ABSTRACT

Vitiligo is an acquired cutaneous disease in which the melanocyte component of the skin is destroyed, resulting in amelanotic lesions of variable size and extent (1-3). Generally, vitiligo initially develops on the hands, wrist, body folds, and orifices such as the eyes, mouth, nose, etc. However, vitiligo lesions can develop anywhere on the body. In some cases the disease is confined to these initial sites, however, in most cases it progresses and can affect the entire body surface (Figure 1). In addition, depigmentation of the uveal tract of the eye and putatively of the ear can also occur resulting in minimal night blindness/ photophobia (4) and sensorineural hypoacusis/high frequency hearing loss (5,6), respectively. As a health consequence, the white lesions of the skin become immunocompromised, exhibiting a muted response to contact antigens (7,8). In addition, amelanotic vitiligo lesions can become susceptible to the damaging effects of solar irradiation (i.e., premature aging/actinic damage (9) and possibly cancer of the skin). The average age of onset of vitiligo is 22 years with no significant differences in mean age at onset or prevalence between males and females (10,11). From the patient’s perspective, the more devastating consequences of this disfiguring loss of skin and eye pigment are the psychological and social problems that result (12,13). This is especially true for African-Americans and American or Asian Indians. Cases of social ostracism and suicide have been occasionally reported.