Patient-derived VIDA and dermoscopy versus sequential planimetry for assessing activity in vitiligo patients receiving narrowband ultraviolet B: a comparative longitudinal study

Abstract

Background Judging the stability/activity of vitiligo is of therapeutic and prognostic significance. Clinical and biochemical activity indicators are available, but none is currently universally accepted. Objective To compare the accuracy of patient-derived vitiligo disease activity score (VIDA) and dermoscopy, versus sequential planimetry in determining vitiligo stability/activity. Patients and methods A total of 120 nonsegmental otherwise healthy vitiligo patients were included, who reported disease stability for the last 6 months. Global assessment and photography were followed by choosing a stable non-repigmenting lesion for longitudinal evaluation of planimetric changes, and dermoscopy. Patients received the standard protocol of narrow band ultraviolet B for 3 months, and patient recall for global and lesional progression was recorded. Accuracy of patient-derived VIDA and dermoscopic signs, versus planimetric changes as the reference were compared for judging vitiligo stability/activity. Results Patient-derived VIDA showed 58.33% accuracy in determining disease stability while Dermoscopy showed 97.50% overall accuracy. The absence of a pigment network and the absence of signs of activity (collective absence of ill-defined border, satellite lesions, and microkoebnerization) showed 100% accuracy in establishing disease stability. On the other hand, the presence of any microkoebnerization, starburst sign, or satellite/tapioca sago sign was 100% indicative of activity. Border definition gave a 91.67% overall accuracy for judging stability, while Perifollicular pigmentation showed an accuracy of 49.17%. Conclusion Patient-derived VIDA is generally unreliable, whereas longitudinal follow-up for planimetric changes, and dermoscopic assessment are of better reliability. The absence of pigment network, and collective absence of ill-defined border, microkoebnerization, and satellite lesions are 100% accurate in predicting stable vitiligo.