Computerized image analysis of clinical and histopathological melanin changes in perilesional skin compared with normal skin in vitiligo

Background Although many studies have focused on vitiliginous skin, studies on perilesional and apparently normal distant skin remain few and controversial. The degree of involvement of these areas and the size of the affected surface area considerably influence strategies of therapeutic options. Objective To compare and correlate colour and histopathological melanin changes in lesional, perilesional skin with distant skin of vitiligo patients using computerized image analysis. Patients and methods Forty vitiligo patients were included. For each patient, three different areas were considered: the lesional, the perilesional and apparently normal distant skin. In each patient, computerized image analysis was carried out for clinical photos and for histopathology of biopsied skin specimens stained with haematoxylin and eosin and Fontana-Masson. Results There was a statistically significant difference in skin colour changes and histopathological pattern between lesional, perilesional skin and distant skin that correlated with disease duration. Conclusion Perilesional skin and apparently normal distant skin in vitiligo patients are involved in the same pathological process affecting lesional skin and this is reflected in both morphological and histopathological patterns but with different degrees.