Vitiligo pp 139-142 | Cite as

Natural History and Prognosis

  • Davinder ParsadEmail author

Core Messages

  • The natural course of vitiligo is highly unpredictable, but some evolution patterns can be delineated.

  • Disease activity scores are needed especially to precisely define stability.

  • The Koebner's phenomenon, tri(multi-)chrome vitiligo, mucosal involvement, leukotrichia, a positive family history, presence of antithy-roid antibodies or association with other autoimmune diseases predict a relatively poor prognosis.

  • The prognosis of vitiligo might be predicted by the location of the initial lesions, a bad prognosis is expected if the initial sites are the posterior trunk and hands, less progression is expected when the initial sites are the face, upper or lower extremities.

  • Leukotrichia means poor prognosis for repigmentation, with the assumption that no mel-anocytes are available within the depigmented area.

  • The repigmentation induced by narrowband UBV therapy in NSV seems more stable than that induced by PUVA. However, ability to retain the pigment depends also on host factors and site of repigmentation (follicular, marginal, and interfollicular).


Initial Site Initial Lesion Vitiligo Patient Posterior Trunk Koebner Phenomenon 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Cui J, Arita Y, Bystryn JC (1993) Cytolytic antibodies to melanocytes in vitiligo. J Invest Dermatol 100:812–815PubMedCrossRefGoogle Scholar
  2. 2.
    Dave S, Thappa DM, Dsouza M (2002) Clinical predictors of outcome in vitiligo. Indian J Dermatol Venereol Leprol 68:323–325PubMedGoogle Scholar
  3. 3.
    Halder RM, Grimes PE, Cowan CA (1987) Childhood viti-ligo. J Am Acad Dermatol 16:948–954PubMedCrossRefGoogle Scholar
  4. 4.
    Hann SK, Chun WH, Park YK (1997) Clinical characteristics of progressive vitiligo. Int J Dermatol 36:353–355PubMedCrossRefGoogle Scholar
  5. 5.
    Hann SK, Kim YS, Yoo JH, Chun YS (2000) Clinical and histopathologic characteristics of trichrome vitiligo J Am Acad Dermatol 42:589–596PubMedGoogle Scholar
  6. 6.
    Hann SK, Lee HJ (1996) Segmental vitiligo: clinical find-ings in 208 patients. J Am Acad Dermatol 35:671–674PubMedCrossRefGoogle Scholar
  7. 7.
    Hann SK, Park YK, Whang KC (1986) Clinical study of 174 patients with generalized vitiligo. Kor J Dermatol 24:798–805Google Scholar
  8. 8.
    Harning R, Cui J, Bystryn JC (1991) Relation between the incidence and level of pigment cell antibodies and disease activity in vitiligo. J Invest Dermatol 97:1078–1080PubMedCrossRefGoogle Scholar
  9. 9.
    Hatchome N, Kato T, Tagamit H (1990) Therapeutic success of epidermal grafting in generalized vitiligo is limited by the Koebner phenomenon. J Am Acad Dermatol 22:87–91PubMedCrossRefGoogle Scholar
  10. 10.
    Falabella R, Arrunategui A, Barona MI, Alzate A (1995) The minigrafting test for vitiligo: detection of stable lesions for melanocyte transplantation. J Am Acad Dermatol 32:228–232PubMedCrossRefGoogle Scholar
  11. 11.
    Gauthier Y (1995) The importance of Koebner's phenomenon in the induction of vitiligo vulgaris lesions. Eur J Dermatol 5:704–708Google Scholar
  12. 12.
    Koga M (1977) Vitiligo: a new classification and therapy. Br J Dermatol 97:255–261PubMedCrossRefGoogle Scholar
  13. 13.
    Koga M, Tango T (1988) Clinical feature and course of type A and type B vitiligo. Br J Dermatol 118:223–228PubMedCrossRefGoogle Scholar
  14. 14.
    Moellmann G, Klein-Angerer S, Scollay DA et al (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
  15. 15.
    Njoo MD, Das PK, Bos JD, Westerhof W (1999) Association of the Koebner phenomenon with disease activity and therapeutic responsiveness in vitiligo vulgaris. Arch Dermatol 135:407–413PubMedCrossRefGoogle Scholar
  16. 16.
    Ortonne JP (2000) Special features of vitiligo. In: Hann SK, Nordlund JJ (eds) Vitiligo. A monograph on the basic and clinical science. Blackwell, Oxford, pp 70–77Google Scholar
  17. 17.
    Parsad D, Kanwar AJ, Kumar B (2006) Psoralen-ultraviolet A vs. narrow-band ultraviolet B phototherapy for the treat- ment of vitiligo. J Eur Acad Dermatol Venereol 20:175–177PubMedCrossRefGoogle Scholar
  18. 18.
    Parsad D, Pandhi R, Dogra S, Kumar B (2004) Clinical study of repigmentation patterns with different treatment modalities and their correlation with speed and stability of repigmentation in 352 vitiliginous patches. J Am Acad Dermatol 50:63–67PubMedCrossRefGoogle Scholar
  19. 19.
    Parsad D, Pandhi R, Juneja A (2003) Effectiveness of oral Ginkgo biloba in treating limited, slowly spreading vitiligo. Clin Exp Dermatol 28:285–287PubMedCrossRefGoogle Scholar
  20. 20.
    Taïeb A, Picardo M; VETF Members (2007) The definition and assessment of vitiligo: a consensus report of the Vitiligo European Task Force. Pigment Cell Res 20:27–35PubMedCrossRefGoogle Scholar
  21. 21.
    Uda H, Takei M, Mishima Y (1984) Immunopathology of vitiligo vulgaris, Sutton's leukoderma and melanoma-associated vitiligo in relation to steroid effects, II: the IgG and C3 deposits in the skin. J Cutan Pathol 11:114–124PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2010

Authors and Affiliations

  1. 1.Department of DermatologyPostgraduate Institute of Medical Education & ResearchChandigarhIndia

Personalised recommendations