Contents

SynopsisCodesLook ForDiagnostic PearlsDifferential Diagnosis & PitfallsBest TestsManagement PearlsTherapyReferences

View all Images (13)

Segmental vitiligo in Adult
Other Resources UpToDate PubMed

Segmental vitiligo in Adult

Contributors: Mehdi Rashighi MD, Vivian Wong MD, PhD, Susan Burgin MD
Other Resources UpToDate PubMed

Synopsis

Segmental vitiligo is considered a subtype of vitiligo but is usually thought of as a separate entity than generalized vitiligo. It is marked by early onset progressive development of circumscribed depigmented macules or patches in a segmental pattern over a period of 6-24 months, followed by rapid spontaneous stabilization. It can be distinguished from generalized vitiligo by its unique unilateral distribution (lesions do not cross the midline) and rapid stabilization. The underlying mechanism is still controversial, although, similar to generalized vitiligo, it is thought to be due to an autoimmune response to melanocytes. It has been suggested that segmental vitiligo is due to a somatic mosaicism in the setting of an early postzygotic event that predisposes only a group of related melanocytes to the autoimmune response.

Segmental vitiligo is 10 times less common than generalized vitiligo. It typically has an earlier age of onset compared with generalized vitiligo. The majority of cases occur before age 30, from infancy to adulthood. The lesions are usually chalk-white in color with well-demarcated margins. They range in size from millimeters to centimeters. The affected skin is asymptomatic but is more prone to sunburn. There is a higher frequency of leukotrichia (white hair) compared to nonsegmental vitiligo. Segmental vitiligo typically involves a single segment (monosegmental) on only one side of the body. However, rare variants that involve multiple segments (distributed either unilaterally or bilaterally) have been reported. Segmental vitiligo typically evolves over a few months after initial presentation and then remains stable in appearance.

Concomitant occurrence of segmental and generalized vitiligo has been described and is referred to as mixed vitiligo. In such cases, segmental disease usually precedes the generalized form by at least 6 months.

Codes

ICD10CM:
L80 – Vitiligo

SNOMEDCT:
403268000 – Segmental vitiligo

Look For

Subscription Required

Diagnostic Pearls

Subscription Required

Differential Diagnosis & Pitfalls

To perform a comparison, select diagnoses from the classic differential

Subscription Required

Best Tests

Subscription Required

Management Pearls

Subscription Required

Therapy

Subscription Required

References

Subscription Required

Last Reviewed:01/31/2017
Last Updated:01/08/2024
Copyright © 2024 VisualDx®. All rights reserved.
Segmental vitiligo in Adult
A medical illustration showing key findings of Segmental vitiligo : Hair color change, Segmental, Unilateral distribution, Depigmented macules/patches
Clinical image of Segmental vitiligo - imageId=6581312. Click to open in gallery.  caption: 'Depigmented and hypopigmented macules and patches on the leg.'
Depigmented and hypopigmented macules and patches on the leg.
Copyright © 2024 VisualDx®. All rights reserved.