Vitiligo in equine: a four-year case study of a roan horse - case report / [Vitiligo em equinos: um estudo de caso de quatro anos de um cavalo roan - relato de caso]

Vitiligo is a dermatological disease affecting both animals and humans. It is characterized by depigmented macules of varying shape and size, originated from melanocyte destruction. Even though there are some theories tackling causation, disease etiopathology is not yet certain. Moreover, lesion areas can either increase or diminish over time, and therefore, available treatment alternatives tend to prove inconsistencies. No epidemiological data or registered cases were found for equines in Brazil. The horse in this case description displayed depigmentation areas in facial regions, including upper lip, nose and lips. However, the individual did not happen to develop any systemic alteration. Through clinical evaluation, backed by a histopathological exam, a definitive vitiligo diagnosis was obtained. However, no therapeutic plan was stipulated. The animal was accompanied for four years, during which period some affected areas diminished while others increased in size. In addition, emergence of new skin lesions was also observed during the time the animal was studied. Overall, this disease does not display alterations to organism functionality, only aesthetic changes. Therefore, treatment plans may vary from case to case, occasionally being even ruled out.(AU)

O vitiligo é uma doença dermatológica que pode afetar animais e humanos. Caracteriza-se por áreas despigmentadas, de formas e tamanhos variáveis, que surgem devido a destruição dos melanócitos. Existem algumas teorias que tentam explicar a etiopatogenia da doença, entretanto ainda não é totalmente esclarecida. As lesões podem aumentar ou diminuir com o tempo, por isso os tratamentos disponíveis são inconsistentes. Não foram encontrados dados epidemiológicos ou relatos de vitiligo em cavalos no Brasil. O equino deste relato apresentava lesões despigmentadas na região da face, incluindo pálpebras, narina e lábios, sem alterações sistêmicas. Por meio da avaliação clínica em conjunto com o exame histopatológico obteve-se o diagnóstico definitivo de vitiligo. Não foi instituído nenhuma terapia, e o equino foi acompanhado durante quatro anos. Durante esse período algumas lesões diminuíram e outras aumentaram de tamanho sendo também observado o aparecimento de novas lesões. O vitiligo não traz alterações sistêmicas, apenas mudanças estéticas, por isso a escolha pelo tratamento dependerá de cada caso.(AU)

Patrón cutáneo pigmentario de disposición lineal en un niño, vitíligo segmentario vs. hipomelanosis de Ito / Linear disposition pigmentary skin pattern in a child, segmental vitiligo vs. Hypomelanosis of Ito

Introducción: algunas enfermedades dermatológicas siguen disposición con patrones lineales. Con hipopigmentación en la infancia se encuentran el vitíligo segmentario, que sigue los dermatomas, aunque puede seguir las líneas de Blaschko y la hipomelanosis de Ito, que a su vez sigue las líneas de Blaschko. Estas dermatosis son infrecuentes en la práctica dermatólogica. Objetivo: profundizar en los elementos diagnósticos que permiten diferenciar dos dermatosis clínicamente caracterizadas por hipopigmentación segmentaria lineal de tipo blaschkoide y el tratamiento. Presentación del caso: a la consulta de Genodermatosis en Las Tunas acude un niño con máculas acrómicas en hemicuerpo izquierdo, sin otras alteraciones. Después de ser evaluado por varias especialidades (Dermatología, Genética, Pediatría, Oftalmología y Neurología), se determina que solo presentaba afectación cutánea, se le realizó biopsia de piel, que corroboró el diagnóstico de vitíligo segmentario. Conclusiones: se presenta el caso porque el vitíligo segmentario es infrecuente, sigue un patrón lineal que puede ser diferenciado de otra dermatosis infrecuente, como la hipomelanosis de Ito, y en el tratamiento es importante brindar apoyo psicológico al paciente para favorecer la obtención de mejores resultados con la Melagenina Plus(AU)

