Validation of the diagnostic criteria for segmental vitiligo.


Journal

Indian journal of dermatology, venereology and leprology
ISSN: 0973-3922
Titre abrégé: Indian J Dermatol Venereol Leprol
Pays: United States
ID NLM: 7701852

Informations de publication

Date de publication:
Historique:
pubmed: 3 7 2020
medline: 18 9 2021
entrez: 3 7 2020
Statut: ppublish

Résumé

Segmental vitiligo has a different clinical course and prognosis as compared to nonsegmental vitiligo, which necessitates its correct diagnosis. It may be difficult to distinguish segmental vitiligo from the limited or focal types of nonsegmental vitiligo. To validate the previously proposed diagnostic criteria for segmental vitiligo. This was a cross-sectional validation study involving patients with limited vitiligo. The diagnostic criteria were used to classify vitiligo lesions as segmental or nonsegmental, and was compared with the experts' diagnosis, which was considered as the "gold standard". The study included 200 patients with 225 vitiligo lesions. As per the diagnostic criteria, 146 vitiligo lesions were classified as segmental and 79 as nonsegmental. The experts classified 147 vitiligo lesions as segmental and 39 as nonsegmental, while the diagnosis either was labeled "unsure" or could not be agreed upon for 39 lesions. As compared with the experts' opinions ("for sure" cases, n = 186), the sensitivity and specificity of the diagnostic criteria was 91.8% (95% confidence interval [CI]: 86.2%-95.7%) and 100% (95% CI: 91%-100%), respectively. The positive predictive value was 100% (95% CI: 97.3-100%), while the negative predictive value was 76.5% (95% CI: 62.5%-87.2%). There was a 93.5% agreement between the clinical criteria and experts' opinions (k = 0.83, P < 0.001). The diagnostic criteria were compared with the experts' opinion in the absence of an established diagnostic "gold standard". The proposed diagnostic criteria for segmental vitiligo performed well, and can be used in clinical practice, as well as in research settings.

Sections du résumé

BACKGROUND BACKGROUND
Segmental vitiligo has a different clinical course and prognosis as compared to nonsegmental vitiligo, which necessitates its correct diagnosis. It may be difficult to distinguish segmental vitiligo from the limited or focal types of nonsegmental vitiligo.
OBJECTIVE OBJECTIVE
To validate the previously proposed diagnostic criteria for segmental vitiligo.
METHODS METHODS
This was a cross-sectional validation study involving patients with limited vitiligo. The diagnostic criteria were used to classify vitiligo lesions as segmental or nonsegmental, and was compared with the experts' diagnosis, which was considered as the "gold standard".
RESULTS RESULTS
The study included 200 patients with 225 vitiligo lesions. As per the diagnostic criteria, 146 vitiligo lesions were classified as segmental and 79 as nonsegmental. The experts classified 147 vitiligo lesions as segmental and 39 as nonsegmental, while the diagnosis either was labeled "unsure" or could not be agreed upon for 39 lesions. As compared with the experts' opinions ("for sure" cases, n = 186), the sensitivity and specificity of the diagnostic criteria was 91.8% (95% confidence interval [CI]: 86.2%-95.7%) and 100% (95% CI: 91%-100%), respectively. The positive predictive value was 100% (95% CI: 97.3-100%), while the negative predictive value was 76.5% (95% CI: 62.5%-87.2%). There was a 93.5% agreement between the clinical criteria and experts' opinions (k = 0.83, P < 0.001).
LIMITATION CONCLUSIONS
The diagnostic criteria were compared with the experts' opinion in the absence of an established diagnostic "gold standard".
CONCLUSIONS CONCLUSIONS
The proposed diagnostic criteria for segmental vitiligo performed well, and can be used in clinical practice, as well as in research settings.

Identifiants

pubmed: 32611883
pii: 288801
doi: 10.4103/ijdvl.IJDVL_704_18
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

656-662

Déclaration de conflit d'intérêts

None

Auteurs

Priyanka Gupta (P)

Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India.

Binod K Khaitan (BK)

Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India.

M Ramam (M)

Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India.

V Ramesh (V)

Department of Dermatology and STD, Safdurjung Hospital, New Delhi, India.

J A Sundharam (JA)

Consultant Dermatologist, Pitampura, New Delhi, India.

Amit Malhotra (A)

Consultant Dermatologist, Jaipur, Rajasthan, India.

Vishal Gupta (V)

Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India.

Vishnubhatla Sreenivas (V)

Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India.

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