In Vivo Data
Core Messages
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The extension and severity of vitiligo guide prognosis and help making therapeutic choices. However, in spite of attempts to standardise clinical judgment, wide variations exist both in assessment rules and interpretation of their use, making intra- and inter-observer variations unavoidable.
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Ultraviolet (UV)-light examination and UV photography remain useful tools for the assessment of Caucasoid patients. Non-invasive instruments that use reflectance spectroscopy provide a convenient and reproducible methodology for the study of vitiligo patients and their follow-up.
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Reflectance confocal microscopy provides microscopical informations in vivo about changes in achromic macules both in repig-mented areas after treatments and in clinically normal-appearing skin of vitiligo patients.
Keywords
Melanin Granule Vitiligo Patient Reflectance Confocal Microscopy Reflectance Spectrophotometry Epidermal MelaninReference
- 1.Agache P (2004) Skin color measurement in measuring the skin. In: Agache P, Humbert P (eds) Measuring the skin. Springer, Berlin, pp 33–39Google Scholar
- 2.Ardigò M, Malizewsky I, Dell'anna ML et al (2007) Preliminary evaluation of vitiligo using in vivo reflectance confocal microscopy. J Eur Acad Dermatol Venereol 21:1344–1350PubMedCrossRefGoogle Scholar
- 3.Aspres N, Egerton IB, Lim AC et al (2003) Imagin the skin. Australas J Dermatol 44:19–27PubMedCrossRefGoogle Scholar
- 4.Asawanonda P, Taylor CR (1999) Wood's light in dermatology. Int J Dermatol 38:801–807PubMedCrossRefGoogle Scholar
- 5.Aydin F, Senturk N, Sahin B et al (2007) A practical method for the estimation of vitiligo surface area: a comparison between the point counting and digital planimetry techniques. Eur J Dermatol 17:30–32PubMedGoogle Scholar
- 6.Bahmer FA (1992) ADASI score: atopic dermatitis area and severity index. Acta Derm Venereol Suppl 176:32–33Google Scholar
- 7.Bertrand C, Corcuff P (1994) In vivo spatio-temporal visualization of the human skin by real-time confocal microscopy. Scanning 16:150–154PubMedCrossRefGoogle Scholar
- 8.Brazzelli V, Prestinari F, Barbagallo T et al (2007) A longterm time course of colorimetric assessment of the effects of imatinib mesylate on skin pigmentation: a study of five patients. J Eur Acad Dermatol Venereol 21:384–387PubMedCrossRefGoogle Scholar
- 9.Brazzelli V, Roveda E, Prestinari F et al (2006) Vitiligo-like lesions and diffuse lightening of the skin in a pediatric patient treated with imatinib mesylate: a noninvasive colori-metric assessment. Pediatr Dermatol 23:175–178PubMedCrossRefGoogle Scholar
- 10.Brazzelli V, Antonieti M, Muzio F et al (2008) The perilesional skin in vitiloigo: a colorimetric “in vivo” study of 25 patients. Photodermatol Photoimmunol Photomed 24:314–317PubMedCrossRefGoogle Scholar
- 11.Brunsting LA, Sheard C (1929) The color of the skin as analyzed by spectrophotometric methods: II. The role of pigmentation. J Clin Invest 7:559–574CrossRefGoogle Scholar
- 12.Boissy RE, Manga P (2004) On the etiology of contact/ occupational vitiligo. Pigment Cell Res 17:208–214PubMedCrossRefGoogle Scholar
- 13.Chiaverini C, Passeron T, Ortonne JP (2002) Treatment of vitiligo by topical calcipotriol. J Eur Acad Dermatol Venereol 16:137–138PubMedCrossRefGoogle Scholar