Introduction: some dermatological diseases are still available with linear patterns. In childhood with hypopigmentation can be found segmental vitiligo (which follows the dermatomes although it can follow the lines of Blaschko), and Hypomelanosis of Ito (which in turn follows the lines of Blaschko). These dermatoses are infrequent in dermatological practice. Objective: to deepen into the diagnostic elements that allows the differentiation of two dermatoses clinically characterized by linear segmental hypopigmentation of blaschkoid type and treatment. Case presentation: a child attends to the consultation of Genodermatoses in Las Tunas presenting acromic macules in left half of the body, without other alterations. After being evaluated by several specialties (Dermatology, Genetics, Pediatrics, Ophthalmology and Neurology), it was determined that only skin affectation was present. A skin biopsy was performed, which corroborated the diagnosis of segmental vitiligo. Conclusions: The case is presented because segmental vitiligo is infrequent, it follows a linear pattern that can be differentiated from another uncommon dermatosis, such as Hypomelanosis of Ito, and in the treatment it is important to provide psychological support to the patient to favor obtaining better results with Melagenina Plus(AU)

Association of vitíligo and autoimmune thyroiditis disease in a male adolescent with obesity / Asociación de vitiligo y tiroiditis crónica autoinmune en adolescente masculino con obesidad

El vitíligo es el trastorno despigmentante adquirido más frecuente, con una prevalencia mundial del 0.5-2%. Su mayor incidencia se produce entre los 10 y 30 años. Se asocia a trastornos tiroideos autoinmunes con presencia de anticuerpos antitiroperoxidasa hasta en un 20%. Se presenta el caso de masculino de 15 años de edad, diagnosticado con vitíligo a los 10 años de edad con seguimiento por dermatología, actualmente en tratamiento. El paciente se encuentra en seguimiento médico por obesidad. Se ha descrito asociación positiva entre vitiligo y tiroiditis autoinmune, duplicando el riesgo a los cinco años de diagnóstico concomitante a patología autoinmune previa. Teniendo en cuenta que el vitiligo precede generalmente al inicio de la disfunción tiroidea, el seguimiento periódico de pacientes con vitiligo es de gran importancia.

Vitiligo is the most common acquired depigmentation disorder with a worldwide prevalence from 0.5 to 2%. It is highest incidence occurs between the ages of 10 to 30 years old. Frequently, it is associated with autoimmune thyroid disorders and related to the presence of anti-thyroid peroxidase antibodies in 20% of the times. We present the case of 15 years old male, diagnosed with vitiligo at 10 years old with currently dermatology follow up under treatment. The patient is in medical monitoring due to obesity. It has been described an association between Vitiligo and Thyroiditis, doubling the risk of presence in five years from the concomitant diagnose to a previous autoimmune pathology. Considering that vitiligo usually precedes the onset of thyroid dysfunction, periodic monitoring in patients with this disorder it is of great importance.

Características epidemiológicas y clínicas en pacientes con vitíligo que acuden al Servicio de Dermatología del Hospital Policia Nacional del Perú Luis Nicasio Sáenz en el periodo enero a junio del 2013 / Epidemiological and clinical characteristics of patients with vitiligo attended in the Dermatology Service at the Hospital of National Police of Peru Luis Saenz Nicasio in the period January to June 2013

Objetivos: Determinar las características epidemiológicas y clínicas en pacientes con vitíligo que acuden al Hospital Policía Nacional del Perú Luis Nicasio Sáenz en el periodo de enero a junio del 2013. Introducción: A nivel mundial el vitíligo, es uno de los trastornos pigmentarios más frecuentes, caracterizado por la aparición de manchas acrómicas secundarias a la destrucción selectiva de melanocitos funcionales Se presenta a cualquier edad, apareciendo en más del 50 por ciento de los casos en menores de 20 años; y en igual proporción en mujeres y varones, siendo las mujeres más propensas a buscar tratamiento. Existe además una historia familiar positiva en al menos el 30 por ciento de los pacientes con vitíligo y es relacionada a múltiples enfermedades autoinmunes. Materiales y Métodos: Se realizó un estudio descriptivo observacional de corte transversal. Se encuestaron 71 pacientes, 2 fichas de recolección fueron eliminadas no poseer información completa. Los 69 pacientes incluidos en el estudio tenían diagnóstico clínico de vitíligo, obteniendo información sobre género, edad actual, edad de inicio, estado civil, grado de instrucción, patrón clínico, antecedentes familiares con vitíligo, y asociación con enfermedades autoinmunes. Los datos fueron sometidos a análisis estadístico en el programa SPSS 22.0 para Windows. Resultados: Se incluyeron 69 pacientes; el 46 por ciento fueron mujeres y el 54 por ciento hombres. La edad promedio fue de ±43.52 años. En el 49.3 por ciento el tiempo transcurrido desde el inicio de la enfermedad hasta el momento del examen fue en el periodo de 1 a 10 años. En el 43.5 por ciento la localización de inicio fue la cara. El 50.7 por ciento presentaron vitíligo vulgar, el 31.9 por ciento el tipo focal. El 10.1 por ciento presentó asociación con enfermedad tiroidea, y el 1.4 por ciento presentó alopecia areata. El 15.9 por ciento presentó antecedentes familiares. Conclusiones: En la población en estudio el vitíligo predominó en...

