{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T02:13:32Z","timestamp":1790993612618,"version":"4.1.0"},"reference-count":39,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,9,18]],"date-time":"2024-09-18T00:00:00Z","timestamp":1726617600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Segmental vitiligo (SV) is a subset of vitiligo typically characterized by its unilateral distribution. The pathogenesis of SV remains unclear, and until now the two main patterns proposed for SV have lacked biological support. This calls for a new approach.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Use data obtained from anatomo-clinical, pathological, and physio-pathological studies to formulate a new hypothesis on segmental vitiligo distribution and its pathogenesis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Using transparent templates of local arterial blood supply, we evaluated anatomical correspondence (AC) in 140 SV lesions according to the number of SV lesions that fit within the corresponding arterial blood-supply areas. SV lesions were graded as 1 (moderate: AC\u2009&amp;lt;\u200950%), 2 (good: AC\u2009&amp;gt;\u200950%), or 3 (excellent: AC of all lesions). To support this anatomical investigation, we searched for complementary assessments according to the activity of SV lesions. Arterial and periarterial network impairment and inflammatory infiltration were histologically studied using nerve growth factor (NGF) and CD4 and CD8 monoclonal antibodies. Increased blood flow of the underlying arteries was also investigated using thermography and ultrasonography.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We recruited 140 patients with a sex ratio of 0.8 and mean age 26.13\u2009years. Localizations: head and neck 84.28%; trunk 6.42%; upper limb 5%; genital areas 2.14%; lower limb 1.42%. The AC of each SV lesion with the underlying artery blood supply territory was rated as 72% excellent; 16% good; and 12% moderate. Histologically (40 patients), we found some periarterial network impairments. Thermal asymmetry was significantly associated with active SV (<jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We hypothesized that SV distribution corresponds to the underlying artery blood-supply territory.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2024.1424887","type":"journal-article","created":{"date-parts":[[2024,9,18]],"date-time":"2024-09-18T04:52:41Z","timestamp":1726635161000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Segmental vitiligo distribution follows the underlying arterial blood supply territory: a hypothesis based on anatomo-clinical, pathological and physio-pathological studies"],"prefix":"10.3389","volume":"11","author":[{"given":"Laila","family":"Benzekri","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muriel","family":"Cario-Andr\u00e9","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatima Zahrae","family":"Laamrani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yvon","family":"Gauthier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,9,18]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"E1","DOI":"10.1111\/j.1755-148X.2012.00997.x","article-title":"Revised classification\/nomenclature of vitiligo and related issues: the vitiligo global issues consensus conference","volume":"25","author":"Ezzedine","year":"2012","journal-title":"Pigment Cell Melanoma Res"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"61","DOI":"10.5021\/ad.2014.26.1.61","article-title":"Clinical course of segmental vitiligo: a retrospective study of eighty seven patients","volume":"26","author":"Park","year":"2014","journal-title":"Ann Dermatol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"671","DOI":"10.1016\/S0190-9622(96)90718-5","article-title":"Segmental vitiligo: clinical findings in 208 patients","volume":"35","author":"Hann","year":"1996","journal-title":"J Am Acad Dermatol"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1111\/j.1346-8138.2002.tb00158.x","article-title":"Clinical course of 44 cases of localized type of vitiligo","volume":"29","author":"Zaima","year":"2002","journal-title":"J Dermatol"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1004","DOI":"10.1111\/j.1365-2133.2010.10202.x","article-title":"Classification of segmental vitiligo on the face: clues for prognosis","volume":"164","author":"Kim","year":"2010","journal-title":"Br J Dermatol"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"750","DOI":"10.1111\/bjd.19661","article-title":"Classification of facial and truncal segmental vitiligo and its clinical course","volume":"184","author":"Oh","year":"2021","journal-title":"Br J Dermatol."