Vitiligo

Last reviewed: 24 Apr 2022
Last updated: 08 Feb 2022

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
More key diagnostic factors

Risk factors

  • age <30 years
  • family history of vitiligo
  • autoimmune disease
  • chemical contact
More risk factors

Diagnostic investigations

1st investigations to order

  • clinical diagnosis
More 1st investigations to order

Investigations to consider

  • Wood lamp exam
  • skin biopsy
More investigations to consider

Treatment algorithm

ONGOING

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.

  • Vitiligo images
  • Differentials

    • Piebaldism
    • Waardenburg syndrome
    • Tuberous sclerosis
    More Differentials
  • Guidelines

    • 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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