Objectives: To determine the epidemiological and clinical characteristics in patients with vitiligo who attend the Hospital Policia Nacional del Peru Luis Nicasio Saenz during the period from January to June 2013. Introduction: Vitiligo, is one of the most common pigmentary disorder worldwide, characterized by the appearance of amelanotic macules, secondary to a selective destruction of functional melanocytes. Vitiligo can onset at any age, appearing in more than 50 per cent of cases in people under 20 years old; it presents equally in men or women, the most likely to seek treatment being women. There is also a positive family history on at least 30 per cent of vitiligo patients and it exist an association to multiple autoimmune diseases. Materials and Methods: A descriptive cross-sectional study was carried out. We collect information from 71 patients, 2 records collection were eliminated for not possess complete information. The 69 patients included in the study had a clinical diagnosis of vitiligo, obtaining information on gender, current age, age of onset, marital status, level of education, clinical pattern, family history of vitiligo, and association with autoimmune diseases. The data were subjected to statistical analysis in SPSS 22.0 for Windows. Results: 69 patients were included; 46 per cent were women and 54 per cent men. The average age was 43.52 years ±. In 49.3 per cent the time passed since the onset of the disease until the time of examination was in the period of 1 to 10 years. In 43.5 per cent the most common site of onset of vitiligo lesion was the face. The 50.7 per cent of patients had vitiligo vulgaris, 3l.9 per cent had the focal type. The 10.1 per cent of patients had association with thyroid disease, and 1.4 per cent had alopecia are ataand 15.9 per cent had family history. Conclusions: In the study vitiligo predominated in males, and the most frequent clinical type was vulgar. Association with thyroid disease was found. Important to...

The utility of dermoscopy in the diagnosis of evolving lesions of vitiligo.

Background: Early lesions of vitiligo can be confused with various other causes of hypopigmentation and depigmentation. Few workers have utilized dermoscopy for the diagnosis of evolving lesions of vitiligo. Aim: To analyze the dermoscopic findings of evolving lesions in diagnosed cases of vitiligo and to correlate them histopathologically. Methods: Dermoscopy of evolving lesions in 30 diagnosed cases of vitiligo was performed using both polarized light and ultraviolet light. Result: On polarized light examination, the pigmentary network was found to be reduced in 12 (40%) of 30 patients, absent in 9 (30%), and reversed in 6 (20%) patients; 2 patients (6.7%) showed perifollicular hyperpigmentation and 1 (3.3%) had perilesional hyperpigmentation. A diffuse white glow was demonstrable in 27 (90%) of 30 patients on ultraviolet light examination. Melanocytes were either reduced in number or absent in 12 (40%) of 30 patients on histopathology. Conclusion: Pigmentary network changes, and perifollicular and perilesional hyperpigmentation on polarized light examination, and a diffuse white glow on ultraviolet light examination were noted in evolving vitiligo lesions. Histopathological examination was comparatively less reliable. Dermoscopy appears to be better than routine histopathology in the diagnosis of evolving lesions of vitiligo and can obviate the need for a skin biopsy.

The role of vitamin D in melanogenesis with an emphasis on vitiligo.

