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.
Female ; Human ; Male ; Vitiligo/pathology ; Vitiligo/classification*

BACKGROUND: There is a long-standing controversy whether melanocytes in vitiligo of more than 1 year duration are actually lost or still present. Resolving this matter is essential in understanding the underlying pathology and for the development of the treatment. On previous immunohistochemical and ultrastructural studies of vitiligo lesions, damage of melanocyte and keratinocyte in early lesions were reported and complete absence of melanocyte in long standing lesions were known. OBJECTIVE: This study aimed to determine the existence of the differences in pathologic changes in melanocytes according to the duration of the lesion. METHODS: We investigated the vitiliginous skin samples from 31 patients with early(less than 1 year duration) vitiligo and 30 patients with long standing(l to 5 years duration) vitiligo under the electron microscopy. RESULTS: Multiple degenerative changes in melanocytes were observed in the early and long standing lesions. In long standing lesions, degeneration of melanocytes including pyknotic, in-dented nuclei, vacuolated cytoplasms and blunted dendrites were more pronounced than early lesions. Even in long standing lesions, definite or presumptive melanocytes were observed in 16(53.3%) of 30 cases. CONCLUSION: Our results suggest that the melanocytes of vitiligo lesions were damaged and that the percentage of degenerative changes increase in accordance with the duration of the lesion. However, in long standing lesions as well as in early lesions, some residual melanocytes can be observed ultrastructurally.
Cytoplasm ; Dendrites ; Humans ; Keratinocytes ; Melanocytes ; Microscopy, Electron ; Pathology ; Skin ; Vitiligo*

The development of human melanocyte culture in vitro from normal adult skin and uninvolved skin of vitiligo patients is essential to investigate the mechanism of depigmentation in vitiligo and other pigmentary dermatoses. By using selective growth and long-term maintenance conditions, we selectively cultured melanocytes derived from normal foreskins and arm skins, and uninvolved foreskins and arm skins of vitiligo patients. The melanocytes of the arm skins were successfully cultured from the roofs of suction blisters. Melanocyte Growth Media (MGM) consisting of MCDB-153 formulation with basic fibroblast growth factor (bFGF), bovine pituitary extract (BPE), insulin, hydrocortisone, phorbol 12-myristate 13-acetate (PMA) and 10% human AB serum was sufficient to grow the melanocytes from normal and vitiligo donors. Melanocytes from uninvolved skin of vitiligo donors showed no different morphologic features, initial seeding capacity and population doubling time compared with those from normal skin. Melanocytes from both cell types grew without any lag period for more than 6 months (6-11 passages). Melanocytes obtained from foreskins had higher initial seeding capacity and shorter population doubling time than those obtained from arm skins using suction-blistered roofs. Our results suggest that the culture method using suction blisters may be a simple and easy way to obtain melanocytes. In addition, vitiligo melanocytes can be successfully cultured with appropriate growth conditions and may show no defective growth patterns. This culture system will be applied to investigate the basic pathophysiology of vitiligo and other various pigmentary dermatoses.
Cells, Cultured ; *Cytological Techniques ; Human ; Melanocytes/*cytology/*pathology ; Reference Values ; Support, Non-U.S. Gov't ; Vitiligo/*pathology

