The Vitiligo European Taskforce came to a consensus about the classification of vitiligo in 2007.
|They decided on four main categories with subtypes. Classification||Subtype||Comments|
|Nonsegmental vitiligo|| Focal
|bilateral and symmetrical in distribution.
Stable or unstable
|Segmental vitiligo|| Focal
Unisegmental, bi- or multisegmental
|Single white patch in 90%
Border often irregular
Affects young people
|Mixed vitiligo|| Nonsegmental combined with segmental vitiligo||Rare|
|Unclassified vitiligo|| Focal at onset
Multifocal asymmetrical non-segmental
At least two scoring systems have been devised for vitiligo and are used in clinical trials.
Vitiligo Area Scoring Index (VASI)
Vitiligo European Task Force (VETF) system
VASI : It measures the extent and degree of depigmentation in 6 sites: hands, upper extremities, trunk, lower extremities and feet, head/neck.
VETF: The VETF assesses the extent, staging and spreading/progression in 5 sites: head/neck, trunk, arms, legs and hands/feet. It grades from 0 (normal pigmentation) to 4 (complete hair whitening). Spreading is assessed using the following scores: 0 (stable disease), -1 (regressive disease) and +1 (progressive disease)
Because vitiligo affects a person’s physical appearance, there are various associated psychological and social impacts. Higher levels of depression and social anxiety have been reported in patients with vitiligo. Patients may also experience low self-esteem, social stigmatization, shame, avoidance of intimacy, adjustment disorder, fear, suicidal ideation, and other psychiatric morbidities .Family support, counselling and cognitive behavioural treatment can be of benefit.
Written by: Abdul Aziz Al-mufadhi, PGY1 Dermatology Resident
bolognia dermatology 4th edition