Dermatoscopic markers of disease activity in vitiligo

Determining vitiligo activity is essential for prognosis and treatment planning.

To describe the dermoscopic findings and correlate them with the activity of the disease.

A single-center, descriptive, analytical study included 233 patients (330 lesions). Lesions were categorized as progressing, repigmenting, stable, or recent. Dermoscopic analysis was performed using a DermLite 4 dermatoscope, with statistical testing through Pearson's chi-square.

Progressing lesions were associated with trichrome pattern, reverse network, nacreous white globules, starburst, comet-tail pattern, micro-Koebner phenomenon, residual peripilar pigmentation with leukotrichia, perilesional polka dots, perifollicular depigmentation, and reverse network (P < .01). Stability was indicated by sharp borders (P < .01). Repigmenting lesions exhibited perifollicular or border hyperpigmentation, erythema, and telangiectasias (P < .01). Early vitiligo was suggested by hypopigmented lesions with attenuated network or perifollicular depigmentation (P < .01). Newly identified markers included distally pigmented bicolored hair for recent lesions and proximally pigmented bicolored hair for repigmentation.

Most patients had prior treatment, potentially influencing dermoscopic patterns.

This study, based on a large sample size, identifies specific dermoscopic markers for vitiligo activity and introduces novel findings like bicolored hairs. These insights can refine clinical assessment and serve as a foundation for future research.