Vitiligo is a common pigmentary disorder caused by the destruction of functional melanocytes. Vitamin D is an essential hormone synthesized in the skin and is responsible for skin pigmentation. Low levels of vitamin D have been observed in vitiligo patients and in patients with other autoimmune diseases. Therefore, the relationship between vitamin D and vitiligo needs to be investigated more thoroughly. We reviewed the literature to date regarding the role of vitamin D in skin pigmentation. Our review revealed that vitamin D defi ciency has been identifi ed in many conditions, including premature and dysmature birth, pigmented skin, obesity, advanced age, and malabsorption. Vitamin D increases melanogenesis and the tyrosinase content of cultured human melanocytes by its antiapoptotic effect. However, a few growth-inhibitory effects on melanocytes were also reported. Vitamin D regulates calcium and bone metabolism, controls cell proliferation and differentiation, and exerts immunoregulatory activities. Vitamin D exerts its effect via a nuclear hormone receptor for vitamin D. The topical application of vitamin D increased the number of L-3,4-dihydroxyphenylalanine-positive melanocytes. The topical application of vitamin D yields signifi cant results when used in combination with phototherapy and ultraviolet exposure to treat vitiligo in humans. Vitamin D decreases the expression of various cytokines that cause vitiligo. In conclusion, application of vitamin D might help in preventing destruction of melanocytes thus causing vitiligo and other autoimmune disorders. The association between low vitamin D levels and the occurrence of vitiligo and other forms of autoimmunity is to be further evaluated.

Vitiligo impact scale: An instrument to assess the psychosocial burden of vitiligo.

Background : Vitiligo is a disease that significantly impairs quality of life. Previous studies have shown that vitiligo has an impact that may not correlate with the size and extent of depigmentation, indicating a need for an independent measure of the psychosocial burden. Aims : To develop a rating scale to assess the psychosocial impact of vitiligo. Methods : The study was undertaken in three broad phases: item generation, pre- and pilot testing, and test administration. Items were generated largely from a qualitative study using semi-structured interviews of patients. Face and content validity were assessed through pre- and pilot testing in 80 patients and the final version was administered to 100 patients who also received the Dermatology Life Quality Index (DLQI) and the Skindex-16. Each patient also underwent a physician global assessment (PGA) of the impact of vitiligo. Test-retest reliability was assessed in 20 patients. Results: Of 72 items initially generated for the scale, 27 were retained in the final version. Subjects were able to comprehend the items and took about 5-7 min to complete the instrument. The scale was internally consistent (Cronbach's α = 0.85). Scores on the scale correlated moderately well with the DLQI and the Skindex (Spearman rank correlation: 0.51 and 0.65, respectively). The scale was able to discriminate between patients having mild and those having moderate and severe impact as assessed by PGA. The test-retest reliability coefficient (Spearman rank correlation) was 0.80. Conclusion: The Vitiligo Impact Scale appears to be a valid measure of the psychosocial impact of vitiligo and this instrument may be useful both in the clinic and in clinical trials.

Association of alopecia areata with segmental vitiligo and segmental lichen planus: a case report

Alopecia areata [AA] is a chronic inflammatory condition that affects the hair follicles and sometimes, the nails. It is believed that AA is caused by T cell-mediated autoimmune response and increased frequency of other autoimmune diseases in persons suffering from AA supports this hypothesis. A 12-year-old boy presented with extensive alopecia areata with pitting in all nails for 6 years. He had developed lesions of vitiligo and lichen planus on trunk in a segmental manner. While the association of alopecia areata and vitiligo as well as lichen planus is well known, segmental nature of both vitiligo and lichen planus is quite rare

Impact on the quality of life of dermatological patients in southern Brazil / Impacto na qualidade de vida de pacientes dermatológicos no sul do Brasil

