Objective:To analyze factors influencing repigmentation patterns in patients with vitiligo treated with phototherapy.Methods:Clinical data were retrospectively collected from patients with vitiligo treated with 308-nm excimer laser or 308-nm excimer lamp at the Department of Dermatology, Xijing Hospital, Air Force Medical University from June 2013 to May 2022. The treatment frequency was thrice weekly, and skin lesions were evaluated via photographs once every 5 sessions of phototherapy. Chi-square test or Fisher′s exact test was used to analyze associations between clinical characteristics and vitiligo repigmentation patterns.Results:A total of 223 patients with vitiligo were included in this study, including 109 males (48.9%) and 114 females (51.1%), and their ages ( M [ Q1, Q3]) were 20 (10, 28) years. Among the 223 patients, 170 (76.2%) were treated with 308-nm excimer laser, and 53 (23.8%) with 308-nm excimer lamp. The repigmentation patterns included the perifollicular pattern in 63 cases (28.3%), marginal pattern in 97 (43.5%), diffuse pattern in 36 (16.1%), and mixed pattern in 27 (12.1%). Analysis of the associations between clinical characteristics and vitiligo repigmentation patterns showed no significant differences in the repigmentation patterns among vitiligo patients of different genders or different Fitzpatrick skin types (both P > 0.05) ; however, the diffuse repigmentation pattern more frequently occurred in the patients aged ≤ 12 years compared with those aged > 12 years ( χ2 = 7.71, P = 0.005), in the patients with vitiligo in the progressive stage compared with those in the stable stage ( χ2 = 4.59, P = 0.030), and in lesions without white hair compared with those with white hair ( χ2 = 6.75, P = 0.009) ; the mixed repigmentation pattern more frequently occurred in the patients with segmental vitiligo compared with those with non-segmental vitiligo ( χ2 = 11.76, P = 0.001) ; the marginal repigmentation pattern more frequently occurred in lesions on the face and neck ( χ2 = 15.82, P<0.001) and extremities ( χ2 = 11.85, P = 0.001) compared with lesions on the trunk; the perifollicular repigmentation pattern more frequently occurred in the patients with stable vitiligo compared with those with progressive vitiligo ( χ2 = 4.70, P = 0.030), and in skin lesions on the trunk compared with those on face and neck ( χ2 = 13.73, P < 0.001) and extremities ( χ2 = 5.49, P = 0.035) ; after 308-nm excimer laser treatment, the proportions of patients with the marginal repigmentation pattern ( χ2 = 12.30, P < 0.001) and those with the diffuse repigmentation pattern ( χ2 = 5.64, P = 0.018) were significantly higher than those after 308-nm excimer lamp treatment, while the proportions of patients with the perifollicular repigmentation pattern ( χ2 = 7.87, P = 0.005) and those with the mixed repigmentation pattern ( χ2 = 17.13, P < 0.001) were significantly higher after 308-nm excimer lamp treatment than those after 308-nm excimer laser treatment. Conclusion:Patients′ age, clinical types and stages of vitiligo, presence or absence of concomitant white hair, skin lesion sites, and phototherapy modalities were factors influencing the repigmentation patterns of vitiligo.

Vitiligo is an immune memory skin disease. T-cell factor 1 (TCF1) is essential for maintaining the memory T-cell pool. There is an urgent need to investigate the characteristics of peripheral memory T-cell profile and TCF1⁺ T-cell frequencies in patients with vitiligo. In this study, 31 patients with active vitiligo (AV), 22 with stable vitiligo (SV), and 30 healthy controls (HCs) were included. We measured circulating memory and TCF1⁺ T-cell frequencies using flow cytometry. The Spearman's rank test was used to evaluate the correlation between cell frequencies and disease characteristics. Receiver operating characteristic curves (ROC) were constructed to investigate the discriminative power of the cell subpopulations. Circulating CD4⁺ and CD8⁺ terminally differentiated effector memory T-cell (T_EMRA) frequencies were significantly higher in the AV group than in HCs (P < 0.05). TCF1⁺ T-cell subpopulations were widespread increased in patients with vitiligo (P < 0.05). After adjusting for potential confounders, CD8⁺ and CD4⁺ central memory (T_CM) cells, and CD8⁺ T_EMRA were correlated with disease activity (P < 0.05). The combined diagnostic value of the four (naïve, effector memory, T_CM, and T_EMRA) CD8⁺TCF1⁺ T-cell subsets was relatively high (area under the ROC curve (AUC) = 0.804, sensitivity = 71.70%, specificity = 83.34%), and the CD8⁺ T-cell subsets combination performed well in discriminating disease activity (AUC = 0.849, sensitivity = 70.97%, specificity = 90.91%). We demonstrated an altered circulating memory T-cell profile and increased TCF1⁺ T-cell percentage in patients with vitiligo. T-cell subpopulations had a strong value for vitiligo diagnosis and activity evaluation. This evidence presents a potential new pharmacological target for inhibiting autoimmunity that leads to vitiligo.