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Vitiligo is an acquired dyschromia of the skin in which there is loss of epidermal melanocytes. The diagnosis is clinical; occasionally, a skin biopsy is necessary:

• A loss of epidermal melanocytes is the pathologic hallmark.
• Depigmented macules and patches appearing chalky or milk-white in color
• Generalized (nonsegmental): Up to 90% of cases and 30% of childhood cases. Is progressive, with flare-ups. Often associated with autoimmunity. Common in sites sensitive to pressure and friction and prone to trauma (Koebner phenomenon):
  • Vulgaris: Presence of scattered macules extensively disseminated; often in symmetrical area and extensor surfaces
  • Acrofacial: Patches are localized on distal extremities and face.
  • Mixed: Coexistance of acrofacialis and vulgaris forms
• Localized: Often begins in childhood. Has rapid ...

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