Extrinsic injury can evoke intrinsic stimulation and subsequently initiate the physiological repair process. Specificity of residual perifollicular pigmentation in vitiligoResidual perifollicular pigmentation is a well-described phenomenon in vitiligo . The Intense pigmentation was found in 16 grafted patients (40%). clear white, faint, multi-dot, and perifollicular for the inside, and sharp, blunt, confetti, and trichrome for the border. This assumes the possibility of Wnt1 induction with NB-UVB therapy, which causes perifollicular repigmentation on vitiligo. These lymphocytes were also demonstrated perifollicularly in considerable density during disease activity in biopsies including black hairs within vitiligo patches. Sao Paulo Med J. 50 re-pigmentation) in 64% patients of vitiligo (n=25)8 this was less reported efficacy as we found. In order to understand the BIOSKIN EVOLUTION therapy it is necessary to have some basic knowledge in dermatology. 2007; 143(5):578-584. These According to Pattern. Hyperpigmentation is a medical term for light brown, irregular patches of skin. It is seen in active lesions as well as lesions in spontaneous remission or after treatment . Hou, Xiaoyuan MD *; perifollicular papular protrusions, a means to protect the skin from the sun exposure to avoid collagen basophilic degeneration, 1,3 which resulted in bluish pigmentation under Wood's lamp. Hypopigmentation with residual perifollicular pigmentation has been reported as a specific pattern in vitiligo. Vitiligo is an acquired depigmenting skin disorder characterized by the loss of melanocytes from the epidermis. A variant While perifollicular depigmentation (PFD) was predictive of stable vitiligo, perifollicular pigmentation (PFP) was characteristic of active disease. Vitiliginous patches were classified into 4 types, regarding the type of interior and border of each lesion observed under a Woods lamp, as follows: clear white, faint, multi-dot, and perifollicular. Nearly all cases of vitiligo are acquired relatively early in life. Dermatology. In addition, clinical observation shows that vitiligo recovery usually exhibits a process called perifollicular repigmentation [8]. Frontal fibrosing alopecia (FFA) is a primary progressive cicatricial alopecia of the frontal, temporal, or frontotemporal scalp. Progressive vitiligo was characterized by perifollicular pigmentation (91.2%), an altered pigment network (97.1%), blurred spot border (94.1%), and specific structures, such as star-like formations and a comet tail. The stable vitiligo was characterized by perifollicular depigmentation (81.8%) and a sharp border of the spots (72.7%). 3. 1 Low levels of quality of life are related to disease activity as well as an occurrence at a young age and spots on the Demonstration of residual perifollicular pigmentation in localized vitiligo--a reverse and novel application of digital epiluminescence dermoscopy. It is one of common skin diseases reported to affect approximately 1% of the population worldwide, irrespective of skin color or ethnic origin. Digital epiluminescence dermoscopy (microscopy) is usually employed to examine melanomas and other pigmented lesions. Another study was conducted in 31 patients of stable vitiligo involving less than 5% body surface area (BSA) after taking verbal and written consent of the patients. Age of onset is bimodal and involves a major genetic component. But, patients are not aware of this option. In cases of AA, patients developed vellus hair. This is a myth. But surely this cant be the whole story because skin (and hair) can, and do, re-pigment in areas where the hairs have lost their colour. The mechanism of perifollicular repigmentation pattern has been investigated extensively and many groups consider that it is the only mode of repigmentation in vitiligo. Pigmentary network changes, and perifollicular and perilesional hyperpigmentation on polarized light examination, and a diffuse white glow on ultraviolet light examination were noted in evolving vitiligo lesions. But, patients are not aware of this option. Two punch biopsies of head and neck lesions were performed. The most common treatment for vitiligo is narrow band ultraviolet B phototherapy, which often is combined with topical therapies such as tacrolimus. 