Vitiligo

Figure 3.46 A: Vitiligo (Courtesy of Dr. Paul Getz) B: Melasma (Courtesy of Dr. Paul Getz) C: Erythema ab igne (Courtesy of Dr. Sophie M. Worobec)

• Acquired pigmentary disorder of skin and mucous membranes with multifactorial etiology (genetic and non-genetic), likely due to autoimmune destruction of melanocytes in affected skin
• Presents with depigmented macules or patches surrounded by normal skin; ↑ accentuation with Wood’s lamp; predilection for periorifical facial areas, bony prominences and sites with ↑ trauma; may be classified into
  • Localized: focal, unilateral, and mucosal
  • Generalized: wide distribution, acrofacial, and mixed
  • Universal: near complete to complete depigmentation
• Treatment: NBUVB, PUVA, topical corticosteroid, topical calcineurin inhibitor, pseudocatalase, excimer laser, surgical therapy
• May be associated with autoimmune endocrinopathy such as thyroid dysfunction (Graves’ disease, Hashimoto’s thyroiditis) and polyglandular dysfunction; anecdotal reports with pernicious anemia and Addison’s disease