Abstract
Background: Vitiligo, also called leukoderma, is either an acquired or familial, but highly complex pigmentation disorder in which melanocytes, the principle pigment-producing cells in humans, are destroyed. Affecting 0.5%-1% of population worldwide, vitiligo can be a highly disfiguring disorder that is characterized by the development of smooth and porcelain-white patches of skin devoid of protective melanin pigmentation.
Methods: This was an cross-sectional study during a period from 2017 to 2018 including 52 clinically diagnosed vitiligo patients. Patient were clinically evaluated and a proper history was taken including patient’s age, sex, site, duration, family history, area of community, itching, associated endocrine disorder, associated skin disorder, and clinically examined for the morphological distribution, pattern, and border of the lesion, and looked for signs such as erythema, koebner phenomenon, leukotrichia.
Results: More than one third of patients were between 20-30 years of age (38.5%). More than half of patients were females (57.7%). The duration of disease was 12-60 months (Sub acute phase/Intermediate lesion) among more than half of patients (57.7%). Vitiligo vulgaris clinical diagnosis was among more than half of patients (55.8%) followed by Generalised & Segmental (17.3%) and Acrofacial vitiligo (9.6%).Diabetes mellitus was among 11.5% patients and Thyroid disorder was in 7.7% patients. On histological aspect Hypomelanosis and Monodermal cells infiltrate was among majority of patients 86.5% and 76.9% respectively followed by Suprabasal vacuolization was 53.8%.
Conclusion: This study indicates the correlation of various pathological alterations with clinical features of vitiligo patients.
Keywords: Vitiligo, Clinical, Histopathological.
References
- Picardo M., TaiiebA :Vitiligo. Heidelberg: Springer; 2010.
- Alikhan A, Felsten LM, Daly M, Petronic-Rosic V. Vitiligo: A comprehensive overview Part 1. Introduction, epidemiology, quality of life, diagnosis, differential diagnosis, associations, histopathology, etiology, and work up. J Am Acad Dermatol. 2011;65:473–491.
- Spritz RA. The genetics of generalized vitiligo and associated autoimmune diseases. J Dermatol Science. 2006;41:3–10.
- Cui J, Shen L, Wang G. Role of hair follicles in the repigmentation of vitiligo. J Invest Dermatol. 1991;97:410-16.
- Abdel-Naser MB, Krüger-Krasagakes S, Krasagakis K, Gollnick H, Abdel-Fattah A, Orfanos CE. Further evidence for involvement of both cell mediated and humoral immunity in generalized vitiligo. Pigment Cell Res. 1994;7:1-8.
- Tobin DJ, Swanson NN, Pittelkow MR, Peters EM, Schallreuter KU. Melanocytes are not absent in lesional skin of long duration vitiligo. J Pathol. 2000;191:407-16.
- PrettiAslanian F, Filgueira A, Cuzzi T, Vergier B. Histopathology. In: Picardo M, Taïeb A (eds.). Vitiligo.Springer-Verlag, Berlin; 2010; p. 25-32.
- Ordóñez NG. Value of melanocytic-associated immunohistochemical markers in the diagnosis of malignant melanoma: a review and update. Hum Pathol. 2014; 45:191-205.
- Singh Suman, Usha and PandeyShyam Sunder. Epidemiological profile of vitiligo in Northern India. Journal of Applied Pharmaceutical Science 01 (10); 2011: 211-214.
- Rajpal S, Atal R, Palaian S, PrabhuS . Clinical Profile And Management Pattern Of Vitiligo Patients In A Teaching Hospital In Western Nepal. Journal of Clinical and Diagnostic Research
- Arycan O, Koç K, Ersoy L. Clinical characteristics in 113 Turkish vitiligo patients. Acta Dermatoven 2008; 17: 129 – 32.
- Kovacs SO. Vitiligo. J Am AcadDermatol 1998;38:647-66
- Al-Mutairi N& Sharma AK. Profile of vitiligo in Farwaniya region in Kuwait. Kuwait Medical Journal. 2006; 38:128-131
- Shajil EM, Agarwal D, Vagadia K, Marfatia YS, Begum R. Vitiligo: clinical profiles in Vadodara, Gujarat. Indian J Dermatol. 2006; 51: 100-104.