2005;123(4):187-91. Finally, in addition to a role for perifollicular melanoblasts and perilesional marginal melanocytes in promoting repigmentation, recent studies suggest eccrine sweat glands might also harbor melanocyte precursors capable of contributing to pigment restoration in patients with vitiligo . Vitiligo is a serious cosmetic condition, mainly for individuals with dark skin. A total of 147 patients with localized vitiligo (progressive disease, n=92; stable period, n=55) were enrolled and received combination therapy for 12 weeks. Blue vitiligo: develops in areas of post inflammatory hyperpigmentation; Trichrome vitiligo: hypopigmented zone between normal and depigmented skin; Quadrichrome vitiligo a fourth Tissue grafting: Mini punch grafting, ultra thin split thickness grafting, blister grafting10, hair follicle grafts, smash grafts. Vitiligo Update Rebat M. Halder, MD, and Johnathan L. Chappell, MD Vitiligo is an acquired dyschromia of the skin in which there is a loss of epidermal refers to the additional presence Vitiligo; Pregnancy and lactation. et al. We report its reverse application in assisting the early diagnosis of a depigmentation condition-localized Blue vitiligo: results in blue coloration of vitiligo macules. Vitiligo has a well-defined border which can be hyperpigmented. Digital epiluminescence dermoscopy (microscopy) is usually employed to examine melanomas and other pigmented lesions. Clinically Melanoma 0-33 34-66 67-100 >100 0-1 2-5 6-10 >10 Histof PH$ FH 1/F/21 Blond/green Mons pubis 2/F/60 Brown/blue 6 Upperarm 3/M/46 Black/brown Upperarm Vitiligo is a common, acquired multifactorial skin disease. Vitiligo causes the skin to lose its natural color in hair, eyes, and mouth. of Nevi* Patient/ Sex/Age,y Hair/Eye Color Size, mm Location Acquired (A)vs Congenital (C) AtypicalNevi* No. Highlights & Basics. Koebner phenomenon: is defined as the development of vitiligo in sites of specific trauma, such as a cut, burn, or abrasion. It has a complex, multifaceted etiology. Although multiple theories trunk and bilateral There is evidence that there are other stem cells in the interfollicular epidermis. Vitiligo is a genetic, autoimmune skin disease causing loss of pigment from areas of the skin, resulting in irregular white spots or patches. The inflammatory response is documented on a These were further treated with System(s) affected: skin, Arch Dermatol. Hyperpigmentation occurs as red and inflamed skin, or there can be a brownish discoloration. Age of onset is bimodal and involves a major genetic component. 22.1) has been described as a specific pattern in vitiligo by Chuh and Zawar [1]. The macular hyperpigmentation involves chiefly the face, neck and upper limbs, although it can be more widespread, and varies from slate grey to brownish black. Correlation of Vitamin D Levels with Pigmentation in Vitiligo Patients Treated with NBUVB Therapy ManuSehrawat, 1 TarlokChandArora, 1 AmritaChauhan, 1 HemantaKumarKar, 1 AmitabhPoonia, 2 andVijayeetaJairath 2 e pigmentation appearing is perifollicular and that too of similar colour as that of the surrounding skin. Perifollicular pigmentation and intra/perilesional erythema with telangiectasia though are findings of stable disease, were observed in both stable and unstable disease in similar numbers. Clinically, the initial response to PUVA therapy was increased hypopigmentation indicating that degenerated cells in the vitiliginous patches might have continued the process of degeneration and did not recover, while the perifollicular and marginal pigmentation suggested that pigmentation occurred from those areas and not from activation of already degenerated The pattern of repigmentation was perifollicular starting from the margins and spreading centripetally which agrees with other studies. MelSCs and melanocytes in NB-UVB induced vitiligo perifollicular repigmentation. Vitiligo is the most common depigmenting disorder and is caused by the destruction of melanocytes Melanocytes Mammalian pigment cells that produce melanins, The vitiligo lesion is clinically defined as an asymptomatic, ivory-white, well-circumscribed, non-palpable, and non-scaling lesion, usually with an oval or linear outline. Suggestive residual pigmentation was detected in 73.6% of patients The average age of onset for vitiligo is approximately 20 years. Perifollicular hyperpigmentation was present in 2 (6.7%) patients and (62.9%) of 35 those with stable vitiligo However, residual perifollicular pigmentation was absent in the 79 patients with non-vitiligo depigmentation. The pigment network is usually absent. After the healing, 82.5% of hairy sites and 81.3% of non hairy sites showed repigmentation. Patients with a history of any autoimmune disease. Patients with a history of keloid formation. On healing, all the lesions of vitiligo showed perifollicular pigmentation in hairy areas and perilesional repigmentation in non hairy areas. These were further treated with ; Current remedies for Vitiligo; Autoimmunity Reviews 9 (2010) 516520. Repigmentation of vitiligo depends upon available melanocytes from three possible sources: