Etiology

  • Autoimmune destruction of melanocytes

  • Associated with thyroid disease, diabetes, alopecia areata

Pathogenesis

  • CD8+ T-cell attack on melanocytes → depigmented patches

Clinical Features

  • Well-defined depigmented macules/patches

  • Symmetrical

  • Acral areas, face, around orifices

  • Wood’s lamp accentuates depigmentation

Treatment

  • Topical steroids or calcineurin inhibitors

  • Phototherapy (NB-UVB)

  • Cosmetic camouflage

  • JAK inhibitors (newer therapy)

  • Surgical grafts for stable cases