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  Mucosal  Acrofacial  Generalised  Universal	bilateral and symmetrical in distribution. Stable or unstable
Segmental vitiligo	 Focal  Mucosal  Unisegmental, bi- or multisegmental	Single white patch in 90% Border often irregular Affects young people Stable Cutaneous mosaicism
Mixed vitiligo	 Nonsegmental combined with segmental vitiligo	Rare
Unclassified vitiligo	 Focal at onset  Multifocal asymmetrical non-segmental  Unifocal mucosal	Early disease

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

Resources:

www.DermNetNZ.org

https://www.medscape.com/

bolognia dermatology 4th edition