BACKGROUNDS: Skin diseases are extremely frequent and may affect quality of life; therefore, it is important to assess it and identify which factors are associated with it. OBJECTIVES: To assess quality of life and its associated factors in dermatological patients. METHODS: A cross-sectional study involving a sample of 548 patients seen at the Dermatology Outpatient Clinic of Sistema Único de Saúde (the Brazilian National Public Health System), University Hospital, Federal University of Rio Grande do Sul (RS). Information related to socio-demographic data, medical consultation and quality of life was collected by means of the Dermatology Life Quality Index. RESULTS: A median of 7 and a mean of 7.7 (SD = 5.0) were obtained with the Dermatology Life Quality Index. The skin diseases with higher scores on the Dermatology Life Quality Index were psoriasis (median = 15.5), vitiligo (median = 13), atopic dermatitis (median = 12) and acne (median = 10). With respect to factors associated with quality of life, it was found that younger, single patients with a low income, one skin disease and longer disease duration presented poorer quality of life. CONCLUSION: The assessment of the impact of dermatoses on patients' quality of life is important for clinical management. It is essential to detect patients at higher risk of experiencing worse quality of life in order to treat them in a more integrated way.

FUNDAMENTOS: As doenças de pele são extremamente freqüentes e os pacientes podem ter a qualidade de vida afetada. Assim é importante medi-la, bem como verificar quais os fatores que podem estar associados. OBJETIVOS: Verificar a qualidade de vida em pacientes dermatológicos e os fatores associados. MÉTODOS: Estudo tranversal com uma amostra de 548 pacientes atendidos no ambulatório de dermatologia do Sistema Único de Saúde do Hospital Universitário da Universidade Federal do Rio Grande. As informações foram coletadas em um questionário pré-codificado e referiam-se à dados sócio-demográficos, da consulta e qualidade de vida. RESULTADOS: O escore total do Dermatology Life Quality Index foi uma mediana de 7 e uma média de 7,7 (DP=5,0). As dermatoses com escore maior no Dermatology Life Quality Index foram psoríase (mediana = 15,5), vitiligo (mediana =13), dermatite atópica (mediana = 12), acne (mediana=10). Com respeito aos fatores associados à qualidade de vida, identificou-se que pacientes mais jovens, com menor renda, solteiros, com uma dermatose e com um tempo maior de evolução da doença, apresentam pior qualidade de vida. CONCLUSÃO: A avaliação do impacto na qualidade de vida em pacientes com dermatoses é importante para o manejo clínico. É essencial a detecção daqueles pacientes com maior risco de apresentar uma qualidade de vida pior, para poder abordá-los de uma forma mais integrada.

Vitiligo-epidemiological study of 4134 patients at the national center for vitiligo and psoriasis in central Saudi Arabia

To assess the clinical patterns, epidemiological profile of vitiligo, and its awareness among Saudi nationals. A retrospective study was conducted among Saudi nationals with a confirmed diagnosis of vitiligo presenting to the National Center for Vitiligo and Psoriasis, Riyadh, Saudi Arabia, from August 2002 to August 2006 using a retrospective questionnaire based on the history and medical records of patients. Of the 4134 cases, 53.5% were females. The mean age of onset of vitiligo was 17.4 years. Vitiligo vulgaris was the most common type in 42.3% of cases, 90.5% had no associated autoimmune conditions. The family history was positive in 42.8%. Twenty-nine percent developed depigmentation on multiple sites, and 68.2% over exposed areas. Nearly 1912 [46.2%] were not aware of its cause, and 2682 [64.9%] were unaware of aggravating factors. Stress as an aggravating factor was considered by 15.1%. Herbal treatments were considered very effective by 45.8%. Vitiligo is affecting Saudi women more than men with an early age of onset. Vitiligo vulgaris being the most prevalent form with a high rate of positive family history and low rate of associated autoimmune diseases. Knowledge of genetic and environmental factors affecting vitiligo is poorly conveyed and explored

Imuno-histoquímica para o diagnóstico precoce de vitiligo / Immunohistochemistry for early diagnosis of vitiligo

