In vitro culture of melanocytes from segmental vitiligo-like nevus depigmentosus lesions and its clinical significance / 中华皮肤科杂志

Objective:To assess the value of culture of epidermal melanocytes from negative-pressure suction blisters in the auxiliary diagnosis of segmental vitiligo-like nevus depigmentosus.Methods:Between June 2019 and March 2020, 8 patients with segmental vitiligo-like nevus depigmentosus, who met the Coupe′s clinical diagnostic criteria, were enrolled from Department of Dermatology, Hangzhou Third People′s Hospital. All patients were evaluated by the Wood′s lamp, reflectance confocal microscopy (RCM) , 308-nm excimer laser radiation, and in vitro culture of epidermal melanocytes from negative-pressure suction blisters. Results:Among the 8 patients, fluorescence was observed in 6 under the Wood′s lamp, dermal papillary rings were incomplete or absent in 4 as shown by RCM, and 5 experienced no repigmentation after 308-nm excimer laser radiation. Among the 8 patients, in vitro cultured lesional melanocytes were all positive for ferrous sulfate staining, yellowish-white precipitates were obtained after digestion and centrifugation of the melanocytes, and stage Ⅰ-Ⅲ melanosomes were observed in the cytoplasm of melanocytes under the electron microscope; however, the precipitates were black in color after digestion and centrifugation of the melanocytes collected from the normal skin tissues at the contralateral anatomical site, and stageⅠ-Ⅳ melanosomes were seen in the cytoplasm of the melanocytes under the electron microscope. Conclusion:Culture of epidermal melanocytes from negative-pressure suction blisters may facilitate the diagnosis of segmental vitiligo-like nevus depigmentosus.

Vitiligo Coexistent with Nevus Depigmentosus: This Was Treated with Narrow-Band UVB and These Lesions Were Followed Using the Mexameter(R), a Pigment-Measuring Device

Nevus depigmentosus (ND) is a congenital, non-progressive, hypopigmented lesion that is usually stable throughout an affected individual's lifetime. The clinical features of vitiligo are similar to those of ND, but the two diseases have different treatment responses and prognoses. We report here on a rare case of vitiligo that was coexistent with ND. Both conditions were treated with narrow-band UVB. An 11-year-old boy presented with two distinct types of hypopigmented lesions, one on the forehead and the other on his back. The first was a hypopigmented patch with leukotrichia, and it was incidentally discovered 3 months before the child was examined at our clinic and it had rapidly increased in size. The second hypopigmented patch was detected at birth and it had slowly been increasing in size. The hypopigmented lesion on the child's forehead was diagnosed as vitiligo, and the one on his back as ND. Once- or twice-weekly narrow-band UVB treatment was initiated. Improvements in the two lesions were assessed with clinical photography and using a Mexameter(R) (Courage-Khazaka Electronic, Germany), which is a pigment-measuring device.

A Case of Multiple Cafe-au-lait Spots with Nevus Depigmentosus and Hemangioma / 대한피부과학회지

When 6 or more Cafe-au-lait spots(CALS) tend to be randomly and widely distributed, we must rule out neurofibromatosis(NF). Nevus depigmentosus is a congenital nonprogressive hypopigmented patch that shows histologically decreased pigmentation while CALS shows increased pigmentation. We report a case of a 16-month-old girl showing generalized multiple cafe-au-lait spots with segmental nevus depigmentosus and capillary hemangioma on her right upper back. A possible explanation for the co-occurrence of CALS and nevus depigmentosus could be the concept of mosaicism.

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.

Study of Vitiligo and Nevus Depigmentosus in Children by Clinical Evaluation and DOPA Staining / 대한피부과학회지

We performed analysis of 79 childhood patients diagnosed as vitiligo and nevus depigmentosus in Tediatric Dermatologie Department of Seoul National University Hospital from March 1987 to September 1987. The results were as follows : 1. Of the 79 patients, 31 patients(39.2%) were vitiligo 21 patients(26.6% )were nevus depigmentosus and 27 patients(34.2%)were uncertain by cliniral diagnostic ctriteri.. 2. Viiligo began rarely in infancy(6.4% )and most appeared evenly in all childhood over 1 year old. Nevus clepigmentosus was present at birth in 57.1% of patients and was discovered within the first 6 months after birth in 42.9% of patients. 3. In vitiligo, most lesions were multiple. The most common site of involvement was the face, and there was this tendency of periorficial predisposition. In nevus ciepigmentosus, most lesions were solitary. The most, common aites of involvement were the lowed limbs and trunk, but there was no tendency of periorfcial presposition. 4. We found focal type of vitiligo in,51,6% of patients, vulgaris type in 32. 3 % acrofacial type in 9.6% and segmerital type in 6.5%. We also found isolated pattern of nevus clepigrnento us in 76.2% of patients, ciermatomal p<:ttern in 19.0ki and whorlec1 pattern in 4.8% The contrast enhiancement between the hypopigmented skin and nomal surrounding skin by Wood's light, examinatior reflected the epiclermal melanin pig merit, i. e., the more marked loss of pigmentation, the more accentuatian of the contrast The before, Wood's light examination without I:3OPA staining could help to ciiagnose the atisculte type of vitiligo showing eidermal melanocytes and nevu c.Iepigmeritosus.