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Vitiligo
From WikEM
Background
- Condition which causes patchy depigmentation of the skin characterized by absence of melanocytes
- Flat achromic patches more commonly found in extremities or concave areas of body surface
- Related with autoimmune diseases such as thyroid gland pathologies as well as melanoma
Differential Diagnosis
- Pityriasis versicolor
- light desquamation, blurred borders
- Pityriasis alba
- Wood's lamp examination with yellow/green fluorescence
- KOH positive
- Chemical leukoderma
- Tuberculoid Leprosy (Hansen's disease)
- Hipopigmented nevus
- stable macule, unilateral
- Hipomelanosis of Ito (Incontinentia pigmenti achromians)
- follows lines of Blaschko
- Nevus anemicus
- no contrast on Wood's lamp examination
- no erythematous response to trauma, cold or heat
- Tuberous sclerosis
- stable polygonal confetti macules
- Piebaldism
- alternating hyperpigmented macules on hipopigmented patches
- triangular shaped depigmented patch on forehead
- Tinea versicolor
Management
- Less than 20% skin surface affected
- Corticosteroid cream, calcineurin inhibitors
- UVB or PUVA phototherapy
- Melanocyte grafting (risk of Koebner phenomenon)
- Cosmetic camouflage solutions
- Over 20% skin depigmentation
- Narrow band UVB phototherapy
- Total skin depigmentation (with sun protection)
