Heritable Disorders: Vitiligo

Question 1

Vitiligo: Clinical Feature. Lesion. Associated lesions

Answer 1

primary pigmentary disorder characterized by depigmentation
• acquired destruction of melanocytes characterized by sharply marginated white patches
• associated with streaks of depigmented hair, chorioretinitis

Question 2

Vitiligo sites:

Answer 2

extensor surfaces and periorificial areas (mouth, eyes, anus, genitalia)

Question 3

Vitiligo phenomenon,

Answer 3

Koebner phenomenon, may be precipitated by trauma

Question 4

Vitiligo Pathophysiology

Answer 4

acquired autoimmune destruction of melanocytes

Question 5

Vitiligo Epidemiology and Inheritance

Answer 5

1% incidence, polygenic

30% with positive family history

Question 6

Vitiligo Investigations

Answer 6

rule out associated autoimmune diseases: thyroid disease, pernicious anemia, Addison’s disease, Type I
DM
• Wood’s lamp to detect lesions: illuminates UV light onto skin to detect amelanosis (porcelain white
discolouration)

Question 7

Vitiligo Management avoid, topical, others, and bleaching

Answer 7

• sun avoidance and protection
• topical calcineurin inhibitor (e.g. tacrolimus, pimecrolimus) or topical corticosteroids
• PUVA or NB-UVB
• make-up
• “bleaching” normal pigmented areas (i.e. monobenzyl ether of hydroquinone 20%) if widespread loss of
pigmentation