BACKGROUND: There have been few clinical studies of halo nevi. OBJECTIVE: The purpose of this study was aimed at evaluating the clinical and histopathologic features of halo nevi and correlation between halo nevi and vitiligo. METHODS: The medical records of 40 patients with halo nevi and biopsy specimens of 30 patients with halo nevi were reviewed. RESULTS AND CONCLUSION: 1.The ratio of male to female patients was 1:1.5. 2.The mean age of the onset was 20.1 years (male : 11.5, female : 25.9). 3.Multiple halo nevi were present in 32.5%(male : 25%, female : 37.5%). 4.The areas in which the lesions developed were head and neck(39.1%), back(32.8%), anterior chest(12.5%), abdomen(10.9%), groin(3.1%), and lower extremity(1.6%) in descending order. 5.The mean duration of each color in central nevus was as follows: black(2.7 years), pink(3.5 years), gray(4.9 years) 6.The most common pathology of the central nevus was intradermal(80%). 7.The halo nevi associated with vitiligo were 21 cases(52.5%) out of 40 patients. Among them, the cases with non-segmental vitiligo were 13(61.9%), the cases with segmental vitiligo were 8(38.1%). 8.Out of the 21 cases with halo nevi associated with vitiligo, the cases with halo nevi prior to vitiligo were 4(19.1%), concurrent onset 12(57.1%) and the cases with halo nevi after vitiligo were 5(23.8%).
Biopsy ; Female ; Head ; Humans ; Male ; Medical Records ; Nevus ; Nevus, Halo* ; Pathology ; Vitiligo

Adult ; Female ; Humans ; Lymphadenitis ; complications ; diagnosis ; pathology ; Positron-Emission Tomography ; Urticaria ; etiology ; Vitiligo ; etiology

To more fully define the nature of the antibody response to melanocytes which is associated with vitiligo, a Western immunoblot assay was used to test the sera of 28 patients with vitiligo (21 with active non-segmental, and 7 with stable segmental diseases) and 26 normal individuals for antibodies to antigens in detergent extracts of melanocyte membrane fractions. Antibodies to melanocytes were found in 26 (93%) of the patients with vitiligo, and in 16 (62%) of the control individuals. Patients with vitiligo and control individuals both had antibodies to an 80 approximately 83 kD antigen. The patient with vitiligo, in addition, had antibody responses to antigens with MWs of 45, 65, and 110 kD. Antibodies to these antigens were present in 46, 25, and 31% of vitiligo patients, but in only 19%. 0%, amd 0%, respectively, of the normal individuals. The heterogeneity of the antibody responses to melanocytes in vitiligo was further confirmed by the presence of antibodies to at least 3 distinct antigens in one-third of vitiligo patients but in none of the normal individuals. There was no difference in antibody response between patients with generalized and segmental vitiligo, suggesting that the pathogenesis of diseases was similar in both cases.
Antibodies/*analysis ; Antigens/immunology ; Blotting, Western ; Human ; Melanocytes/*immunology ; Reference Values ; Support, Non-U.S. Gov't ; Vitiligo/*immunology/*pathology

Patients with vitiligo seem be less prone to the development of lentigines as a side effect of long-term photochemotherapy than do psoriatics. An 8-year-old boy who had a vitiliginous patch on his left thigh, had been receiving photochemotherapy since he was 2 years old. At the age of 3, multiple star-shaped brownish macules developed at the site of treatment. Photochemotherapy was continued until the patient was 6 year old, at which time no improvement in the vitiligo was seen, so photochemotherapy was discontinued. Now 2 years after treatment the lentigines still persist. On electron microscopic examination, the melanocytes showed two patterns of cell death: coagulative necrosis and apotosis together with atypical cytoplasmic and melanosomal alterations.
Case Report ; Child ; Human ; Lentigo/*etiology/pathology ; Male ; Melanocytes/ultrastructure ; Microscopy, Electron ; PUVA Therapy/*adverse effects ; Vitiligo/drug therapy

The Korean list of occupational skin diseases was amended in July 2013. The past list was constructed according to the causative agent and the target organ, and the items of that list had not been reviewed for a long period. The revised list was reconstructed to include diseases classified by the International Classification of Diseases (10th version). Therefore, the items of compensable occupational skin diseases in the amended list in Korea comprise contact dermatitis; chemical burns; Stevens-Johnson syndrome; tar-related skin diseases; infectious skin diseases; skin injury-induced cellulitis; and skin conditions resulting from physical factors such as heat, cold, sun exposure, and ionized radiation. This list will be more practical and convenient for physicians and workers because it follows a disease-based approach. The revised list is in accordance with the International Labor Organization list and is refined according to Korean worker's compensation and the actual occurrence of occupational skin diseases. However, this revised list does not perfectly reflect the actual status of skin diseases because of the few cases of occupational skin diseases, incomplete statistics of skin diseases, and insufficient scientific evidence. Thus, the list of occupational diseases should be modified periodically on the basis of recent evidence and statistics.
Burns, Chemical/pathology ; Dermatitis, Contact/pathology ; Humans ; Occupational Diseases/*economics ; Occupational Exposure ; Republic of Korea ; Skin/*pathology ; Skin Diseases/*economics/*pathology ; Skin Diseases, Infectious/pathology ; Stevens-Johnson Syndrome/pathology ; Vitiligo/pathology ; Workers' Compensation/*economics

