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Vitiligo - Anogenital in
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Vitiligo - Anogenital in

See also in: Overview,External and Internal Eye
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Contributors: Vivian Wong MD, PhD, Susan Burgin MD
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Synopsis

Vitiligo is a common autoimmune disease that causes depigmented, white patches of the skin that may contain hairs that are white in color. While any part of the body can be affected, vitiligo often demonstrates distinct patterns, including symmetric involvement of the face, upper chest, hands, ankles, axillae, groin, and around orifices (eyes, nose, mouth, urethra, and anus), often favoring sites of frequent friction or trauma. Vitiligo usually begins between the ages of 2 and 40.

While the precise etiology of vitiligo remains debated, two leading hypotheses include: 1) host attack on normal melanocytes; and 2) intrinsic melanocyte defects. Genetic predisposition and trauma are other risk factors for vitiligo development. While the majority of vitiligo patients are otherwise healthy, an association with autoimmune thyroid dysfunction (hyperthyroidism or hypothyroidism) has been demonstrated. In new-onset vitiligo patients with systemic symptoms, thyroid screening with anti-thyroid peroxidase (TPO) antibody and a serum thyroid-stimulating hormone (TSH) is recommended. Additional associations include endocrinopathies, such as diabetes mellitus and Addison disease, along with other autoimmune processes. Rarely, it may exist as part of polyglandular autoimmune syndrome, particularly type III (Hashimoto thyroiditis, vitiligo, and alopecia areata and/or another organ-specific autoimmune disease).

Variants of vitiligo include:
  • Inflammatory vitiligo – Margins of vitiligo with raised erythematous inflammatory borders.
  • Trichrome vitiligo – Three distinct zones including a depigmented zone, a uniformly hypopigmented intermediate band, and a zone of normal skin. More common in individuals of African descent.
  • Vitiligo ponctué (aka confetti type) – Tiny, punctate-like depigmented macules on a hyperpigmented macule or on normal skin.
  • Blue vitiligo – When vitiligo develops on a postinflammatory hyperpigmented lesion, giving it a bluish tint.
Rarely, vitiligo may be associated with uveitis.

Related topic: Segmental vitiligo

Codes

ICD10CM:
L80 – Vitiligo

SNOMEDCT:
56727007 – Vitiligo

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

Best Tests

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Management Pearls

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Therapy

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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References

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Last Reviewed: 07/27/2017
Last Updated: 08/14/2017
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Vitiligo - Anogenital in
See also in: Overview,External and Internal Eye
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Vitiligo : Dorsum of hand, Face, Fingers, Hair color change, Scattered few, Symmetric extremities, Widespread, Depigmented macules/patches
Clinical image of Vitiligo
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