},{"key":"ref7","doi-asserted-by":"publisher","first-page":"322","DOI":"10.1111\/bjd.12652","article-title":"Classification of segmental vitiligo on the trunk","volume":"170","author":"Van Geel","year":"2014","journal-title":"Br J Dermatol"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"209","DOI":"10.3349\/ymj.2000.41.2.209","article-title":"Classification of segmental vitiligo on the face","volume":"41","author":"Hann","year":"2004","journal-title":"Yonsei Med J"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"547","DOI":"10.1111\/j.1600-0625.2006.00448.x","article-title":"What is the biological basis of pattern formation of skin lesions?","volume":"15","author":"Chuong","year":"2006","journal-title":"Exp Dermatol"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1159\/000452949","article-title":"The puzzle of skin patterns","volume":"4","author":"Tenea","year":"2017","journal-title":"Integr Med Int"},{"key":"ref11","first-page":"61","article-title":"Clinical patterns of vitiligo","volume":"22","author":"Habib","year":"2012","journal-title":"J Coll Phys Surg Pak"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"adv00707","DOI":"10.2340\/actadv.v102.399","article-title":"Segmental pigmentation disorder: clinical manifestations and epidemiological features in 144 patients, a retrospective case-control study","volume":"102","author":"Oren-Shabtai","year":"2022","journal-title":"Acta Derm Vener"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"223","DOI":"10.1111\/j.1365-2133.1988.tb01778.x","article-title":"Clinical features and course of type a and type B vitiligo","volume":"118","author":"Koga","year":"1988","journal-title":"Br J Dermatol"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1016\/s0923-1811(99)00090-0","article-title":"Cutaneous blood flow and adrenoceptor response increase in segmental-type vitiligo lesions","volume":"23","author":"Wu","year":"2000","journal-title":"J Dermatol Sci"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"180","DOI":"10.1016\/S1607-551X(08)70115-3","article-title":"Low-energy helium-neon laser therapy induces repigmentation and improves the abnormalities of cutaneous microcirculation in segmental-type vitiligo lesions","volume":"24","author":"Wu","year":"2008","journal-title":"Kaohsiung J Med Sci"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"444","DOI":"10.1097\/01.moh.0000177827.78280.79","article-title":"The lymphocyte homing receptors: gatekeepers of the multistep paradigm","volume":"12","author":"Sackstein","year":"2005","journal-title":"Curr Opin Hematol"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"646","DOI":"10.1111\/j.1755-148X.2008.00511.x","article-title":"Segmental vitiligo as the possible expression of cutaneous somatic mosaicism: implications for common non segmental vitiligo","volume":"21","author":"Taieb","year":"2008","journal-title":"Pigment Cell Melanoma Res"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1111\/bjd.12013","article-title":"The distribution pattern of segmental vitiligo: clues for somatic mosaicism","volume":"168","author":"Van Geel","year":"2013","journal-title":"Br J Dermatol"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1016\/j.det.2016.11.005","article-title":"Segmental vitiligo","volume":"35","author":"Van Geel","year":"2017","journal-title":"Dermatol Clin"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"568447","DOI":"10.3389\/fimmu.2020.568447","article-title":"Autoimmunity in segmental vitiligo","volume":"11","author":"Speeckaert","year":"2020","journal-title":"Front Immunol"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1111\/pcmr.13064","article-title":"Varicella-zoster virus in actively spreading segmental vitiligo skin: pathological, immunochemical, and ultrastructural findings (a first and preliminary study)","volume":"36","author":"Gauthier","year":"2022","journal-title":"Pigment Cell Melanoma Res"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"S269","DOI":"10.1016\/j.jid.2022.09.527","article-title":"Varicella-zoster virus in actively spreading segmental vitiligo skin","volume":"142","author":"Cario","year":"2022","journal-title":"J Invest Dermatol"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"715","DOI":"10.4103\/0378-6323.102362","article-title":"A descriptive study to characterize segmental vitiligo","volume":"78","author":"Khartan","year":"2012","journal-title":"Indian J Dermatol Venereol Leprol"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"216","DOI":"10.1016\/j.abd.2022.05.001","article-title":"Silva