Prediction of response to surgical therapy in nonsegmental vitiligo based on an immunohistochemical cutoff value

[摘要] Background  Objective assessment of stability is still lacking in nonsegmental vitiligo (NSV). Objective  To suggest immunohistochemical cutoff values that can predict a good response to surgical therapy of NSV cases. Patients and methods  Fifteen active and 15 stable NSV cases were included in the present study. A 3-mm perilesional biopsy from perilesional skin was obtained for immunohistochemical staining for CD8, CD45RO, and FoxP3. Mini punch graft was done for all cases, and response was assessed after 6 months. Good responders had spread of pigment more than 1 mm, and poor responders had no spread of pigment or loss of color. Comparison of immunohistochemical findings according to response to surgery was done, and a cutoff value was calculated when feasible. Results  Ten active and 10 stable cases continued 6 months of follow-up. Loss of color occurred in all active cases, whereas five patients had no spread and five patients had good response in the stable group. Good responders had a significantly lower level of CD8+ (P=0.001) and CD45RO+ cells (P=0.020), with cutoff values of 7 and 11 cells/high-power field, respectively. No significant difference was found in FoxP3+ cells. Conclusion  A suggested cutoff value of 7 CD8+ T cells and 11 CD45RO+ cells/high-power field can predict a good response to surgery in NSV.

[学科分类] 皮肤病学

[关键词] CD45RO+;CD8+ T cells;FoxP3;nonsegmental vitiligo;stability in vitiligo