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French researchers better defined and compared the clinical features of nonsegmental vitiligo (NSV) and segmental vitiligo (SV) in children.

SV occurs in a minority of patients and is thought to be more frequent in children. There are limited data regarding the differences between these two forms.

NSV was found to be associated with a higher number of lesions and a larger body surface area of involvement. In NSV, a higher incidence of the Koebner phenomenon (spread due to skin trauma) was found, as well as a more frequent progression of the disease within one year. Additionally, thyroid abnormalities and hyperpigmented rims around vitiligo were seen exclusively in NSV. Interestingly, only NSV was found to be associated with autoimmune manifestations in the children studied. 

The researchers proposed that NSV and SV had different causes, with NSV being an autoimmune disorder; whereas SV results from dysfunction of sympathetic nerves in the affected area.  (June 2010 Journal of the American Academy of Dermatology, “Segmental and Nonsegmental Childhood Vitiligo has Distinct Clinical Characteristics: A Prospective Observational Study,” Juliette Mazereeuw-Hautier, MD, PhD, Sophie Bezio, Emmanuel Mahe, MD, Christine Bodemer, MD, PhD, Catherine Eschard, MD, Valeries Viseux, MD, Christine Labreze, MD, Patrice Plantin, MD, Sebastien Barbarot, MD, Pierre Vabres, MD, Ludovic Martin, MD, Carle Paul, MD, Ph.D., Jean-Philippe Lacour, MD and the Groupe de Recherche Clinique en Dermatologic Pediatrique.)

Editor’s background comment:  When progression, prognosis and treatment are considered, vitiligo can be classified into two major clinical types: segmental and nonsegmental.  Segmental vitiligo (SV) usually has an onset early in life and tends to spread rapidly at the onset over the affected area, usually confined to one side of the body, then remains stable thereafter.  Depigmented patches can persist unchanged for the life of the patient. More than half the SV patients have patches of white hair.   Nonsegmental Vitiligo (NSV) includes all types of vitiligo except segmental vitiligo, such as focal vitiligo (one area of vitiligo) and the more common generalized vitiligo, which is generally progressive and often mirrors on both sides of the body.  Also, while it is uncommon, a person with SV can later develop NSV.