- Nunes DH &Esser LMH. Vitiligo epidemiological profile and the association with thyroid disease. An Bras Dermatol. 2011; 86: 241-248.
- Jaishankar TJ, Baruah MC, Garg BR. Vitiligo in children. Int J Dermatol 1992;31:621-623.
- Chanda M, Dey SK, Gangopadhyay DN. Thyroid function in vitiligo. Indian J Dermatol 1996; 41: 125 – 28.
- Martis J, BhatR, Nandakishore B, Shetty JN. A clinical study of vitiligo. Indian J DermatolVenereolLeprol 2002; 68: 92‐
- Reghu R. & James E. Epidemiological profile and treatment pattern of vitiligo in a tertiary care teaching hospital. Int J Pharm Sci.2011; 3: 137-141.
- Handa S &Dogra S. Epidemiology of Childhood Vitiligo: A Study of 625 Patients from North India. Pediatr Dermatol 2003; 20: 207–10.
- Handa S &Kaur I. vitiligo: clinical findings in 1436 patients. J Dermatol.1999; 26: 653-657.
- Agarwal S, Ojha A, Gupta S. Profile of vitiligo in Kumaun region of Uttarakhand, India. Indian J Dermatol 2014;59:209
- Van Geel N, Speeckaert R, De Wolf J, Bracke S, Chevolet I, Brochez L, Lambert J.Clinical significance of Koebner phenomenon in vitiligo. Br J Dermatol. 2012 Nov;167(5).
- Osman AM, Elkordufani Y, Abdullah MA. The Socio-demography and Clinical Profile of Vitiligo in Sudan. Sudan Journal of Medical Science Vol. 3 (4) 2008: pp. 301-307
- Gopal K, Rama Rao GR, Kumar YH, AppaRao MV, Vasudev PS. Vitiligo: A part of a systemic autoimmune process. Indian J DermatolVenereolLeprol 2007; 73: 162-165.
- Arycan O, Koç K, Ersoy L. Clinical characteristics in 113 Turkish vitiligo patients. Acta Dermatoven 2008; 17: 129 – 32.
- Huggins RH, Janusz CA, Schwartz RA. Vitiligo: A sign of systemic disease. Indian J Dermatol Venereol Leprol. 2006; 72: 68-71.
- Reghu R. & James E. Epidemiological profile and treatment pattern of vitiligo in a tertiary care teaching hospital. Int J Pharm Sci.2011; 3: 137-141.
- Leopold F. Montes, Jorge Abulafia, Walter H. Wilborn,Barbara M. Hyde, Carolina M. Montes.Value of histopathology in vitiligo. IJD 2003; 42 (1): 57-61.
- Garcia-Romero MT, Esmeralda OSP, Marisol DL, Sonia TC, Maria LNR (2012) Chronic Actinic Damage in Pigmented and Depigmented Skin of Hispanic Patients with Vitiligo: Clinical and Histological Differences. J ClinExpDermatol Res 3:154.
- NagaralGirish V., Karibasappa. A study on histopathological changes in lesions of vitiligo in Karnataka population. Int J Res Dermatol. 2017 Mar;3(1):94-96.
- Attili VR, Attili SK. Segmental and generalized vitiligo: Both forms demonstrate inflammatory histopatho-logical features and clinical mosaicism. Indian J Dermatol 2013;58:433-8.
- Anisha B Patel. Clinicopathological correlation of acquired hypopigmentary disorders. Symposium dermatopathology 2013;79:376-382.
- Gokhale, BB., Mehta, LN. (1983). Histopathology of Vitiliginous Skin. International Journal of Dermatology, Vol. 22, No. 8 (Oct 1983), pp.477-80, 0011-905.
Corresponding Author
Dr. Vivek Gupta, MD
Professor and Head of Department, Department Of Pathology, Hind Institute Of Medical Sciences, Safedabad, Barabanki, U.P.225003.
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