387例节段型白癜风患者的临床分析

Clinical analysis of 387 patients with segmental vitiligo

目的探讨节段型白癜风的病情发展特征。方法问卷调查方法收集2011年10月至2012年10月于我科门诊就诊的387例节段型白癜风患者的资料，进行分析。结果387例中329例（85．0％）发病由局限型发展为节段型，58例首发为节段型。在局限型发展为节段型患者中，220／329例（66．9％）在发病前3个月进展最快，进展3年趋于稳定。在58／387例（15．0％）直接以节段型发病的患者中，40／58例（69．0％）在1个月内进展最快，1年后基本稳定。107／387例（27．6％）发病数年后病情仍不稳定。333／387例（86．0％）以单一神经节段发病，其中三叉神经分布区发病的患者173／333例（52．0％）。稳定长达1年的患者中，62例接受自体黑素细胞移植治疗，56例（90．3％）达到80％以上的复色效果。结论节段型发病快于局限型发病，半数以上患者病情进展3年后稳定。自体黑素细胞移植治疗是稳定期节段型白癜风有效的治疗方法之一。

Objective To characterize the progression of segmental vitiligo. Methods Clinical data were collected using questionnaires from 387 patients with segmental vitiligo at the Department of Dermatology, Third People＇s Hospital of Hangzhou, between October 2011 and October 2012. The progression of segmental vitiligo was analyzed. Results Among the 387 patients, 329 initially sufferred from focal vitiligo that evolved into segmental vitiligo later, 58 began with segmental vitiligo. Vitiligo progressed most rapidly in the initial three months, and tended to be stable after three years in 220 （66.9%） of the 329 patients experiencing the evolution from focal to segmental vitiligo. By contrast, vitiligo developed most rapidly in the first month, and tended to be quiescent after one year in 40 （69.0%） of the 58 patients presenting with segmental vitiligo only. The condition still remained active in 27.6% （107/387） of these patients after several years of progression. Totally, 333 （86.0%） patients showed the involvement of single ganglion at the onset of vitiligo, including 173 （52.0%） patients with the involvement of trigeminal ganglion. Autologous melanocyte transplantation was conducted for 62 patients whose condition had been quiescent for more than one year, and 56 （90.3%） patients achieved more than 80% repigmentation. Conclusions Segmental vitiligo, which tends to remain quiescent after three-year progression, seems to have a more rapid onset than focal vitiligo. Autologous melanocyte transplantation appears to be an effective treatment for segmental vitiligo in stable stage.