- 14.Clarys P, Alewaeters K, Lambrecht R et al (2000) Skin color measurements: comparison between three instruments: the Chromameter®, the DermaSpectrometer® and the Mexameter®. Skin Res Technol 6:230–238PubMedCrossRefGoogle Scholar
- 15.Corcuff P, Leveque JL (1996) In vivo vision of the human skin with the tandem scanning microscope. Dermatology 186:50–54CrossRefGoogle Scholar
- 16.Corcuff P, Bertrand C, Leveque JL (1993) Morphometry of human epidermis in vivo by real-time confocal microscopy. Arch Dermatol Res 285:475–481PubMedCrossRefGoogle Scholar
- 17.Corcuff P, Gonnord G, Pierard GE et al (1996) In vivo con-focal microscopy of human skin: a new design for cosmetology and dermatology. Scanning 18:351–355PubMedCrossRefGoogle Scholar
- 18.Diffey BL, Oliver RJ, Farr PM (1984) A portable instrument for quantifying erythema induced by ultraviolet radiation. Br J Dermatol 111:663–672PubMedCrossRefGoogle Scholar
- 19.Duteil L (2002) Objective methods to assess pigmentation. In: Ortonne JP, Ballotti R (eds) Mechanism of suntanning. Martin Dunitz, LondonGoogle Scholar
- 20.Edwards EA, Duntley SQ (1939) The pigments and color of living human skin. Am J Anatomy 65:1–33CrossRefGoogle Scholar
- 21.Ellengogen R, Jankauskas S, Collini F (1990) Achieving standardized photographs in aesthetic surgery. Plast Reconstr Surg 86:955–962CrossRefGoogle Scholar
- 22.Fain PR, Babu SR, Bennett DC et al (2006) HLA class II haplotype DRB1*04-DQB1*0301 contributes to risk of familial generalized vitiligo and early disease onset. Pigment Cell Res 19:51–57PubMedCrossRefGoogle Scholar
- 23.Feather J, Ellis DJ, Leslie G (1988) A portable reflectometer for the rapid quantification of cutaneous haemoglobin and melanin. Phys Med Biol 33:711–722PubMedCrossRefGoogle Scholar
- 24.Fullerton A, Fischer T, Lathi A et al (1996) Guidelines for measurement of skin colour and erythema. A report from the Standardization Group of the European Society of Contact Dermatitis. Contact Dermatitis 31:1–10CrossRefGoogle Scholar
- 25.Gilchrest BA, Fitzpatrick TB, Anderson RR et al (1977) Localization of melanin pigmentation in the skin with Wood's lamp. Br J Dermatol 96:245–248PubMedCrossRefGoogle Scholar
- 26.Gniadecka M, Wulf HC, Mortensen N et al (1996) Photoprotection in vitiligo and normal skin. Acta Derm Venereol 76:429–432PubMedGoogle Scholar
- 27.Goldman RJ, Salcido R (2002) More than one way to measure a wound: an overview of tools and techniques. Adv Skin Wound Care 15:236–245PubMedCrossRefGoogle Scholar
- 28.Hajizadeh-Saffar M, Feather JW, Dawson JB (1990) An investigation of factors affecting the accuracy of in vivo measurements of skin pigments by reflectance spectropho-tometry. Phys Med Biol 35:1301–1315PubMedCrossRefGoogle Scholar
- 29.Hamzavi I, Jain H, McLean D et al (2004) Parametric modelling of narrowband UV-B phototherapy for vitiligo using a novel quantitative tool: the Vitiligo Area Scoring Index. Arch Dermatol 140:677–683PubMedCrossRefGoogle Scholar
- 30.Hettiaratchy S, Papini R (2004) Initial management of a major burn: II — assessment and resuscitation. BMJ 329:101–103PubMedCrossRefGoogle Scholar
- 31.Huzaira M, Rius F, Rajadhyaksha M et al (2001) Topographic variations in normal skin, as viewed by in vivo reflectance confocal microscopy. J Invest Dermatol 116:846–852PubMedCrossRefGoogle Scholar
