Abstract:

Objective To investigate the early diagnosis of vitiligo and its differential diagnosis from other depigmentated diseases using polarized light dermoscopy （PD） imaging analysis. Methods Patients with localized depigmented macules were enrolled into this study. PD was used to observe the micromorphology, feature and color of skin lesions. Histopathology was performed to confirm the diagnosis of all cases except for those of pityriasis versicolor which were confirmed by clinical and laboratory examination. Results Of the 176 patients, 97 were diagnosed as vitiligo. Residual perifollicular pigmentation was observed in 91.94% （57/62） of patients with progressing vitiligo and 62.86% （22/35） of those with stable vitiligo, with significant difference between the two groups of patients （P < 0.05）. However, residual perifollicular pigmentation was absent in the 79 non-vitiligo depigmented cases. The presence of telangiectasia, early reservoirs of pigmentation and perilesional hyperpigmentation were related to the stage of vitiligo and treatment history of patients. Conclusions PD, which efficiently eliminates the interference of reflected light on skin lesions of vililigo, is an imaging technique that allows for the visualization of minor structures and features of the skin lesions that are indiscernible to naked eyes. In a nutshell, the application of PD has offered references to the early diagnosis of vitiligo and its differential diagnosis from other depigmentation diseases.