Dicembre Vol.3 N° 3 - 2007 - Salute per tutti

Vitiligo Activity Index, a new activity evaluation index for bilateral vitiligo vulgarisFigure 4.Follicle repigmentationin a male patient, 28 yearsold, with improving VVBfollowing up a UVB narrowband phototherapy.The pinhead sizeof follicle repigmentationis clearly noticeable.a)course worsening or improvement, we formulateda classifying index of VVB clinical activitylevel, called Vitiligo Activity Index.As shown in Figure 7 we divided skin surface ineight areas: head, neck, torso, genitalia, rightarm, left arm, right leg and left leg; each andevery one of this area should have its own evaluationfollowing the criteria we propose.First step in VAI index evaluation is countingthe areas where vitiligo patches appear; theresulting value (between 0 and 8) is calledVitiligo Affected Areas (VAA) and represents arough evaluation of vitiligo extension on thesubject. Should a patch cover more than onea rea, all the covered areas are taken intoaccount and considered as affected.Evaluation should proceed with a morphologicalanalysis of VAA patches with a dermatoscope,following these three simple rules:1) If the area presents patches with pinpointdepigmentation or laminated edges, even ifstationary patches are present or there arenoticeable signs of repigmentation, the valueto be assigned to the area is 3.2) If the area does not contain pinpoint depigmentationor edge lamination but it presentsimprovement signs such as follicle repig-b)Figure 5.Pictures of lumbar regionpatch in young VVB malepatient taken at thebeginning of therapy (a),after a month (b),after two months (c).Repigmentation dotsprogressively increasein diameter and latermerge giving to smallareas of the patcha healthy pigmentation.c)Figure 6. Example of stationary patch. Edges are well-definedand there is a clear difference between the vitiligo patchtone and the healthy skin tone without delamination. Armpitpatches in young VVB female patient, 28 years old.Journal of Plastic Dermatology 2007; 3, 337