Leukotrichia linked to segmental vitiligo, poor treatment response
MedWire News: Patients with segmental vitiligo - pigment loss on only one side of the body - are very likely to have leukotrichia, study findings suggest.
The presence of white hairs (leukotrichia) in segmental vitiligo also appears to contribute to the lack of response to medical therapy, report Dong-Youn Lee (Sungkyunkwan University School of Medicine, Seoul, Korea) and colleagues in the International Journal of Dermatology.
Segmental vitiligo differs from nonsegmental in that it has distinct clinical features, a natural course, has an earlier onset, and more rapid progression, explain the researchers. It is also often associated with white hairs, but the exact incidence of leukotrichia in segmental vitiligo patients is unknown.
Lee and co-authors investigated 82 segmental vitiligo patients, aged up to 75 years, who visited their clinic during a 5-year period.
The mean age at onset of the condition was 20 years, and the researchers found that all patients showed evidence of leukotrichia in their skin lesions, regardless of age or disease duration. The extent of leukotrichia in the patients varied, they report.
The research team also studied the effects of medical treatment, including phytotherapy and surgery, on 18 patients who had a majority of white hairs in the skin lesion.
All patients showed poor results with phytotherapy; repigmentation ranged from zero to 19%. Suction blister epidermal grafting showed better results, however, achieving repigmentation ranging from 80 to 100%.
The researchers note that repigmentation depends on available melanocytes, and the hair follicle is the main source of these melanin-producing cells.
As a result, "the presence or absence of white hairs in the lesional skin may be an important parameter for the prediction of repigmentation," write Lee and colleagues.
They recommend the use of a digital microscope to detect the existence of white hairs, and suggest that the evaluation of leukotrichia should be part of a routine assessment of vitiligo.
Further studies are still needed to assess the relationship between the amount of white hairs and the effect of medical therapy, they conclude.
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