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Introduction

Vitiligo is an acquired depigmentation disorder characterized by the progressive loss of melanocytes, leading to focal, well-demarcated patches of completely depigmented skin and/or hair.  The prevalence is similar in all racial and ethnic groups; it can occur in all ages but is most common at age <30.  The condition has significant psychosocial implications.

Pathophysiology

The exact pathogenesis of vitiligo likely involves a combination of genetic and environmental factors (eg, sunburn, trauma) that result in a loss of melanocytes.  An autoimmune mechanism leading to melanocyte destruction is likely, supported by the presence of melanocyte-specific autoantibodies and a greater prevalence of other autoimmune diseases (eg, autoimmune thyroid disease, alopecia areata) in patients with vitiligo.  Other possible contributing factors include neurohumoral toxicity specific for melanocytes and melanocytic self-destruction (eg, production of toxic intermediates during melanin synthesis).

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