Korean J Dermatol.
2008 May;46(5):569-577.
Value of Histological Staining in Differential Diagnosis of Vitiligo
- Affiliations
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- 1Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea. schul@chonnam.ac.kr
Abstract
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BACKGROUND: Vitiligo is a depigmented disorder, causing serious cosmetic problems for patients. In diagnostic and therapeutic aspects, vitiligo should be differentiated from other hypopigmented disorders as the therapeutic approach and prognosis are different for each disease.
OBJECTIVE
This study aimed to compare the usefulness of several markers for melanocytes or melanin in differential diagnosis of vitiligo.
METHODS
Twenty-eight patients were studied, who were diagnosed clinically as suffering from one of the following diseases: vitiligo, nevus depigmentosus, pityriasis alba, postinflammatory hypopigmentation, and idiopathic guttate hypomelanosis. Skin samples (frozen or paraffin-fixed) were obtained from depigmented patches and normal neighboring skin (control). Histological staining was performed by using Fontana-Masson, S-100, MART-1, and DOPA. The staining level of lesional skin was compared with that of normal skin.
RESULTS
When the staining level of vitiligo was compared with that of others, vitiligo was significantly lower in Fontana-Masson (13.3+/-17.2% vs 44.4+/-23.7%), S-100 (49.5+/-14.9% vs 74.7+/-24.2%), MART-1 (7.4+/-8.7% vs 68+/-33.9%), and DOPA (9.5+/-11.3% vs 58.2+/-29.5%) (p<0.0001).
CONCLUSION
MART-1 and DOPA are valuable markers in differential diagnosis of vitiligo. However, Fontana-Masson, a marker of melanin, had some limits in detecting melanocytes, and S-100 showed non-specific staining other than melanocytes.