Value of Histological Staining in Differential Diagnosis of Vitiligo / 대한피부과학회지

ABSTRACT

BACKGROUND: Vitiligo is a depigmented disorder, causing serious cosmetic problems for patients. In diagnostic and therapeutic aspects, vitiligo should be differentiated from other hypopigmented disorders as the therapeutic approach and prognosis are different for each disease. OBJECTIVE: This study aimed to compare the usefulness of several markers for melanocytes or melanin in differential diagnosis of vitiligo. METHODS: Twenty-eight patients were studied, who were diagnosed clinically as suffering from one of the following diseases: vitiligo, nevus depigmentosus, pityriasis alba, postinflammatory hypopigmentation, and idiopathic guttate hypomelanosis. Skin samples (frozen or paraffin-fixed) were obtained from depigmented patches and normal neighboring skin (control). Histological staining was performed by using Fontana-Masson, S-100, MART-1, and DOPA. The staining level of lesional skin was compared with that of normal skin. RESULTS: When the staining level of vitiligo was compared with that of others, vitiligo was significantly lower in Fontana-Masson (13.3+/-17.2% vs 44.4+/-23.7%), S-100 (49.5+/-14.9% vs 74.7+/-24.2%), MART-1 (7.4+/-8.7% vs 68+/-33.9%), and DOPA (9.5+/-11.3% vs 58.2+/-29.5%) (p<0.0001). CONCLUSION: MART-1 and DOPA are valuable markers in differential diagnosis of vitiligo. However, Fontana-Masson, a marker of melanin, had some limits in detecting melanocytes, and S-100 showed non-specific staining other than melanocytes.