白癜风白发的临床特征及治疗现状分析

The Clinical Features and Treatment Effect of Vitiligo-associated Leukotrichia(VAL)

目的了解白癜风白发的临床特征和治疗现状,为白癜风白发的诊治提供临床依据。方法对2020年7月-2021年4月就诊于本科的白癜风患者进行问卷调查、皮肤科查体、Wood灯检查,并对白癜风白发的临床特征、Wood灯检查和治疗现状进行分析。结果337例白癜风患者完成调查,42.14%(142例)患者伴白发。白癜风白发患者中,127例(169处)终毛变白,毛发变白以头面部为主(139处)。在139处头面部白发中,白发为首发表现者占比26.62%(37/139),毛发变白1年以内的患者处于进展期的比例为93.83%(76/81),远大于毛发变白1年以上者为46.55%(27/58),差异有统计学意义(P<0.05)。Wood灯检查示8处白发区域在自然光下基底白斑不明显,借助Wood灯检查得以明确,10处白发Wood灯下无荧光增强。节段型白癜风是白癜风并发白发的独立危险因素。91/139处白发经过治疗,仅9处出现复色。63.64%(14/22)毳毛变白的患者经过治疗,白斑复色程度均不足25%。结论白癜风伴发白发的比例为42.14%,以节段型、头面部最为多见。毛发变白时间小于1年提示病情进展,伴白发患者除毛发复色困难外,其局部皮肤复色同样困难,因此应探索更有效的治疗方法。

Objective To study the clinical features and treatment effect of VAL(vitiligo-associated leukotrichia).Methods Patients with vitiligo were enrolled and asked to complete questionnaires, dermatological and wood′s light examination.The clinical features and treatment effect were analyzed.Results A total of 337 patients with vitiligo were enrolled.VAL was found in 142 patients(42.14%),with terminal hairs involvement in 127 patients(169 lesions),mainly on the scalp and eyebrows(139 lesions).Among 139 lesions of leukotrichia on the head and face, 37(26.62%) sites with leukotrichia were as the first manifestation, and 81 were less than one year, of which, 76(93.8%) were in the progressive stage.Fifty-eight patients had the history over 1 year and 27(46.55%) were in the progressive stage(P<0.05).Eight lesions with invisible white patches and 10 lesions had no fluorescence enhancement under VAL by Wood lamp examination.Segmental vitiligo were independent risk factors for VAL.Ninety-one patients received treatment.Only 9 had partial repigmentation.The repigmentation was found in 63.64%(14/22) patients with body hair leukotrichia and the repigmentation was all less than 25%.Conclusion Vitiligo-associated leukotrichia was found in 42.14% patients with vitiligo, mostly seen in segmental vitiligo.Leukotrichia occurs mainly on the scalp and eyebrows.The hair whitening time less than one year indicates the activity of the disease.Treatment of VAL and leukoderma in VAL area is still a challenge, so it need more effective treatment methods.