Abstract:

Liu Tao*, Xu Ai′e. *Department of Dermatology, Hangzhou Clinical College Affiliated to Anhui Medical University, Hangzhou 310009, China Corresponding author: Xu Ai′e, Email: xuaiehz@msn.com 【Abstract】 Objective To determine the stage of vitiligo according to clinical and skin computed tomography （CT） features. Methods The stage of vitiligo was determined in 200 patients according to a questionnaire-based analysis of clinical features and skin CT findings respectively. Rapid progressive stage was defined as the score for vitiligous lesions or CT findings being higher than 2, slow progressive stage as the score varying from 1 to 2, and stable stage as the score less than 1. Skin samples were obtained at lesional sites receiving CT examination from 5 patients with progressive and 5 patients with stable vitiligo, and subjected to hematoxylin-eosin （HE） staining. Results No significant difference was observed between staging results based on clinical features and skin CT findings. The patients diagnosed with progressive vitiligo based on clinical features presented with grey-white or pale white patches with elevated or obscure boundaries, or trichrome vitiligo, while those with stable vitiligo presented with milky-white or porcelain-white lesions with sharp boundaries and pigmented islands. As CT showed, progressive vitiligo was characterized by a loss of integrity in dermal papillary rings at the dermo-epidermal junction level, obscure boundaries between vitiligo lesions and surrounding normal skin, presence of highly refractive cells at the dermo-epidermal junction level in the margins of vitiligo lesions, while stable vitiligo characterized by complete absence of dermal papillary rings at the dermo-epidermal junction level, sharp boundaries between the lesions and surrounding normal skin, and presence of highly refractive dendritic melanocytes. HE staining showed plenty of CD8+ T lymphocytes in the papillary dermis in the margins of progressive vitiligo lesions, but no CD8+ T lymphocyte was seen in those of stable vitiligo lesions. Conclusions Both clinical and skin CT features can be used to determine the stage of vitiligo, and the staging results are consistent with those based on histopathological findings.