节段型白癜风的研究进展

Update on segmental vitiligo

节段型白癜风是白癜风的一种亚型，沿皮神经节段分布。与其他类型白癜风相比，其在临床表现、发病机制和治疗等方面均有其自身特点。临床上具有发病早、皮损不对称、进展迅速的特点，很少向其他部位蔓延，很少伴有其他自身免疫病。病因及发病机制尚不明确，目前有神经学说、遗传学说、免疫学说及三步骤理论等。节段型白癜风的一线治疗是避免诱发因素，局部外用糖皮质激素、钙调神经磷酸酶抑制剂、维生素D3衍生物等，快速进展期可考虑系统给予小剂量糖皮质激素；二线治疗为窄谱中波紫外线、准分子激光或氦氖激光等；三线治疗是复色仍不理想，考虑手术治疗。

Segmental vitiligo, a subtype of vitiligo, is distributed segmentally along cutaneous nerves. Compared with other types of vitiligo, segmental vitiligo has distinctive clinical manifestations, pathogenesis and treatment. It is characterized by early onset, asymmetric skin lesions, rapid progression, and low likelihood of spreading to other sites or being accompanied by other autoimmune diseases. The etiology and pathogenesis of segmental vitiligo remain unclear, and several hypotheses have been put forward, such as the neural theory, genetic theory, immunological theory and a new three-step theory. The first-line treatment of segmental vitiligo is avoidance of causative factors, topical application of glucocorticoids, calcineurin inhibitors, vitamin D3 derivatives, and oral administration of a small dose of glucocorticoids at rapid progression stage. The second- line treatment is narrow-band ultraviolet B, excimer laser or helium-neon laser, etc. Surgery may serve as the third-line treatment when repigmentation is unsatisfying.