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VITILIGO
Definition:
A autoimmune condition presenting with depigmented macules on the body
Pathogenesis:
Destruction of melanocytes in basal layer of the epidermis.
Clinical features
depigmented macules
no change in texture of the skin
any part of the body may be involved
Differential Diagnosis
Pityriasis versicolor
Post inflammatory hypopigmentation
Dicoid lupus erythematosus
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Vitiligo |
P versicolor |
Post inflam. hypopig |
| Colour |
White (depigmented) |
hypopigmented |
hypopigmented |
| scaling |
absent |
fine, branny scales |
absent |
| preceding inflammation |
absent |
absent |
present eg eczema |
| KOH |
negative |
positive |
negative |
Post inflammatory hypopigmentation follows some recognizable injury
Discoid Lupus Erythematosus - clinical features: (FEATS)
Follicular plugging
Erythema
Atrophy
Telangiectasia
Scaling
Management
Topical steroids followed by sun exposure
Topical psoralen followed by sun exposure eg Eau de cologne
Topical oxoralen followed by sun exposure
PUVA
(Psoralen and Ultra violet A light)
Surgical treatments
Punch graft replacement of pigment
20% repigment spontaneously
Associated autoimmune diseases
Alopecia areata
Pernicious anaemia
Autoimmune haemolytic anaemia
Autoimmune thyroiditis
Type I Diabetes
Addisons disease
Myasthenia gravis
SLE
Systemic sclerosis
Dermatomyositis
Rheumatoid arthritis
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