title: Confetti-like depigmentation: A potential sign of rapidly progressing vitiligo.
abstract: BACKGROUND
  Confetti-like depigmentation was noted in patients reporting recent worsening of vitiligo.
  
  
  OBJECTIVE
  We sought to determine if confetti-like depigmentation is a marker of rapidly progressing vitiligo.
  
  
  METHODS
  Review of patient records and images of patients from a vitiligo registry resulted in 7 patients with 12 images that fit inclusion criteria and were evaluated for percent depigmentation by 3 independent reviewers. The Vitiligo Disease Activity Score and the Koebner Phenomenon in Vitiligo Score in an additional cohort of patients with confetti-like lesions were compared with patients who had vitiligo without confetti-like lesions.
  
  
  RESULTS
  The mean percentage of depigmentation at baseline was 19.2%, which increased to 43.9% in images obtained at a mean of 16 weeks of follow-up. Vitiligo Disease Activity Score and Koebner Phenomenon in Vitiligo Score were significantly higher in the patients with confetti-like lesions compared with those without confetti-like lesions. A skin biopsy specimen of a confetti-like lesion in 1 patient revealed an inflammatory infiltrate in the papillary dermis with CD8(+) T cells localized to the dermoepidermal junction.
  
  
  CONCLUSIONS
  Small, single-center retrospective review and lack of full-body photographs are limitations.
  
  
  CONCLUSIONS
  A confetti-like pattern of depigmentation may be a negative prognostic indicator for patients with rapidly progressing vitiligo. Further, prospective studies to evaluate this physical finding should be performed.
authors.affiliation: Department of Dermatology, University of Texas Southwestern Medical Center, Texas, California.
authors.forename: Juan Jesús
authors.initials: JJ
authors.lastname: Sosa
authors.affiliation: Department of Dermatology, University of Texas Southwestern Medical Center, Texas, California.
authors.forename: Sharif D
authors.initials: SD
authors.lastname: Currimbhoy
authors.affiliation: Department of Dermatology, University of Texas Southwestern Medical Center, Texas, California.
authors.forename: Uzoamaka
authors.initials: U
authors.lastname: Ukoha
authors.affiliation: Department of Dermatology, University of Texas Southwestern Medical Center, Texas, California.
authors.forename: Samantha
authors.initials: S
authors.lastname: Sirignano
authors.affiliation: Department of Dermatology, David Geffen School of Medicine at the University of California, Los Angeles, California.
authors.forename: Ryan
authors.initials: R
authors.lastname: O'Leary
authors.affiliation: Department of Dermatology, University of Texas Southwestern Medical Center, Texas, California.
authors.forename: Travis
authors.initials: T
authors.lastname: Vandergriff
authors.affiliation: Department of Clinical Sciences (Biostatistics), University of Texas Southwestern Medical Center, Texas, California; Department of Psychiatry, University of Texas Southwestern Medical Center, Texas, California.
authors.forename: Linda S
authors.initials: LS
authors.lastname: Hynan
authors.affiliation: Department of Dermatology, University of Texas Southwestern Medical Center, Texas, California. Electronic address: amit.pandya@utsouthwestern.edu.
authors.forename: Amit G
authors.initials: AG
authors.lastname: Pandya
mesh_terms: D000328:Adult; D000368:Aged; D002140:California; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017496:Hypopigmentation / Q000453:epidemiology / Q000473:pathology*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010781:Photography / Q000379:methods*; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D013997:Time Factors; D014820:Vitiligo / Q000473:pathology* / Q000503:physiopathology*
keywords: depigmentation; leukoderma; melanocyte; pigmentation; skin of color; vitiligo