Revised classification/nomenclature of vitiligo and related issues: the Vitiligo Global Issues Consensus Conference

TLDR

During the 2011 International Pigment Cell Conference, the Vitiligo European Taskforce convened a consensus conference on globally important vitiligo research issues. The conference, guided by an international panel, focused on four topics—classification and nomenclature, disease stability, Koebner's phenomenon, and autoimmune vitiligo—discussed by seven geographically diverse working groups. The consensus classified segmental vitiligo separately, used “vitiligo” as an umbrella for all non‑segmental forms (including mixed), recommended assessing disease stability at the lesion level, endorsed the VETF KP classification, and concluded that autoimmune vitiligo should not be a distinct category because all forms likely involve autoimmune or inflammatory mechanisms.

Abstract

During the 2011 International Pigment Cell Conference (IPCC), the Vitiligo European Taskforce (VETF) convened a consensus conference on issues of global importance for vitiligo clinical research. As suggested by an international panel of experts, the conference focused on four topics: classification and nomenclature; definition of stable disease; definition of Koebner's phenomenon (KP); and 'autoimmune vitiligo'. These topics were discussed in seven working groups representing different geographical regions. A consensus emerged that segmental vitiligo be classified separately from all other forms of vitiligo and that the term 'vitiligo' be used as an umbrella term for all non-segmental forms of vitiligo, including 'mixed vitiligo' in which segmental and non-segmental vitiligo are combined and which is considered a subgroup of vitiligo. Further, the conference recommends that disease stability be best assessed based on the stability of individual lesions rather than the overall stability of the disease as the latter is difficult to define precisely and reliably. The conference also endorsed the classification of KP for vitiligo as proposed by the VETF (history based, clinical observation based, or experimentally induced). Lastly, the conference agreed that 'autoimmune vitiligo' should not be used as a separate classification as published evidence indicates that the pathophysiology of all forms of vitiligo likely involves autoimmune or inflammatory mechanisms.