Summary
Definition
History and exam
Key diagnostic factors
- acral and periorificial depigmentation
- perianal and genital depigmentation
- recent cutaneous trauma
- localized sunburn pain
- enhancement and fluorescence with UV-A exposure
- halo nevus
- universal depigmentation
Risk factors
- age <30 years
- family history of vitiligo
- autoimmune disease
- chemical contact
Diagnostic tests
1st tests to order
- clinical diagnosis
Tests to consider
- Wood lamp exam
- skin biopsy
Treatment algorithm
segmental vitiligo or limited vitiligo
widespread vitiligo (more than 3% body surface area)
Contributors
Authors
John E. Harris, MD, PhD
Professor
Department of Dermatology
University of Massachusetts Medical School
Worcester
MA
Disclosures
JEH has acted as a consultant and/or investigator for: Pfizer, Genzyme/Sanofi, Aclaris Therapeutics Inc., Incyte, Rheos Medicines, Sun Pharmaceuticals, LEO Pharma, Villaris Therapeutics Inc., Dermavant, Temprian, AbbVie Inc., Janssen, TeVido, BioDevices, EMD Serono, Almirall, Boston Pharma, Sonoma Biotherapeutics Inc., Methuselah Health, Twi Biotech, Pandion, Cogen Therapeutics Inc., Admirx, BridgeBio, AnaptysBio, Avita, Frazier Management. He has equity in TeVido Biodevices, Rheos, and Villaris Therapeutics Inc., and is the Scientific Founder of Villaris Therapeutics Inc. JEH is an author of a number of references cited in this topic.
Mehdi Rashighi, MD
Assistant Professor
Department of Dermatology
University of Massachusetts Medical School
Worcester
MA
Disclosures
MR has received consulting fees and/or research grants from the following: Pfizer, AbbVie, Dermavant, LEO Pharma, and Almirall. MR is an author of a reference cited in this topic.
Acknowledgements
Professor John E. Harris and Dr Mehdi Rashighi would like to gratefully acknowledge Dr Bernhard Ortel, a previous contributor to this topic. BO declares that he has no competing interests.
Peer reviewers
Iltefat Hamzavi, MD
Senior Staff Physician
Multicultural Dermatology Center
Henry Ford Hospital
Detroit
MI
Disclosures
IH is an author of a number of references cited in this topic.
Piergiacomo Calzavara-Pinton, MD
Chair
Dermatology Department
University of Brescia
Brescia
Italy
Disclosures
PC-P is an author of a number of references cited in this topic.
References
Key articles
Ortonne J-P. Vitiligo and other disorders of hypopigmentation. In: Bolognia JL, Jorrizzo JL, Rapini RP, eds. Dermatology. New York, NY: Mosby; 2008:913-38.
Taieb A, Picardo M. Clinical practice: vitiligo. N Engl J Med. 2009 Jan 8;360(2):160-9. Abstract
Taieb A, Alomar A, Böhm M, et al; Vitiligo European Task Force (VETF); European Academy of Dermatology and Venereology (EADV); Union Européenne des Médecins Spécialistes (UEMS). Guidelines for the management of vitiligo: the European Dermatology Forum consensus. Br J Dermatol. 2013 Jan;168(1):5-19.Full text Abstract
Whitton ME, Pinart M, Batchelor J, et al. Interventions for vitiligo. Cochrane Database Syst Rev. 2015 Feb 24;(2):CD003263.Full text Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Piebaldism
- Waardenburg syndrome
- Tuberous sclerosis
More DifferentialsGuidelines
- British Association of Dermatologists guidelines for the management of people with vitiligo 2021
- Guidelines for the management of vitiligo
More Guidelines
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