- 32.Knaysi GA, Crikelair GF, Cosman B (1968) The rule of nines; its history and accuracy. Plastic Reconst Surg 41:560–563CrossRefGoogle Scholar
- 33.Kollias N (2007) Skin documentation with multimodal imaging or integrated imaging approaches. In: Wilhelm KP, Elsner P, Berardesca E, Maibach HI (eds) Bioengineering of the skin. Skin imaging and analysis, 2nd edn. Informa Healthcare, New York, pp 221–246Google Scholar
- 34.Kollias N, Gillies R, Cohen-Goihnab C et al (1997) Fluorescence photography in the evaluation of hyperpig-mentation in photodamaged skin. J Am Acad Dermatol 36:226–230PubMedCrossRefGoogle Scholar
- 35.LePoole IC, Das PK (1997) Microscopic changes in vitiligo. Clin Dermatol 15:863–873CrossRefGoogle Scholar
- 36.Marrakchi S, Bouassida S, Meziou TJ et al (2007) An objective method for the assessment of vitiligo treatment. Pigment Cell Melanoma Res 21:106–107CrossRefGoogle Scholar
- 37.Middlekamp-Hup MA, Park HY, Lee J et al (2006) Detection of UV-induced and epidermal changes over time using in vivo reflectance confocal microscopy. J Invest Dermatol 126:401–407Google Scholar
- 38.Minsky M (1961) Microscopy apparatus. US Patent # 3013467. Filed 1957, Awarded 1961Google Scholar
- 39.Minsky M (1998) Memoir on inventing the confocal scanning microscope. Scanning J 10:123–128Google Scholar
- 40.Montes LF, Abulafia J, Wilborn WH et al (2003) Value of histopathology in vitiligo. Int J Dermatol 42:57–61PubMedCrossRefGoogle Scholar
- 41.New KC, Petroll WM, Boyde A et al (1991) In vivo imaging of human teeth and skin using real-time confocal microscopy. Scanning 13:369–372CrossRefGoogle Scholar
- 42.Neuse WHG, Neumann NJ, Lehmann P et al (1996) The history of photography in dermatology. Arch Dermatol 132:1492–1498PubMedCrossRefGoogle Scholar
- 43.Noon JP, Evans CE, Haynes WG et al (1996) A comparison of techniques to assess skin blanching following the topical application of glucocorticoids. Br J Dermatol 134:837–842PubMedCrossRefGoogle Scholar
- 44.Ortonne JP, Nordlund J (2006) Mechanisms that cause abnormal skin color. In: Nordlund JJ, Boissy RE, Hearing VJ, King RA, Oetting WS, Ortonne JP (eds) The pigmentary system, 2nd edn. Blackwell, Oxford, pp 489–502Google Scholar
- 45.Paraskevas LR, Halpern AC, Marghoob AA (2005) Utility of the Wood's light: five cases from a pigmented lesion clinic. Br J Dermatol 152:1039–1044PubMedCrossRefGoogle Scholar
- 46.Park SB, Suh DH, Youn JI (1999) A long-term time course of colorimetric evaluation of ultraviolet light-induced skin reactions. Clin Exp Dermatol 24:315–320PubMedCrossRefGoogle Scholar
- 47.Pierard GE (1998) EEMCO guidance for the assessment of skin colour. J Eur Acad Dermarol Venereol 10:1–11Google Scholar
- 48.Queille-Roussel C, Poncet M, Schaefer H (1991) Quantification of skin color changes induced by topical cor-ticosteroidi preparations using Minolta Chroma Meter. Br J Dermatol 124:264–270PubMedCrossRefGoogle Scholar
- 49.Rajadhyaksha M, Anderson RR, Webb RH (1999) Videorate confocal scanning laser microscope for imaging human tissues in vivo. Appl Optics 38:2105–2115CrossRefGoogle Scholar
- 50.Rajadhyaksha M, Gonzalez S, Zavislan JM (2004) Detectability of contrast agents for confocal reflectance imaging os skin and microcirculation, J Biomed Opt 9(2):323–331PubMedCrossRefGoogle Scholar
- 51.Rajadhyaksha M, González S, Zavislan JM et al (1999) In vivo confocal scanning laser microscopy of human skin II: advances in instrumentation and comparison to histology. J Invest Dermatol 113:293–303PubMedCrossRefGoogle Scholar
