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First histopathological and immunophenotypic analysis of early dynamic events in a patient with segmental vitiligo associated with halo nevi
Authors:Nanja A C Van Geel  Ilse G Mollet  Sofie De Schepper  Esther P M Tjin  Karim Vermaelen  Rachael A Clark  Thomas S Kupper  Rosalie M Luiten  Jo Lambert
Institution:1. Department of Dermatology, Ghent University Hospital, Ghent, Belgium

Equally contributed.;2. Department of Dermatology, Ghent University Hospital, Ghent, Belgium;3. Department of Dermatology and the Netherlands Institute for Pigment Disorders, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands;4. Laboratory of Immunoregulation and Mucosal Immunology, Department of Pulmonary Medicine, Ghent University Hospital, Ghent, Belgium;5. Harvard Skin Disease Research Center and the Department of Dermatology, Brigham and Women’s Hospital, Boston, MA, USA

Abstract:Segmental vitiligo is often ascribed to the neurogenic theory of melanocyte destruction, although data about the initial etiopathological events are scarce. Clinical, histopathological and T-cell phenotypic analyses were performed during the early onset of a segmental vitiligo lesion in a patient with associated halo nevi. Histopathological analysis revealed a lymphocytic infiltrate, mainly composed of CD8+ T-cells and some CD4+ T-cells around the dermo–epidermal junction. Flow cytometry analysis of resident T-cells revealed a clear enrichment of pro-inflammatory IFN-γ producing CD8+ T-cells in lesional skin compared to the non-lesional skin. Using human leukocyte antigen-peptide tetramers (MART-1, tyrosinase, gp100), increased numbers of T cells, recognizing melanocyte antigens were found in segmental vitiligo lesional skin, as compared with the non-lesional skin and the blood. Our findings indicate that a CD8+ melanocyte specific T cell-mediated immune response, as observed in generalized vitiligo, also plays a role in segmental vitiligo with associated halo nevi.
Keywords:vitiligo  segmental vitiligo  etiopathogenesis  histopathology  melanocyte  halo nevi
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