Skin inflammatory (nontumor)
Pigmentary disorders

Topic Completed: 1 August 2011

Minor changes: 2 April 2019

Copyright: 2002-2019,, Inc.

PubMed Search: Vitiligo [title] skin

Mowafak Hamodat, M.B.Ch.B., M.Sc.
Page views in 2019: 4,747
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Cite this page: Hamodat M Vitiligo. website. Accessed May 27th, 2020.
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
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