- 52.Rajadhyaksha M, Grossman M, Esterowitz D et al (1995) Video-rate confocal scanning laser microscopy for human skin: melanin provides strong contrast. J Invest Dermatol 104:946–952PubMedCrossRefGoogle Scholar
- 53.Ratner D, Thomas CO, Bickers D (1999) The uses of digital photography in dermatology. J Am Acad Dermatol 41:749–756PubMedCrossRefGoogle Scholar
- 54.Schallreuter KU, Büttner G, Pittelkow MR et al (1994) Cytotoxicity of 6-biopterin to human melanocytes. Biochem Biophys Res Commun 204:43–48PubMedCrossRefGoogle Scholar
- 55.Seitz JC, Whitmore CG (1988) Measurement of erythema and tanning responses in human skin using a tristimulus colorimeter. Dermatological 177:70–75CrossRefGoogle Scholar
- 56.Serup J, Agner T (1990) Colorimetric quantification of erythema — a comparison of two colorimeters (Large Micro Color and Minolta Chroma Meter CR-200) with a clinical scoring schema and laser-Doppler flowmetry. Clin Exp Dermatol 15:267–272PubMedCrossRefGoogle Scholar
- 57.Shigeaki S, Imura M, Ota M (1985) The relationship of skin color, spectophotometric techniques. J Invest Dermatol 84:265–267CrossRefGoogle Scholar
- 58.Stalder JF, Le Forestier D (1992) La photographie en pratique dermatologique. Ann Dermatol Venereol 119:695–702PubMedGoogle Scholar
- 59.Stamatas GN, Zmudzka BZ, Kollias N et al (2004) Non-invasive measurements of skin pigmentation in situ. Pigment Cell Res 17:618–626PubMedCrossRefGoogle Scholar
- 60.Taïeb A, Picardo M (2007) The definition and assessment of vitiligo: a consensus report of the Vitiligo European Task Force. Pigment Cell Res 20:27–35PubMedCrossRefGoogle Scholar
- 61.Takiwaki H, Overgaard L, Serup J (1994) Comparison of narrow-band reflectance spectrophotometric and tristimulus colorimetric measurements of skin color. Skin Pharmacol 7:217–255PubMedCrossRefGoogle Scholar
- 62.Takiwaki H, Miyaoka Y, Kohno H et al (2002) Graphic analysis of the relationship between skin colour change and variations in the amounts of melanin and haemoglobin. Skin Res Technol 8:78–83PubMedCrossRefGoogle Scholar
- 63.Taylor SC (2002) Skin of color: biology, structure, function, and implications for dermatologic disease. J Am Acad Dermatol 46:41–62CrossRefGoogle Scholar
- 64.Taylor S, Westerhof W, Im S et al (2006) Noninvasive techniques for the evaluation of skin color. J Am Acad Dermatol 54:282–290CrossRefGoogle Scholar
- 65.Tearney GJ, Brezinski ME, Southern JF et al (1995) Determination of the refractive index of highly scattering human tissue by optical coherence tomography. Opt Lett 20:2258–2260PubMedCrossRefGoogle Scholar
- 66.Tuzun Y, Yazici H (1981) A method of measuring skin lesions. Arch Dermatol 117:192PubMedCrossRefGoogle Scholar
- 67.Van Geel N, Ongenae K, Vander Haeghen Y et al (2004) Autologous transplantation techniques for vitiligo: how to evaluate treatment outcome. Eur J Dermatol 14:46–51PubMedGoogle Scholar
- 68.Van Geel N, Vander Haeghen Y, Ongenae K et al (2004) A new digital image analysis system useful for surface assessment of vitiligo lesions in transplantation studies. Eur J Dermatol 14:150–155Google Scholar
- 69.Vitkin IA, Woolsey J, Wilson BC et al (1994) Optical and thermal characterization of natural (sepia officinalis) melanin. Photochem Photobiol 59:455–462PubMedCrossRefGoogle Scholar
