| What defines rapidly progressive disease activity in vitiligo? | >5 new lesions in last 1 month, or >15 lesions in last 3 months | Disease activity ▷ Progressive: new lesions, or spread of existing lesions → Rapidly progressive: >5 new lesions in last 1 month, or >15 lesions in last 3 months → Slowly progressive: <5 new lesions in last 1 month, or < 15 lesions in last 3 months ▷ Stable: no new lesions, no spread of existing lesions B. | 98 | definition | 1.000 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1725967363_vitiligo.pdf | Disease activity ▷ Progressive: new lesions, or spread of existing lesions → Rapidly progressive: >5 new lesions in last 1 month, or >15 lesions in last 3 months → Slowly progressive: <5 new lesions in last 1 month, or < 15 lesions in last 3 months ▷ Stable: no new lesions, no spread of existing lesions B. | 1 | page=1,block=22 | 0.700 | valid |
| What defines stable disease activity in vitiligo? | no new lesions, no spread of existing lesions | Disease activity ▷ Progressive: new lesions, or spread of existing lesions → Rapidly progressive: >5 new lesions in last 1 month, or >15 lesions in last 3 months → Slowly progressive: <5 new lesions in last 1 month, or < 15 lesions in last 3 months ▷ Stable: no new lesions, no spread of existing lesions B. | 259 | definition | 0.980 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1725967363_vitiligo.pdf | Disease activity ▷ Progressive: new lesions, or spread of existing lesions → Rapidly progressive: >5 new lesions in last 1 month, or >15 lesions in last 3 months → Slowly progressive: <5 new lesions in last 1 month, or < 15 lesions in last 3 months ▷ Stable: no new lesions, no spread of existing lesions B. | 1 | page=1,block=22 | 0.700 | valid |
| What items are listed under “REFER TO GENERAL PRINCIPLES OF MANAGEMENT”? | Tertiary Level • Same as in primary/secondary care • Topical PUVA/PUVAsol • Handheld NbUVB • Targeted phototherapy • Surgical management – minipunch grafting, suction blister epidermal grafting, noncultured epidermal suspension | REFER TO GENERAL PRINCIPLES OF MANAGEMENT
Tertiary Level • Same as in primary/secondary care • Topical PUVA/PUVAsol • Handheld NbUVB • Targeted phototherapy • Surgical management – minipunch grafting, suction blister epidermal grafting, noncultured epidermal suspension | 42 | list | 0.820 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1725967363_vitiligo.pdf | Tertiary Level • Same as in primary/secondary care • Topical PUVA/PUVAsol • Handheld NbUVB • Targeted phototherapy • Surgical management – minipunch grafting, suction blister epidermal grafting, noncultured epidermal suspension | 1 | page=1,block=22 | 0.700 | valid |
| What type of foods are incorrectly believed to cause vitiligo? | milk, curd, lemon, fish | • Not the same as leprosy • Does not spread by touch • Not caused by certain foods such as milk, curd, lemon, fish etc • Treatment is available for vitiligo • Multifactorial, predominantly autoimmune Tertiary Level • Sunscreen/photoprotection • Depigmenting agent like monobenzyl ether of hydroquinone 20% may be considered if patient wishes for complete depigmentation | 91 | list | 0.740 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1725967363_vitiligo.pdf | • Not the same as leprosy • Does not spread by touch • Not caused by certain foods such as milk, curd, lemon, fish etc • Treatment is available for vitiligo • Multifactorial, predominantly autoimmune Tertiary Level • Sunscreen/photoprotection • Depigmenting agent like monobenzyl ether of hydroquinone 20% may be considered if patient wishes for complete depigmentation | 1 | page=1,block=17 | 0.700 | valid |
| What is a characteristic of nevus depigmentosus regarding its onset? | Present since birth or early childhood | • Leprosy > Hypopigmented, not depigmented macules > Overlying sensory loss > Enlarged peripheral nerves • Pityriasis alba > Hypopigmented scaly lesions usually on a child’s face • Nevus depigmentosus > Present since birth or early childhood > Single hypopigmented macule/ segmental lesion | 203 | factual | 0.570 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1725967363_vitiligo.pdf | • Leprosy > Hypopigmented, not depigmented macules > Overlying sensory loss > Enlarged peripheral nerves • Pityriasis alba > Hypopigmented scaly lesions usually on a child’s face • Nevus depigmentosus > Present since birth or early childhood > Single hypopigmented macule/ segmental lesion | 1 | page=1,block=9 | 0.700 | valid |
| What is a typical presentation of nevus depigmentosus? | Single hypopigmented macule/ segmental lesion | • Leprosy > Hypopigmented, not depigmented macules > Overlying sensory loss > Enlarged peripheral nerves • Pityriasis alba > Hypopigmented scaly lesions usually on a child’s face • Nevus depigmentosus > Present since birth or early childhood > Single hypopigmented macule/ segmental lesion | 244 | factual | 0.570 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1725967363_vitiligo.pdf | • Leprosy > Hypopigmented, not depigmented macules > Overlying sensory loss > Enlarged peripheral nerves • Pityriasis alba > Hypopigmented scaly lesions usually on a child’s face • Nevus depigmentosus > Present since birth or early childhood > Single hypopigmented macule/ segmental lesion | 1 | page=1,block=9 | 0.700 | valid |
