The International Classification (VGICC Consensus)
The Vitiligo Global Issues Consensus Conference (VGICC) established a definitive clinical taxonomy classifying vitiligo into two primary categories: Non-Segmental Vitiligo (NSV) and Segmental Vitiligo (SV).
1. Non-Segmental Vitiligo (NSV) – ~90% of Cases
Non-segmental vitiligo is characterized by bilateral, symmetrical lesion distribution. It can occur at any age and often follows an unpredictable cycle of active spread and periods of spontaneous stability.
- Generalized (Vitiligo Vulgaris): The most common form, with scattered patches distributed symmetrically across both sides of the trunk, limbs, and facial regions.
- Acrofacial: Confined primarily to the distal extremities (fingertips, toes) and the face (around the mouth and eyes).
- Mucosal: Localized exclusively to mucous membranes of the oral cavity or genitalia.
- Universal: Extensive depigmentation covering 80% to 90% or more of the entire cutaneous body surface.
2. Segmental Vitiligo (SV) – ~10% of Cases
Segmental vitiligo develops unilaterally, strictly conforming to a dermatome or cutaneous nerve segment on one side of the body. Key clinical features include:
- Early age of onset (often during childhood or adolescence).
- Early follicular involvement leading to localized white hair (poliosis).
- Rapid spread for 6 to 24 months followed by long-term natural stabilization.
- Infrequent association with other systemic autoimmune diseases.
3. Undetermined / Mixed Vitiligo
Includes focal vitiligo (an isolated, small macule that has not yet declared itself as segmental or generalized) and rare mixed forms.
Frequently Asked Questions
Can segmental vitiligo turn into generalized vitiligo?
It is very rare. In less than 2% of cases, patients develop mixed vitiligo where generalized patches arise years after a stabilized segmental patch.
Which type responds best to surgical treatment?
Stable segmental vitiligo and localized stable non-segmental vitiligo respond exceptionally well to surgical melanocyte grafting, frequently achieving 90%+ repigmentation.