Clinical course of segmental vitiligo: a retrospective study of eighty-seven patients

Abstract

Background: Vitiligo is an acquired disorder characterized by a progressive loss of melanocytes, which is difficult to manage and has an unknown prognosis. The subtype of segmental vitiligo (SV) has been established but it has not been adequately characterized.

Objective: To collect long-term follow-up data for evaluating the clinical course of SV.

Methods: This study included 87 patients who were diagnosed with SV and were monitored at a clinic. Patients were classified into the following three groups according to disease activity.

Results: Among the patients with SV, 63.2% had stable disease, 14.9% had disease recurrence between two and four years after disease onset, and 21.8% had disease recurrence at four or more than four years after disease onset. Among the 44 patients (50.2%) who were monitored continuously over a four-year period, 19 (43.2%) experienced a recurrence at four or more than four years after disease onset.

Conclusion: Our results suggest that, contrary to previous reports, some patients with SV may not experience disease stability over an extended period of time. Disease recurrence can occur after years of stability, and we propose that long-term follow-up data can be used to characterize SV. This information about the clinical course of SV has implications for treatment and prognosis.

Keywords: Prognosis; Recurrence; Segmental; Vitiligo.

Fig. 1

Segmental vitiligo. Disease activity could be confirmed by a photo review. The black arrows in photos indicate sites of recurrence after a period of stability. (A, B) Male/13 years old (onset: at 8 years of age). The patient hadwhite patches on the lower eyelid and perinasal area and the lesions progressed to the cheek after five years. (C, D) Male/19 years old (onset: at 12 years of age). The patient had a white patch on the left of neck and the lesions progressed to the right side after six years. (E, F) Female/16 years old (onset: at 4 years of age). She had been in a stable state for 10 years and visited the clinic for a recurrence at 15 years of age (E) and the lesions was progressing for one year (F). (G, H) Male/22 years old (onset: at 16 years of age). The patient had a white patch on the right side of the chin and the lesions progressed to the neck after four years. (I, J) Male/8 years old (onset: at 2 years of age). The patient had white patches on the inguinal area and the lesions progressed to the lateral side of thigh after five years.

Fig. 2

Duration of the disease, length of the observation period and time to recurrence in individual cases.