Skin-nontumor / Clinical dermatology
Other dermatoses

Author: Mowafak Hamodat, M.D., MB.CH.B, MSc., FRCPC (see Authors page)

Revised: 21 July 2016, last major update August 2011

Copyright: (c) 2002-2016,, Inc.

PubMed Search: Vitiligo [title] skin

Cite this page: Vitiligo. website. Accessed October 20th, 2018.
Definition / general
  • Partial or complete loss of pigment producing melanocytes within the epidermis
  • Affects 1% of world’s population; more noticeable in dark skinned individuals
  • Usually hands / wrists, axilla, perioral, periorbital, anogenital skin
  • Focal: only a few areas
  • Segmented: one side of the body only
  • Generalized: most common, both sides of body
  • Trichrome: patient has three shades of skin color
Clinical features
Clinical images

Images hosted on other servers:

Various images

Microscopic (histologic) description
  • Difficult to diagnose by histology; decreased melanocytes (use S100 or MelanA and control biopsy from adjacent normal skin)(Am J Dermatopathol 2008;30:112)
  • At advancing border, melanocytes may be increased in size with an increased number of dendrites; occasionally lymphocytes are present in this region, particularly if an inflammatory border is present; epidermotropic lymphocytes may form small Pautrier-like collections in the basal layer, with an associated perivascular infiltrate of mononuclear cells involving the superficial plexus and some superficial edema
  • Focal spongiosis may be present in marginal areas
  • Degenerative changes have also been reported in nerves and sweat glands
  • Langerhans cells are usually increased
  • Melanocytes are always reduced more in vitiligo than they are in nevus depigmentosus
Electron microscopy description
  • No melanocytes
Differential diagnosis
  • Albinism: melanocytes are present, but no melanin due to defect in tyrosinase enzyme
Additional references