We compared the clinical efficacy of a short-term intervention of 308-nm excimer laser with that of narrow-band UVB (NBUVB) phototherapy for vitiligo patients to see the early response. Twenty-three symmetrically patterned patches of vitiligo on 8 patients were selected. Vitiligo patches on one side of the body were treated 2 times per week for a maximum of 20 treatments with the excimer laser, and NBUVB phototherapy was used on patches on the other side. Improvement (repigmentation) was assessed on a visual scale via serial photographs taken every five treatments and scored as follows: 0, or=75% improvement. At five treatments, the excimer laser-treated patches had an average score of 0.26, compared with 0.04 for patches treated with NBUVB phototherapy. A slightly higher repigmentation (p>0.05) in the excimer treated area was thus observed. At 10, 15, or 20 treatments, the differences between the average scores were significant: 0.83, 1.17, and 1.39 for the excimer-treated patches, and 0.17, 0.30, and 0.74 for the NBUVB pho-totherapy-treated areas (p<0.05). In conclusion, the 308-nm excimer laser appears to be more effective than NBUVB phototherapy, as it produces more rapid and profound repigmentation.
Adult ; Chlorides/*therapeutic use ; Comparative Study ; Female ; Humans ; Lasers/*therapeutic use ; Male ; Middle Aged ; Treatment Outcome ; *Ultraviolet Therapy ; Vitiligo/pathology/*radiotherapy ; Xenon/*therapeutic use

OBJECTIVE: To evaluate the efficacy and influential factors for 308 nm excimer laser in the treatment of stable vitiligo patients.
 METHODS: A total of 207 stable vitiligo patients with 1 763 patches were treated with 308 nm excimer laser. Open-label study was carried out to investigate the efficacy and safety regarding the treatment with 308 nm excimer laser, and to compare the response under different conditions including gender, age, duration, lesion location, and hair color.
 RESULTS: After treatment, 560 (31.8%) patches achieved 100% repigmentation, 650 (36.9%) lesions showed 75%-99% repigmentation, 189(10.7%) showed 50%-75% repigmentation, 231(13.1%) showed 25%-49% repigmentation, 108(6.1%) showed 1%-24% repigmentation, 25(1.4%) displayed no response. The rates of total excellent response (50%-100% repigmentation) in underage patients was 86.9%, much higher than that in adult patients (P<0.001). Total excellent response rates was 90.6% in disease duration <2 years, and 40.7% in disease duration ≥2 years. Lesions on the faciocervical region responded better than trunk and limbs, showing 95.4%, 70.3%, and 41.7% total excellent response, respectively. Patients with poliosis showed 54.9% in total excellent response rate, much lower than 84.5% in patients without poliosis(P<0.001). No significant response differences in gender were found.
 CONCLUSION 308 nm excimer laser is effective and safe in treatment of vitiligo. Aging, disease duration, lesion location, and hair color in lesion may be the influential factors for 308 nm excimer laser in treatment of vitiligo patients.
Adolescent ; Adult ; Age Factors ; Extremities ; pathology ; radiation effects ; Face ; pathology ; radiation effects ; Female ; Hair Color ; Humans ; Lasers, Excimer ; therapeutic use ; Male ; Skin Pigmentation ; radiation effects ; Torso ; pathology ; radiation effects ; Treatment Outcome ; Vitiligo ; therapy