A vitiligo patient is found to have segmental vitiligo on the left cheek corresponding to the V2 dermatome. The clinical significance of segmental vitiligo compared to non-segmental vitiligo includes all of the following EXCEPT:

• A Tends to stabilise after initial rapid spread
• B Poor response to medical (immunomodulatory) treatments but better response to surgical melanocyte grafting
• C Associated with halo naevi on the same segment
• D Higher association with autoimmune thyroid disease ✓

Explanation

Segmental vitiligo (SV) is characterised by a unilateral distribution following a dermatomal or quasi-dermatomal pattern, early rapid onset with subsequent stabilisation, and a non-autoimmune (primarily sympathetic nervous system dysregulation) pathomechanism. Unlike non-segmental vitiligo (NSV), SV has a low association with other autoimmune diseases including thyroid disease — this association is characteristic of NSV. SV responds poorly to immunomodulatory treatments (steroids, calcineurin inhibitors) but excellent response to surgical grafting. Halo naevi on the same segment are a recognised association.

Reference: Neena Khanna Illustrated Synopsis of Dermatology & STD, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.