A Study on Stability of Acrofacial Vitiligo

Introduction: Acrofacial vitiligo being cosmetically disfiguring, can affect patients self-esteem, employability and interaction with society. The resistant nature if this form of vitiligo adds to anger
and disillusionment in the affected individual. The defiant form in addition to its unstable nature necessitates the further study on acrofacial vitiligo.

Objectives: To determine the clinical morphology with respect to stability of Vitiligo. Materials and Methods: A cross sectional study was done over a period of one year comprising of patients with acro-facial vitiligo. Relevant investigations including histopathology and patch test were done wherever necessary.

Results: A total of 191 cases of acrofacial vitiligo were included in the study. Among stable acral vitiligo (59.48%), ill-defined margins were seen in 84.61% and dorsum was the commonest
site (23.57%). Among unstable Vitiligo, joint was predominantly involved (27.03%).

Conclusion: Being prone for injuries, acrofacial areas are unstable. Well defined margins do not strike to the stability of acral vitiligo and signs of activity can be seen even in stable vitiligo. Hence unlike vitiligo of other areas, where well defined margins can be a marker of stable Vitiligo, margins may not be a scale for defining the stability of acral Vitiligo. Involvement of bony prominences could indicate unstable course and least involvement of proximal area of the phalanges may indicate its unstable nature.