Rapid disease progression, worse prognosis associated with vitiligo clinical markers
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The presence of clinical markers in patients with vitiligo may have an association with worsening prognoses and rapid disease progression, according to a perspective cohort study published in JAMA Dermatology.
“We analyzed a large cohort of patients with vitiligo from China and found a significantly higher frequency of active disease among those with at least one of the three clinical markers compared with patients without a clinical marker,
Li Zhang, MD, PhD, of the department of dermatology at Huashan Hospital at Fudan University in Shanghai, and colleagues wrote.
The disease was defined as active if lesions appeared as hypomelanotic with poorly defined borders or had a Vitiligo European Task Force-spreading score of at least 1. The disease was defined as progression in terms of the proportion of patients with higher Vitiligo Area Scoring Index (VASI) scores and increased serum CXCL10 levels determined by enzyme-linked immunosorbent assay.
A total of 425 patients with vitiligo were recruited from the outpatient department of Huashan Hospital. Patients received narrowband UV-B phototherapy twice a week and applied 0.1% tacrolimus topically twice a day.
Mean age of disease onset of enrolled patients was 25.7 years and mean disease duration was 5.3 years with a mean baseline VASI score of 15.55. Of the 425 patients, 201 had at least clinical marker.
The proportion of patients in active stage in the clinical marker-positive group was higher than in the clinical marker-negative group (71%). Higher levels of serum CXCL10 were also found in patients with multiple clinical markers. Results showed that the presence of clinical markers was associated with disease progression at month (70.6% vs 26.8%) and months (31.3% vs 4%) of follow-up.
“Patients with multiple clinical markers had more progressive lesions than did those with a single clinical marker, as well as greater frequency of active disease and severity of symptoms, longer length of progression and worse repigmentation,” the researchers wrote.
These results suggest that patients with multiple clinical markers may require more intensive treatment for the disease – by Erin T. Welsh
Disclosures: The authors report no relevant financial disclosures.