| What is the management approach for rapidly progressive vitiligo? | Oral corticosteroids (minipulse) and/or → Azathioprine/ Methotrexate | Extent of involvement: limited (≤5%) or extensive (>5%) • Limited stable/slowly progressive vitiligo: → Topical treatment- Mid-potent/potent corticosteroids, tacrolimus, topical PUVA/PUVAsol (Avoid prolonged use) • Extensive stable/slowly progressive vitiligo: → Narrow-band ultraviolet B (NbUVB), oral Psoralen + Ultraviolet A (PUVA)/PUVAsol • Rapidly progressive vitiligo (limited or extensive): → Oral corticosteroids (minipulse) and/or → Azathioprine/ Methotrexate • Non-responders: > Consider combining different modalities if unsatisfactory response with monotherapy > Consider surgical treatment for stable limited vitiligo/ segmental vitiligo (unresponsive to medical treatment) > Consider camouflage for poorly responsive vitiligo lesions • Monitoring of patients on systemic treatment > Height (children), weight, blood pressure and blood sugar in patients on oral corticosteroids > Complete Hemogram, Liver Function Test in patients on drugs such as Azathioprine, Methotrexate Generalized vitiligo Acrofacial vitiligo Segmental vitiligo Universal vitiligo Progressive vitiligo with Koebner’s phenomenon ACROFACIAL VITILIGO • Affects the distal extremities and/or face/genitals • Less responsive to treatment OTHER VARIANTS • Focal • Follicular • Mucosal • Universal ≥ 80% of body surface area involvement | 400 |
| What is the recommended treatment for limited stable or slowly progressive vitiligo? | Topical treatment- Mid-potent/potent corticosteroids, tacrolimus, topical PUVA/PUVAsol (Avoid prolonged use) | Extent of involvement: limited (≤5%) or extensive (>5%) • Limited stable/slowly progressive vitiligo: → Topical treatment- Mid-potent/potent corticosteroids, tacrolimus, topical PUVA/PUVAsol (Avoid prolonged use) • Extensive stable/slowly progressive vitiligo: → Narrow-band ultraviolet B (NbUVB), oral Psoralen + Ultraviolet A (PUVA)/PUVAsol • Rapidly progressive vitiligo (limited or extensive): → Oral corticosteroids (minipulse) and/or → Azathioprine/ Methotrexate • Non-responders: > Consider combining different modalities if unsatisfactory response with monotherapy > Consider surgical treatment for stable limited vitiligo/ segmental vitiligo (unresponsive to medical treatment) > Consider camouflage for poorly responsive vitiligo lesions • Monitoring of patients on systemic treatment > Height (children), weight, blood pressure and blood sugar in patients on oral corticosteroids > Complete Hemogram, Liver Function Test in patients on drugs such as Azathioprine, Methotrexate Generalized vitiligo Acrofacial vitiligo Segmental vitiligo Universal vitiligo Progressive vitiligo with Koebner’s phenomenon ACROFACIAL VITILIGO • Affects the distal extremities and/or face/genitals • Less responsive to treatment OTHER VARIANTS • Focal • Follicular • Mucosal • Universal ≥ 80% of body surface area involvement |
| What treatment is suggested for extensive stable or slowly progressive vitiligo? | Narrow-band ultraviolet B (NbUVB), oral Psoralen + Ultraviolet A (PUVA)/PUVAsol | Extent of involvement: limited (≤5%) or extensive (>5%) • Limited stable/slowly progressive vitiligo: → Topical treatment- Mid-potent/potent corticosteroids, tacrolimus, topical PUVA/PUVAsol (Avoid prolonged use) • Extensive stable/slowly progressive vitiligo: → Narrow-band ultraviolet B (NbUVB), oral Psoralen + Ultraviolet A (PUVA)/PUVAsol • Rapidly progressive vitiligo (limited or extensive): → Oral corticosteroids (minipulse) and/or → Azathioprine/ Methotrexate • Non-responders: > Consider combining different modalities if unsatisfactory response with monotherapy > Consider surgical treatment for stable limited vitiligo/ segmental vitiligo (unresponsive to medical treatment) > Consider camouflage for poorly responsive vitiligo lesions • Monitoring of patients on systemic treatment > Height (children), weight, blood pressure and blood sugar in patients on oral corticosteroids > Complete Hemogram, Liver Function Test in patients on drugs such as Azathioprine, Methotrexate Generalized vitiligo Acrofacial vitiligo Segmental vitiligo Universal vitiligo Progressive vitiligo with Koebner’s phenomenon ACROFACIAL VITILIGO • Affects the distal extremities and/or face/genitals • Less responsive to treatment OTHER VARIANTS • Focal • Follicular • Mucosal • Universal ≥ 80% of body surface area involvement |
| What type of skin lesions are typically found on a child’s face in pityriasis alba? | Hypopigmented scaly lesions usually on a child’s face | • Leprosy > Hypopigmented, not depigmented macules > Overlying sensory loss > Enlarged peripheral nerves • Pityriasis alba > Hypopigmented scaly lesions usually on a child’s face • Nevus depigmentosus > Present since birth or early childhood > Single hypopigmented macule/ segmental lesion | 125 | factual | 0.570 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1725967363_vitiligo.pdf | • Leprosy > Hypopigmented, not depigmented macules > Overlying sensory loss > Enlarged peripheral nerves • Pityriasis alba > Hypopigmented scaly lesions usually on a child’s face • Nevus depigmentosus > Present since birth or early childhood > Single hypopigmented macule/ segmental lesion | 1 | page=1,block=9 | 0.700 | valid |