The classification of segmental vitiligo on the face

Segmental vitiligo usually has an onset early in life and spreads rapidly within the affected area. Among 1,300 patients with vitiligo, 191 patients with segmental vitiligo involving the face were evaluated. In this study, the distribution of segmental vitiligo on the face could be classified into 5 patterns which have distinctive features. This classification of facial segmental vitiligo can provide some indication of the future distribution of early lesions if they have begun to spread.

Bilateral Segmental Vitiligo

Segmental vitiligo is considered to be characterized by unilateral depigmented patches along dermatomes, but we found two cases of segmental vitiligo in which the vitiligo lesions appeared bilaterally on the same or different dermatomes. The clinical course of bilateral segmental vitiligo seems to be the same as that of unilateral segmental vitiligo.

Differences in Expression of HLA Antigens among Subtypes of Vitiligo / 대한피부과학회지

BACKGROUND: Vitiligo is an acquired disorder with destruction of melanocytes and is clinically characterized by depigmented patches of skin. The pathogenesis of vitiligo is still unclear, but melanocyte self destruction, neurohumoral factors, autoimmunity and inherent cellular defects have all been proposed as possible etiological factors. OBJECTIVE: The purpose of this study was to find out the differences in expression of HLA antigens among subtypes of vitiligo according to classification, onset and family history and then to disclose the pathogenesis of vitiligo in view of genetic and autoimmunological aspects. METHODS: We investigated HLA-A, B, C, DR in subgroups of 87 vitiligo patients according to type, onset, and family history. Results : 1. There were no HLA antigens with significantly increased frequency in vitiligo patients compared to the control group. 2. There was a significant increase in frequency of HLA-DRl2 in patients of non-segmental vitiligo with a family history ; an increase in frequency of HLA Cw2 in patients without a family history ; and a significant increase in frequency of HLA-DRl2 in all patients of non-segmental vitiligo compared to the control group.(p(c)<0.05). 3. The frequency of HLA-B63 was significantly increased in all patients of segmental vitiligo compared to the control group(p(c)<0.05), but there were no HLA antigens with significantly increased frequency in patients of subgroups of segmental vitiligo divided by the presence or absence of a family history of vitiligo. 4. The frequency of HLA-B54 was significantly increased in all vitiligo patients with a family history(p(c)0.05) but there were no HLA antigens with significantly increased frequency in all vitiligo patients without a family history. 5. There were no HLA antigens with significantly increased frequency in vitiligo patients subgrouped by age of onset (less or over 16 years) of disease. Conclusion : From the above results, we can assume that non-segmental vitiligo may have autoimmune mechanisms in the pathogenesis, as there was a significant increase in HLA-DRl2 in patients with non-segmental vitiligo.

Clinical Features and Histopathological Characteristics of Nevus Depigmentosus / 대한피부과학회지

BACKGROUND: Nevus depigmentosus was first reported in 1884 by Lesser. It is defined as a congenital non-progressive hypopigmented macule or patch that is stable in its relative size and distribution throughout the life of the individual. The etiopathogenesis and histopathological characteristics of nevus depigmentosus are not fully established. OBJECT: The purpose of this study is to investigate the clinical and histopathological characteristics and pathogenesis of nevus depigmentosus. METHODS: Clinieal survey was carried out on forty-nine patients with nevus depigmentosus and two skin biopsies were taken from eighteen patients; from the central part of the depigmented lesion and the border of the lesion including the perilesional normal skin. The sections were stained with hematoxylin-eosin, Fontana-Masson and S-100 protein. The ultrastructural evaluation were also done to detect alternation of melanocytes. RESULTS: The results are as follows ; 1. The lesions were mostly (91.8%) present before the age of three, but some lesions appeared in childhood (8.2%). 2. The lesions were most frequently found on the trunk (42.9%), followed by the face and scalp (20.4%). 3. There were 33 patients (67.3%) with the isolated type, 15 patients (30.6%) with the dermatomal type and one patient with the whorled type. 4. Histopathological studies have shown that the stainability of Fontana-Masson in the lesions of nevus depigmentosus was decreased compared with perilesional nomal skin, but there were no changes in the number of melanocytes. 5. There was a great reduction in the number of melanosomes in melanocytes and keratinocytes of nevus depigmentosus. In keratinocytes, there was some aggregations of melanosomes and some of them showed membrane bound architecture. CONCLUSION: The results of this study support the fact that nevus depigmentosus is caused by functional defects of melanocytes and morphological abnonnalities of melanosomes.

Clinical Features of Vitiligo

Vitiligo is a relatively common depigmentary disorder occurring in approximately 1-2% of the general population. All races are affected. Both sexes are likely to be affected equally; the female prevalence in some studies can probably be attributed to cosmetic reasons. It can occur and spread at any stage of life and is often associated with a positive family history. Up to 30 percent of patients have reported vitiligo in another family member. The lesion is characterized by discrete, pale-white macules, few or several in number, which tend to enlarge centrifugally over time. It is not contagious, nor is it a serious health problem. However, it can be troublesome in brown and black people as well as in white persons who tan deeply (skin phototype IV), and often leads to social embarrassment and psychological turmoil.

A Case of Primary Cutaneous Plasmacytoma

A 66-year-old female patient had a firm, non-tender, dome shaped mass on the scalp. The lesion had enlarged slowly for 2 years, and measured about 4 × 6 cm. The histologic finding of the skin biopsy specimen demonstrated an infiltration of immature plasma cells in the dermis, which express monoclonal cytoplasmic lambda light chain by immunohistochemical stainings, and staging work-up after the biopsy revealed no evidence of disease in other foci. The mass on the scalp was treated successfully by radiation therapy, with the diagnosis of primary cutaneous plasmacytoma.