O vitiligo é uma doença de pele freqüente que acomete 1% da população e é caracterizada por máculas despigmentadas conseqüentes à perda progressiva e localizada dos melanócitos da epiderme. Na maioria dos pacientes, o diagnóstico é feito por exame clínico. A biópsia da pele é realizada quando há necessidade de diagnóstico diferencial com doenças hipocromiantes. O diagnóstico histopatológico de vitiligo é difícil nos preparados corados por hematoxilina e eosina (HE). Há poucos estudos sobre a melhoria da qualidade diagnóstica no vitiligo. OBJETIVO: Avaliar a utilidade dos marcadores imuno-histoquímicos proteína S-100, human melanoma black-45 (HMB-45) e Melan-A para o diagnóstico precoce em casos clinicamente suspeitos ou duvidosos de vitiligo. Material e métodos: Lâminas histológicas de biópsias de pele sã e lesada de 10 pacientes com suspeita clínica de vitiligo coradas pelos métodos de HE, proteína S-100, HMB-45 e Melan-A. Utilizou-se contracoloração com Giemsa como modificação técnica para diferenciar a melanina da imunomarcação. RESULTADOS: Seis casos, com manifestação clínica recente, apresentaram infiltrado linfocitário, do tipo dermatite de interface, na pele lesada na HE. As colorações por S-100, HMB-45 e Melan-A marcaram os melanócitos da camada basal da pele sã, e a proteína S-100 evidenciou as células de Langerhans. Na pele lesada, os melanócitos estavam ausentes ou diminuídos quando comparados com a pele normal. A proteína S-100 demonstrou maior número de células de Langerhans, o que é característico das lesões de vitiligo. CONCLUSÃO: A imuno-histoquímica pode ser utilizada como método auxiliar no diagnóstico dos casos duvidosos de vitiligo.

Vitiligo is a frequent skin disease that affects 1% of the population. It presents depigmented macules resulting from a gradual loss of melanocytes in the epidermis. In most cases, the diagnosis is made by clinical examination. Skin biopsies are performed when it is necessary to compare it with other hypomelanosis. Histopathological diagnosis of vitiligo is often difficult in hematoxylin-eosin (H&E) stained sections. There are a few studies on the improvement of diagnostic quality in vitiligo. OBJECTIVE: To evaluate the use of immunohistochemical markers, such as S-100 protein, human melanoma black-45 (HMB-45) and Melan-A, in the early diagnosis of clinically suspected or doubtful cases of vitiligo. Materials and methods: Histological sections of biopsies from healthy and affected skin areas from 10 patients clinically suspected of vitiligo. The samples were stained with H&E, S-100 protein, HMB-45 and Melan-A methods. Counterstaining with Giemsa was applied as a technical modification to differentiate melanin from immunolabelling. RESULTS: Six cases with recent clinical manifestation showed lymphocyte infiltrates, such as interface dermatitis, in the affected skin in the H&E staining technique. S-100 protein, HMB-45 and Melan-A staining marked the basal layer melanocytes of the healthy skin and S-100 protein antigen evidenced Langerhans cells. Melanocytes were absent or less frequent in affected skin areas in comparison with normal skin. S-100 protein showed a larger number of Langerhans cells, what is a common feature of vitiligo lesions. Conclusion: Immunohistochemistry may be used as an auxiliary technique for the diagnosis of suspected vitiligo cases.

[Epidemiological and clinical features of juvenile vitiligo: about 106 cases]

Vitiligo is acquired circumscribed leukoerma. Half of all cases begin before the age of 20 years. Our study was to specify the epidemiological and clinical features of juvenile vitiligo [JV]. Through a retrospective study we collected all cases of vitiligo aged less than 16 years, followed during 9 years, between 1997 and 2005 in the Dermatology department of the la Rabta hospital. For every patient, we have focused the epidemiologic, clinical and therapeutic data. One hundred and six cases of JV were enrolled. The mean age was 10 years, with sex ratio [M/F] about 0.49. The mean duration of disease was about 1.5 years. A positive family history of vitiligo and autoimmune disease was noted respectively in 13.2%et 1.9%of our patients. Vulgaris presentation was observed in 53.77%of cases. More patients in our study were treated with topical steroid. There was a paucity of published data regarding JV, they reported some characteristics [female preponderance, higher incidence of family history of vitiligo, autoinimune and/or endocrine disease, increased segmental presentation]. Despite these features, it is premature to conclude that JV is a distinct subset of vitiligo

Radiotherapy-induced depigmentation in a patient with breast cancer.

Vitiligo is a common dermatological disorder. A middle-aged woman with preexisting vitiligo was diagnosed with breast carcinoma. After surgery and chemotherapy she received regional radiotherapy. Six months after the completion of radiotherapy she developed depigmentation in the irradiated area. This article discusses the etiology for this phenomenon and the literature in this regard.

