According to the development of vitiligo, vitiligo can be divided into progressive stage and stable stage. Both the patients themselves or the parents of the children, and the clinicians are concerned about which period the patients are in, because the treatment methods we use are different for different disease stages.
There are many vitiligo treatment methods, including topical hormones, tacrolimus, pimecrolimus, vitamin D3 analogs, tincture of bone marrow, 308nm excimer laser, PUVA and NB-UVB, epidermal transplantation, oral hormones, compound glycopyrrolate and other means. The method used is closely related to the condition of the disease.
Then how to determine whether the patient is in the progressive or stable stage?
1, according to the characteristics of the development of lesions: if the patient’s lesions have not expanded or the white spots have not increased in the past 1 year, it can basically be judged as a stable stage. If the number of white spots has increased or the original white spots have increased in the past year, it can be regarded as the progressive stage. The progressive stage can be further classified according to the speed of progression, which is generally done by the VIDA score. A score of 4 is assigned if new lesions or enlargement of the original lesions appear within the last 6 weeks, +3 if new lesions or enlargement of the original lesions appear within the last 3 months, +2 if new lesions or enlargement of the original lesions appear within the last 6 months, +1 if new lesions or enlargement of the original lesions appear within the last 1 year, 0 if stable for at least 1 year, and -1 if stable for at least 1 year with spontaneous pigment regeneration. A total score >1 is considered as progressive stage, >4 is rapid progressive stage.
2, according to the WOOD lamp test results: WOOD lamp (WOOD lamp, Wood lamp) is used through the filter containing nickel oxide and obtained 320nm ~ 400nm long-wave ultraviolet light, if the melanin reduction is strong refraction, light color. Vitiligo patients emit bright white fluorescence when the lesion is irradiated by Wood’s lamp. If a significant white fluorescence appears in a normal looking area (looks normal to the naked eye), it suggests that vitiligo is in the progressive stage.
The appearance of isomorphic reaction also indicates that vitiligo is in the progressive stage.
In conclusion, clinicians have to judge the condition based on the patient’s disease characteristics, medical history and other information. I hope that patients or parents of the affected children will pay attention to the changes in the white spot area during their daily life so as to provide the correct information to the doctor and finally choose the appropriate treatment.