Anatomical segmentations in all forms of vitiligo: A new dimension to the etiopathogenesis.
BACKGROUND
We have reported segmented lesions in acral vitiligo as well as in generalized vitiligo and thereby proposed somatic mosaicism as a predisposing feature in all forms of vitiligo. This study is a further attempt to characterize and understand such segmented lesions by screening a large series of patients.


METHODS
We searched our electronic archives (from 2002 to 2014) and identified/reviewed the photos of 615 vitiligo patients inclusive of all clinical types. Over 3500 photographs were screened for patterns that were repeatedly seen in two or more patients and a composite picture of these were marked on a body map.


RESULTS
Similar unilateral/bilateral segmented lesions were identified among all forms of vitiligo during relatively stable phases of the disease. These appeared to be related to small and large anatomical divisions of the body. In rapidly evolving disease on the trunk, the lesions conformed to Blaschkoid patterns. Several instances of stable mirror image lesions, symmetric incremental progressions and regressions were also recorded.


CONCLUSIONS
These are observations of a retrospective, single-center review which need to be substantiated further in larger prospective studies.


CONCLUSIONS
Similar unilateral/bilateral segmented patterns delineating major/minor anatomical divisions of the body may indicate a preexisting developmental defect (such as mosaicism).
Visakha Institute of Skin and Allergy, Marripalem, Visakhapatnam, Andhra Pradesh, India.
Venkata Ratnam
VR
Attili
Visakha Institute of Skin and Allergy, Marripalem, Visakhapatnam, Andhra Pradesh, India.
Sasi Kiran
SK
Attili
D018450:Disease Progression; D005260:Female; D006706:Homeostasis / Q000502:physiology; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012880:Skin Pigmentation / Q000502:physiology; D060726:Torso / Q000033:anatomy & histology / Q000473:pathology; D014820:Vitiligo / Q000175:diagnosis* / Q000209:etiology*