Sự khác biệt về đặc điểm lâm sàng và yếu tố liên quan giữa bạch biến không phân đoạn giai đoạn hoạt động và giai đoạn ổn định

Non-segmental vitiligo (NSV), a common pigmentary disorder, accounts for a significant majority of vitiligo cases and presents distinct clinical characteristics and progression patterns compared to its segmental counterpart. Understanding the nuances between the active and stable phases of NSV is crucial for effective patient management, as its course is complex and influenced by various risk factors, leading to diverse clinical manifestations and prognoses. Existing methods for assessing disease activity can be subjective, underscoring the need for objective markers. This study aims to delineate the differences in clinical characteristics and associated factors between active and stable non-segmental vitiligo, providing valuable insights to improve diagnostic accuracy and optimize therapeutic strategies.

Dermatologists, medical researchers, residents, and general practitioners interested in the diagnosis, prognosis, and management of non-segmental vitiligo.

This cross-sectional descriptive study investigated 200 patients with non-segmental vitiligo (NSV) at the National Hospital of Dermatology and Venereology, comparing clinical characteristics and associated factors between active and stable disease phases. The research employed a structured questionnaire to collect comprehensive clinical data, which was subsequently analyzed using descriptive statistics, Chi-square tests, and independent samples T-tests to identify significant differences. Findings revealed a mean onset age of 30.2 ± 16.9 years for NSV patients, with notable associations with autoimmune conditions like Graves' disease (9%) and diabetes mellitus (6%). A significant proportion (72%) of patients were in the active stage. Psychological stress was identified as a critical factor, being significantly more prevalent in the active group (30.5% vs. 14.3%, p=0.014). Distinct clinical signs such as the Koebner phenomenon, confetti-like depigmentation, and trichrome sign were exclusively observed in 34% of active vitiligo cases and entirely absent in the stable group (p < 0.001), serving as strong indicators of disease activity. Conversely, leukotrichia (white hair within lesions) was more frequent in the stable stage (37.5% vs. 18.1%, p=0.004) and correlated with a longer disease duration, suggesting prolonged disease stability but potentially poorer repigmentation outcomes due to irreversible melanocyte depletion. These findings underscore the importance of recognizing specific clinical markers and psychological factors to accurately assess disease activity, tailor treatment, and predict prognosis in patients with non-segmental vitiligo. Early identification of active disease and its triggers, along with comprehensive patient support, can optimize treatment efficacy and improve long-term outcomes, especially before the irreversible loss of follicular pigment cell reservoirs.