Vitíligo: aspectos clínicos y epidemiológicos / Vitiligo: clinical and epidemiological aspects

El vitíligo es una enfermedad adquirida de la piel, caracterizada por ausencia de melanocitos funcionales provocando máculas despigmentadasy afecta aproximadamente al 1% de la población. La causa no se conoce y los tratamientos actuales no son del todo satisfactorios.Objetivo: Describir algunas características clínicas y epidemiológicas en pacientes con vitíligo diagnosticados en el Hospital Regional Docentede Trujillo entre enero de 1994 y diciembre de 2003. Material y métodos: Estudio descriptivo retrospectivo. Se evaluaron la frecuencia, sexo, edad de inicio, edad en que se hizo el diagnóstico,duración, localización de las lesiones iniciales, sitios comprometidos, modo de inicio y procedencia.Resultados: Se encontró una frecuencia de 1.5%. El 47.9% fueron hombres y 52.1% mujeres con una relación hombre/mujer de 0.92. La edadde inicio promedio fue de 23.9 años. La edad promedio en que se hizo el diagnóstico fue 26.1 años. La duración promedio de la enfermedadfue de 2.4 años. El modo de inicio fue unicéntrico en el 60.6% siendo el sitio más frecuente la cara (31.2% de las lesiones iniciales). El 22.9% de las lesiones totales se encontraron en las extremidades superiores. Al momento de la consulta el 46.7% de los pacientes presentaba al menosuna lesión en la cara. El 42.6% de pacientes procedía de Trujillo. Conclusiones: Los datos encontrados son similares a los de otras poblaciones; se proporcionan las bases para futuros trabajos.

Vitiligo is an acquired disorder of the skin represented by the absence of functional melanocytes causing depigmented maculae and affect sapproximately 1% of the general population. Cause is unknown and actual treatments are not enough satisfactories. Objective: To analyze some clinical and epidemiological features of patients with vitiligo diagnosed at Regional Hospital of Trujillo betweenJanuary 1994 and December 2003. Methods: This is a descriptive and retrospective study. It was evaluated frequency, sex, age at onset, age at initial visit, duration, site of theinitial lesion, involved sites, mode of onset and procedence.Results: The frequency was 1.5%. 47.9% were male and 52.1% female. The mean age of onset was 23.9 years old. The mean age at the first visit was 26.1 years old. Duration of disease was 2.4 years. Onset mode was unicentric in 60.6% and the most common site was face (31.2% of initial lesions). 22.9% of the total lesions were found in upper limbs. At moment of visit, 46.7% of patients had al least one lesion in face. 42.6% of patients were from Trujillo.

[Epidemiological and clinical profile of vitiligo in Tunisia: retrospective study of 503 cases]

Background: Vitiligo is an acquired leucoderma whose etiology remains unknown. Its frequency in the world is estimated at 1%

Aim: The purpose of our study is to asses, with through a retrospective hospital series, the epidemiologic, clinical, therapeutic and course of this dermatosis and to compare our results with those of the literature

Methods: This is a retrospective study of consecutive patients attending the outpatient dermatological department at Charles Nicolle Hospital in Tunis over a 5 year-period [from June 1999 to July 2000]

Results: 503 patients were reviewed during a 5-year period. They were 288 women and 215 men [sex-ratio F/H=1.33]. The average age was 28.2 years [extremes of 3 and 80 years]. The peak of frequency was located in the 2nd decade of the life [26%]. A family history of vitiligo was found in 27% of the cases. The average time of consultation was 21 months. The localization of the lesions was ubiquitary prevalent at the uncovered areas. An association with other pathological conditions was found in 23% of cases. Most patients were treated by a photochemotherapy [78.2%]. Photoprotection was advised among all patients. The course was specified in 112 cases corresponding to a partial [28.9%] or a complete repigmentation [0,8%], a stabilization of lesions [41.6%] and an extension [26%]

Conclusion: Our results are consistent with the literature stressing the frequency of vitiligo which can cause an aesthetic and psychological damage of variable and sometimes major importance