de Castro CS. Experimental approaches to assess melanocytes mosaicism in segmental vitiligo","volume":"98","author":"Delatorre","year":"2023","journal-title":"An Bras Dermatol"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1111\/j.1600-0749.1992.tb00003.x","article-title":"Catecholamines and vitiligo","volume":"5","author":"Morrone","year":"1992","journal-title":"Pigment Cell Res"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"384","DOI":"10.4103\/ijmr.IJMR_657_16","article-title":"Plasma and urinary vanillylmandelic acid levels in patients with generalized vitiligo","volume":"147","author":"Basnet","year":"2018","journal-title":"J Med Res"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"01","DOI":"10.31579\/2578-8949\/082","article-title":"The neuronal theory in the pathogenesis of vitiligo: past and present","volume":"6","author":"Al Abadie","year":"2021","journal-title":"J Dermatol Derm"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"382","DOI":"10.61872\/sdj-2018-05-405","article-title":"The face, a vascular perspective","volume":"128","author":"Von Arx","year":"2018","journal-title":"Swiss Dent J"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"829","DOI":"10.1139\/H09-076","article-title":"Adrenergic control of the human cutaneous circulation","volume":"34","author":"Hodges","year":"2009","journal-title":"Appl Physiol Nutr Metab"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"e135","DOI":"10.4317\/medoral.20754","article-title":"Research vascular mapping of the face: B-mode and doppler ultrasonography study","volume":"21","author":"Tucunduva","year":"2016","journal-title":"Med Oral Patol Oral Chir Bucal"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"965","DOI":"10.1212\/wnl.20.10.965","article-title":"Acquired unilateral vitiligo and poliosis of the head and subacute encephalitis","volume":"20","author":"Nelhaus","year":"1970","journal-title":"Neurology"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"624","DOI":"10.1111\/j.1525-1470.2010.01319.x","article-title":"Segmental vitiligo following encephalitis","volume":"27","author":"Singh","year":"2010","journal-title":"Pediatr Dermatol"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"112","DOI":"10.1016\/j.jneuroim.2017.03.014","article-title":"Varicella-zoster virus vasculopathy: the expanding clinical spectrum and pathogenesis","volume":"308","author":"Nagel","year":"2017","journal-title":"J Neuroimmunol"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"614","DOI":"10.1016\/j.ophta.2022.07.027","article-title":"Progressive choroidal vitiligo after varicella-zoster virus reactivation","volume":"130","author":"Licini","year":"2022","journal-title":"Ophtalmology"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"e201652","DOI":"10.1001\/jamaophthalmol.2020.1652","article-title":"Depigmented Chorioretinal lesions following varicella-zoster virus infection","volume":"138","author":"Long","year":"2020","journal-title":"JAMA Ophthalmol"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"1996","DOI":"10.4103\/ijo.IJO_2099_22","article-title":"Choroidal lesions in varicella zoster virus uveitis","volume":"71","author":"Kawali","year":"2023","journal-title":"Indian J Ophthalmol"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"4994","DOI":"10.1128\/JVI.69.8.4994-5010.1995","article-title":"Egress of varicella-zoster virus from the melanoma cell: a tropism for the melanocyte?","volume":"69","author":"Harson","year":"1995","journal-title":"J Virol"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"965","DOI":"10.1016\/j.jaad.2010.08.031","article-title":"Segmental vitiligo associated with generalized vitiligo (mixed vitiligo): a retrospective case series of 19 patients","volume":"65","author":"Ezzedine","year":"2011","journal-title":"J Am Acad Dermatol"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"982","DOI":"10.1111\/ijd.16090","article-title":"Clinicodemographic features of mixed vitiligo","volume":"61","author":"Kumar","year":"2022","journal-title":"Int J Dermatol"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2024.1424887\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,18]],"date-time":"2024-09-18T04:52:43Z","timestamp":1726635163000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2024.1424887\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,18]]},"references-count":39,"alternative-id":["10.3389\/fmed.2024.1424887"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2024.1424887","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9,18]]},"article-number":"1424887"}}