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Is Dermoscopy, Reflectance Confocal Microscopy Combo Best for Assessing Vitiligo?

Sensitivity and specificity of dermoscopy combined with RCM was higher than RCM or dermoscopy alone

By Dermsquared Editorial Team | January 17, 2024

WEDNESDAY, Jan. 17, 2024 -- For patients with vitiligo, dermoscopy combined with reflectance confocal microscopy (RCM) has higher sensitivity and specificity for measuring disease activity and treatment response, according to a study published online Dec. 18 in Clinical, Cosmetic and Investigational Dermatology.

Hui-Fen Wang, from the First Affiliated Hospital of Army Medical University in Chongqing, China, and colleagues assessed disease activity by Vitiligo Disease Activity score, dermoscopy, RCM, and dermoscopy combined with RCM among 279 patients with vitiligo.

The researchers found that the sensitivity and specificity of dermoscopy combined with RCM were higher than RCM or dermoscopy alone. At baseline, leukotrichia, pigment network absent, and perilesional hyperpigmentation under dermoscopy in the repigmentation process suggested a poor treatment response; a good treatment response was indicated by incompletely disappearing pigment rings under RCM and perifollicular hyperpigmentation under dermoscopy. By dermoscopy, the proportion of patients with telangiectasia and increased pigment at the lesions and around the hair follicles was significantly higher in the good versus the poor treatment response group; by RCM, the proportion of patients with both increased pigment granules and dendritic melanocytes was higher in the good versus the poor treatment response group.

"Our study identified that both dermoscopy and RCM can be used to evaluate vitiligo disease activity and monitor treatment response, which is helpful to make optimal treatment regimens," the authors write. "The combination of dermoscopy and RCM can make up for the technical deficiency of each alone and present more objective evaluation than the traditional assessment method."


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