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Diagnosis Standard of Vitiligo

vitiligo diagnosisTypical vitiligo easy to diagnose


The vitiligo classification in the past in a mess, in the clinic we often divided vitiligo according to it shape, site, depigmentated situation, we divided vitiligo into different types. 1n 1994, the pigment disease group in whole country discussed and draft the vitiligo clinical classification divided vitiligo into type 2, the second, the second phase.

1. Type 2

(1) the usual type

① localized: single or clustered white spots with different size and localized in a certain site.

② generalized: generalize or multiple vitiligo often symmetrical distribute, the total area of the vitiligo often not more than 50% of the body surface area.

③ generalized: often develop from sporadic vitiligo, most of the vitiligo will integrated together into irregular large scale white patches, sometimes only residue small patches normal skin in the shape of island.

④ acra type: the vitiligo first occur in the body of acromegaly such as face, hands, feet, toes, fingers and other parts and mainly distribute in that area, a little can accompany trunk generalized vitiligo.

(2) segmental type

One or several patches of vitiligo distribute towards the skin area dominated by one of the nerve segment, often distribute unilaterally.

The second

1. The color of complete vitiligo is pure white or porcelain white, there are no pigment regenerating phenomenon in the vitiligo, the vitiligo react with DOPA present negative.

2. Incomplete vitiligo have incomplete depigmentation, you can see the melanin dots in the vitiligo, the number of melanophore in the vitiligo tissue is decreased, it react with DOPA present positive.

The second phase

Clinical stages: we classified vitiligo in clinic into two phases, the progressive stage and stable stage.

(1) progressive phase

The progressive phase it means the vitiligo continuously expand and have new vitiligo occurred, the isomorphic reaction is positive that is formed into new vitiligo in the bases of other skin diseases. The vitiligo increased in the progressive stage, the original vitiligo gradually migrate to the normal skin, the vitiligo gradually expand, the boundary between the vitiligo and normal skin become uncleared; we often can see the vitiligo expand because the intense stimulation of the external medicine; a lot of patients suffer from mechanical stimulation such as friction that include tights, tight bra, waistband, sanitary belt, hernia joe and so on make the previously normal skin occur vitiligo or promote the original vitiligo expand and appear isomorphic reaction phenomenon. Other local stimulation such as burns, sunburns, frostbiting, radioactive rays, infection also have this reaction even cause the lesion area spread to whole body.

(2) stable phase

The vitiligo stop spreading in the stable phase and the boundary is clear, the pigment in the edge is increased. In this phase the vitiligo will not appear isomorphic reaction phenomenon because of the external medicine and mechanical irritations, so in this phase, the vitiligo patients can choose external medicine with light sensitive effect to promote the vitiligo in the stable phase transform to the improve phase. In the improve phase, the boundary is clear, the pigment increased in the edge and appear pigment belt, the later gradually permeate into the center of vitiligo make the vitiligo inside shrink or there are pores appeared in the vitiligo or pigment doted in the island shape pigment area, the number of vitiligo gradually decreased.

4. Traditional Chinese medicine pathogenesis and syndrome differentiation

Chinese medicine holds that internal injuries caused by seven emotions, stagnation of liver qi, qi obstruction, affected wind-evil again desperate to skin cause localized qi and blood disorder finally induce vitiligo, or because of deficiency of liver-yin and kidney-yin, deficiency of qi and blood caused this disease.

Syndrome differentiation of traditional Chinese medicine

(1) stagnation and blood stasis type

Principal syndrome:the vitiligo on the head, face and trunk with irregular shape, have no inflammatory or scurf. Melancholic spirit,irritable, pale tongue or extravasated blood, moss thin white, loose and slow pulse.

Differentiation:the wind evil attack Cou, qi-blood disharmony.

(2) kidney-yin-deficiency type

Main symptom:not stable easy occur part, it can be localized or generalized, the hair in the vitiligo most is white, dizziness tinnitus, soreness and weakness of waist and knees, lusterless complexion, the tongue coating is thin, veins thin.


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