.
go back to reference Chuh AAT, Zawar V. Demonstration of residual perifollicular pigmentation in localized vitiligo—a reverse and novel application of digital epiluminescence dermoscopy. Comput Med Imaging Graph. 2004;28:213–7.CrossRef Chuh AAT, Zawar V. Demonstration of residual perifollicular pigmentation in localized vitiligo—a reverse and novel application of digital epiluminescence dermoscopy. Comput Med Imaging Graph. 2004;28:213–7.CrossRef
18.
go back to reference Jha AK, Sonthalia S, Lallas A. Dermoscopy as an evolving tool to assess vitiligo activity. J Am Acad Dermatol. 2018;78:1017–9.CrossRef Jha AK, Sonthalia S, Lallas A. Dermoscopy as an evolving tool to assess vitiligo activity. J Am Acad Dermatol. 2018;78:1017–9.CrossRef
19.
go back to reference Errichetti E, Stinco G. Dermoscopy in general dermatology: a practical overview. Dermatol Ther (Heidelb). 2016;6:471–507.CrossRef Errichetti E, Stinco G. Dermoscopy in general dermatology: a practical overview. Dermatol Ther (Heidelb). 2016;6:471–507.CrossRef
20.
go back to reference Thatte S, Khopkar U. The utility of dermoscopy in the diagnosis of evolving lesions of vitiligo. Indian J Dermatol Venereol Leprol. 2014;80:505.CrossRef Thatte S, Khopkar U. The utility of dermoscopy in the diagnosis of evolving lesions of vitiligo. Indian J Dermatol Venereol Leprol. 2014;80:505.CrossRef
21.
go back to reference Mohammad TF, Al-Jamal M, Hamzavi IH, et al. The Vitiligo Working Group recommendations for narrowband ultraviolet B light phototherapy treatment of vitiligo. J Am Acad Dermatol. 2017;76:879–88.CrossRef Mohammad TF, Al-Jamal M, Hamzavi IH, et al. The Vitiligo Working Group recommendations for narrowband ultraviolet B light phototherapy treatment of vitiligo. J Am Acad Dermatol. 2017;76:879–88.CrossRef
22.
go back to reference Errichetti E, Zalaudek I, Kittler H, et al. Standardization of dermoscopic terminology and basic dermoscopic parameters to evaluate in general dermatology (non-neoplastic dermatoses): an expert consensus on behalf of the International Dermoscopy Society. Br J Dermatol. 2020;182:454–67.CrossRef Errichetti E, Zalaudek I, Kittler H, et al. Standardization of dermoscopic terminology and basic dermoscopic parameters to evaluate in general dermatology (non-neoplastic dermatoses): an expert consensus on behalf of the International Dermoscopy Society. Br J Dermatol. 2020;182:454–67.CrossRef
23.
go back to reference Hamzavi I, Jain H, McLean D, Shapiro J, Zeng H, Lui H. Parametric modeling of narrowband UV-B phototherapy for vitiligo using a novel quantitative tool: the Vitiligo Area Scoring Index. Arch Dermatol. 2004;140:677–83.CrossRef Hamzavi I, Jain H, McLean D, Shapiro J, Zeng H, Lui H. Parametric modeling of narrowband UV-B phototherapy for vitiligo using a novel quantitative tool: the Vitiligo Area Scoring Index. Arch Dermatol. 2004;140:677–83.CrossRef
24.
go back to reference Birlea SA, Goldstein NB, Norris DA. Repigmentation through melanocyte regeneration in Vitiligo. Dermatol Clin. 2017;35:205–18.CrossRef Birlea SA, Goldstein NB, Norris DA. Repigmentation through melanocyte regeneration in Vitiligo. Dermatol Clin. 2017;35:205–18.CrossRef
25.
go back to reference Lee JH, Fisher DE. Melanocyte stem cells as potential therapeutics in skin disorders. Expert Opin Biol Ther. 2014;14:1569–79.CrossRef Lee JH, Fisher DE. Melanocyte stem cells as potential therapeutics in skin disorders. Expert Opin Biol Ther. 2014;14:1569–79.CrossRef
26.
go back to reference Bolognia JL, Orlow SJ. Melanocyte Biology. In: Bolognia JL, Schaffer JV, Cerroni L, editors. Dermatology. 4th ed. Oxford: Elsevier; 2018. p. 1092. Bolognia JL, Orlow SJ. Melanocyte Biology. In: Bolognia JL, Schaffer JV, Cerroni L, editors. Dermatology. 4th ed. Oxford: Elsevier; 2018. p. 1092.
27.
go back to reference Lee DY, Kim CR, Park JH, Lee JH. The incidence of leukotrichia in segmental vitiligo: implication of poor response to medical treatment. Int J Dermatol. 2011;50:925–7.CrossRef Lee DY, Kim CR, Park JH, Lee JH. The incidence of leukotrichia in segmental vitiligo: implication of poor response to medical treatment. Int J Dermatol. 2011;50:925–7.CrossRef
28.
go back to reference Lee DY, Lee JH. White hairs in segmental vitiligo are related to poor response to phototherapy: demonstration with portable digital microscopy. J Dermatol. 2010;37:500–1.CrossRef Lee DY, Lee JH. White hairs in segmental vitiligo are related to poor response to phototherapy: demonstration with portable digital microscopy. J Dermatol. 2010;37:500–1.CrossRef
29.
go back to reference Song HS, Choi GS, Shin JH. Preservation of melanoblasts of white hair follicles of segmental vitiligo lesions: a preliminary study. J Eur Acad Dermatol Venereol. 2011;25:240–2.CrossRef Song HS, Choi GS, Shin JH. Preservation of melanoblasts of white hair follicles of segmental vitiligo lesions: a preliminary study. J Eur Acad Dermatol Venereol. 2011;25:240–2.CrossRef
30.
go back to reference Jee HJ, Do JE, Noh S, Park SH, Oh SH. Leukotrichia in stable segmental vitiligo: implication of an alternate treatment option. Ann Dermatol. 2014;26:132–4.CrossRef Jee HJ, Do JE, Noh S, Park SH, Oh SH. Leukotrichia in stable segmental vitiligo: implication of an alternate treatment option. Ann Dermatol. 2014;26:132–4.CrossRef
31.
go back to reference Kim MS, Cho EB, Park EJ, Kim KJH, Kim KJH. Effect of excimer laser treatment on vitiliginous areas with leukotrichia after confirmation by dermoscopy. Int J Dermatol. 2016;55:886–92.CrossRef Kim MS, Cho EB, Park EJ, Kim KJH, Kim KJH. Effect of excimer laser treatment on vitiliginous areas with leukotrichia after confirmation by dermoscopy. Int J Dermatol. 2016;55:886–92.CrossRef
Metadata
Title
Dermoscopic and Clinical Response Predictor Factors in Nonsegmental Vitiligo Treated with Narrowband Ultraviolet B Phototherapy: A Prospective Observational Study
Authors
Enzo Errichetti
Enrico Zelin
Caterina Pinzani
Athanassios Kyrgidis
Aimilios Lallas
Giuseppe Stinco
Publication date
01-10-2020
Publisher
Springer Healthcare
Published in
Dermatology and Therapy / Issue 5/2020
Print ISSN: 2193-8210
Electronic ISSN: 2190-9172
DOI
https://doi.org/10.1007/s13555-020-00431-6

Other articles of this Issue 5/2020

Dermatology and Therapy 5/2020 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.