- 70.Wachtel TL, Berry CC, Wachtel EE (2000) The inter-rater reliability of estimating the size of burns from various burn area chart drawings. Burns 26:156–170PubMedCrossRefGoogle Scholar
- 71.Wang X, Milner TE, Chang MC et al (1996) Group refractive index measurement of dry and hydrated type I collagen films using optical low-coherence reflectometry, J Biomed Opt 1:212–216PubMedCrossRefGoogle Scholar
- 72.Weatherall IL, Coombs BD (1992) Skin color measurements in terms of CIELAB color space values. J Invest Dematol 99:468–473CrossRefGoogle Scholar
- 73.Westerhof W (2006) Dermatoscopy. In: Serup J, Jemec GBE, Grove GL (eds) Handbook of non-invasive methods and the skin, 2nd edn. CRC, Boca Raton, pp 113–114Google Scholar
- 74.Westerhof W (2006) Colorimetry. In: Serup J, Jemec GBE, Grove GL (eds) Handbook of non-invasive methods and the skin, 2nd edn. CRC, Boca Raton, pp 635–651Google Scholar
- 75.Whitton ME, Ashcroft DM, Barrett CW et al (2006) Interventions for vitiligo. Cochrane Database Syst Rev 1:CD003263Google Scholar
- 76.Wood RW (1919) Secret communications concerning light rays. J Physiol 5 serie:t IXGoogle Scholar
- 77.Yamashita T, Kuwahara T, Gonzales S et al (2005) Non-invasive visualization of melanin and melanocytes by reflec-tance-mode confocal microscopy. J Invest Dermatol 124:235–240PubMedCrossRefGoogle Scholar
- 1.Bartosik J, Wulf HC, Kobayasi T (1998) Melanin and mel-anosomes complexes in long standing stable vitiligo: ultrastructural study. Eur J Dermatol 8:95–97PubMedGoogle Scholar
- 2.Bhawan J Bhutani LK (1983) Keratinocyte damage in viti-ligo. J Cutan Pathol 10:207–212PubMedCrossRefGoogle Scholar
- 3.Birbeck MS, Breathnach AS, Everall JD An electron microscope study of basal melanocytes and high level clear cells (Langerhans cells) in vitiligo. J Invest Dermatol 37:51–64Google Scholar
- 4.Bleehen SS (1976) The treatment of vitiligo with topical corticosteroids: light and electron microscopic studies. Br J Dermatol 94:43–49PubMedCrossRefGoogle Scholar
- 5.Bleehen SS (1979) Histology of vitiligo. Pigment Cell Res 5:54–61Google Scholar
- 6.Boissy RE, Liu YY, Medrano E et al (1991) Structural aberrations of the rough endoplasmic reticulum and melanosome compartmentalisation in long term cultures of melanocytes from vitiligo patients. J Invest Dermatol 97:395–404PubMedCrossRefGoogle Scholar
- 7.Boissy RE (1991) Dilated rough endoplasmic reticulum and premature death in melanocytes cultured from vitiligo mouse. Am J Pathol 138:1511–1525PubMedGoogle Scholar
- 8.Bose SK, Ortonne JP (1964) Focal gaps in the basement membrane of involved skin of vitiligo: are they normal? J Dermatol 21:152–159Google Scholar
- 9.Breathnach AS, Bor S, Wyllie LM. Electron microscopy of peripheral nerve terminals and marginal melanocytes in viti-ligo. J Invest Dermatol;47:125–140Google Scholar
- 10.Brown J, Winkelmann RK, Wolff K (1967) Langerhans cells in vitiligo. J Invest Derm 49:386–390PubMedGoogle Scholar
- 11.Fitzpatrick TB, Parrish JA, Pathak MA (1957) Melanin biosynthesis and the pathophysiology and treatment of vitiligo with Trioxalen. Giornale Italiano di Dermatologia 110:121–130Google Scholar
- 12.Galadari E. (1993) Ultrastructural study of vitiligo. Int J Dermatol 32:269–271PubMedGoogle Scholar
- 13.Gauthier Y, Surlève-Bazeille JE (1974) Ultrastructure des fibres nerveuses périphériques dermiques dans le vitiligo. Bull Soc Fr Dermatol Syphil 81:550–554Google Scholar
- 14.Gauthier Y, Cario-André M, Lepreux S et al (2003) Melanocyte detachment after skin friction in non lesional skin of patient with generalized vitiligo. Br J Dermatol 148:95–101PubMedCrossRefGoogle Scholar
- 15.Gonzalves RP, Bechelli LM, Simao T et al (1978) Etude quantitative ultrastructurale de la couche basale de l'epiderme dans les taches de vitiligo et dans la melanodermie périlé-sionnelle. Ann Dermatol Venereol 205:395–400Google Scholar
- 16.Hann SK, Park YK, Lee KG (1992) Epidermal changes in active vitiligo. J Dermatol 19:217–222PubMedGoogle Scholar
- 17.Hunter JA, MC Vittie E, Comaisk JS (1975) Light and elec-tronmicroscopic studies of physical injury to the skin: friction. Br J Dermatol 90:491–498CrossRefGoogle Scholar
- 18.Husain I, Vijayan E, Ramaiah A, Pasricha JS, Madan NC (1982) Demonstration of tyrosinase in the vitiligo skin of human beings by a sensitive fluorometric method as well as by 14C(U)-l-tyrosine incorporation into melanin. J Invest Dermatol 78:243–252PubMedCrossRefGoogle Scholar
- 19.Ishi M, Hamada T (1981) Ultrastructural studies of vitiligo with inflammatory raised borders. J Dermatol 8:312–322Google Scholar
- 20.Kao M (1990) Depletion and repopulation of Langerhans cells in non segmental type of vitiligo. J Dermatol 17:287–296PubMedGoogle Scholar
- 21.Kumakiri M, Hashimoto K, Willis I (1978) Biological changes of human cutaneous nerves caused by ultraviolet irradiation: an ultrastructural study. Br J Dermatol 99:65–70PubMedCrossRefGoogle Scholar
- 22.Le Poole C, Van den Wijngaard MC, Westerhof W et al (1993) Presence or absence of melanocytes in vitiligo lesions: an immunohistochemical investigation. J Invest Dermatol 100:816–822PubMedCrossRefGoogle Scholar
- 23.Mishima Y (1972) Dendritic cell dynamics in progressive depigmentation. Arch Dermatol Res 87:243–267Google Scholar
- 24.Moellmann G, Klein-Angerer S, Scobly DA (1982) Extracellular granular material and degeneration of kerati-nocytes in the normally pigmented epidermis of patients with vitiligo. J Invest Dermatol 79:321–330PubMedCrossRefGoogle Scholar
- 25.Morahashi M, Hashimoto K, Goodman TF et al (1977) Ultrastructural studies of vitiligo, Vogt-Koyanagi syndrome and incontinentia pigmenti achromians. Arch Dermatol 113:755–766CrossRefGoogle Scholar
- 26.Mottaz JH, Thorne G, Zelickson A (1971) Response of the epidermal melanocytes to minor trauma. Arch Dermatol 104:611–618PubMedCrossRefGoogle Scholar
- 27.Niebauer G (1965) On the dendritic cells in vitiligo. Dermatologica 130:317–324PubMedCrossRefGoogle Scholar
- 28.Ortonne JP (1983) Vitiligo and other hypomelanoses of hair and skin. In: Ortonne JP, Mosher DB, Fitzpatrick TB (eds) Disorders with circumscribed hypomelanosis. Plenum, New YorkGoogle Scholar
- 29.Ortonne JP, Thivolet J (1980) PUVA induced repigmentation of vitiligo: scanning electron microscopy of hair follicles. J Invest Dermatol 74:40–42PubMedCrossRefGoogle Scholar
- 30.Perrot H et al (1974) Etude ultrastructurale du vitiligo. Lyon Med 232:439–446Google Scholar
- 31.Pinkus H (1959) Vitiligo: what is it? J Invest Dermatol 32:281–284PubMedCrossRefGoogle Scholar
- 32.Tobin JD, Swanson N, Pittelkow M et al (2000) Melanocytes are not absent in lesional skin of long duration vitiligo. J Pathol 191:407–416PubMedCrossRefGoogle Scholar
- 33.Zelickson AS, Mottaz JH (1968) Epidermal dendritic cells. Arch Dermatol 98:652–658PubMedCrossRefGoogle Scholar