from the hair follicle unit which is the main provider of pigment cells, from This article discusses the surgical 9, No. A decrease in melanin synthesis by a normal number of melanocytes (e.g. Under dermoscopy, you might see residual perifollicular pigmentation and telangiectasia in the depigmented area. Dermoscopic patterns in vitiligo include a diffuse white structureless area, which is seen as white glow due to absent pigment network because of the absence of melanocytes in the lesions a. the tissue grafts and the cellular grafts. Microscopic examination of involved skin shows a complete absence of melanocytes in association with a total loss of epidermal pigmentation. Suggestive residual pigmentation was detected in 73.6% of patients at the first visit and repigmentation was observed in 67.9% of patients at least 3 months after treatment. But surely this Vitiligo can appear on any part of the body, in many different shapes and forms. The predominant findings Quadrichrome: as above but with marginal/perifollicular hyperpigmentation; Blue: Dermal melanophages give blue hue in areas affected by prior postinflammatory hyperpigmentation. Characterized by the appearance of rounded, oblong and irregularly shaped spots with clear boundaries, milky white, ranging in size from 5 millimeters Specialty. Principal Investigator: Nanda Rachmad Putra Gofur | ResearchGate, the professional network for scientists We report its reverse application in assisting the early diagnosis of a depigmentation condition-localized vitiligo. Mixed connective tissue disease (MCTD) is a distinct disease entity with mixed features of systemic lupus erythematosus, systemic sclerosis, myositis, and rheumatoid arthritis with high titers of antibodies to U1 ribonucleoprotein (U1RNP). Hypopigmentation with residual perifollicular pigmentation has been reported as a specific pattern in vitiligo. A pattern of depigmentation with residual reservoirs of perifollicular pigments is clearly visualized. It is characterized by progressive depigmentation of the epidermis in circumscribed areas, typically without erythema or scaling. The autoimmune basis of segmental vitiligo (SV) has only recently been recognized. Small dots of pigments appear at the root of hairs, gradually increase in size and join together to become bigger patch of pigmentation. Pigment originating from hair follicles leads to a "perifollicular" or "follicular" pattern and appears as a small dot or freckle emerging from the hair follicle inside the depigmented area. The surgical management of acral vitiligo can be classified as. Hairs within the area are often white with loss of perifollicular pigmentation. Vitiligo, at times, could be confused with chemical leukoderma and vitiligo This study aims to investigate whether clinically acceptable micro Quadrichrome vitiligo, in which a fourth dark color is present in areas undergoing perifollicular hyperpigmentation Perifollicular repigmentation was induced in a patient with SV and concurrent leukotrichia that was previously unresponsive to narrow-band ultraviolet B (NBUVB) phototherapy after the patient suffered an accidental burn on the denuded but uncovered area during phototherapy following an epidermal graft. Patterns of Vitiligo. The salt and pepper appearance of the skin is composed of salt (vitiligo-like depigmentation) and pepper (perifollicular pigmentation). Due to the ability to increase of UV exposure, follicular mechanism stimulation was enhanced in In one study, 51.3% of patients believed that their vitiligo was caused by poor medical care, 30% thought personal behavior played a major role, 25% - wrong diet, 21.3% - The condition of Two Rare Cases of Facial Vitiligo-Like Hypopigmentation With Upper Dermal Elastic Fibers Degeneration. Although the perifollicular re-pigmentation pattern of vitiligo has been the subject to intensive investigation, little attention has been paid to formation of the marginal re-pigmentation pattern, in which unaffected melanocytes bordering the depigmented skin may be activated, allowing them to migrate into the leukoderma areas. Authors: Monisha Gupta, Brent J Doolan Pages: 1 - 3 Abstract: Monisha Gupta, Brent J Doolan Pigment International 2022 9(1):1-3 Citation: Pigment International 2022 9(1):1-3 PubDate: Mon,16 May 2022 DOI: 10.4103/pigmentinternational.pigmentinternational_47_21 Issue No: Vol. Repigmentation is evaluated according to peculiar pattern of pigmentation onset after the particular treatment Perifollicular: Usually seen after medical management over the the patch with black hairs. Clinical Findingsin Patients With MelanocyticNevi With Perifollicular Hypopigmentation No. It can affect people of any age, gender and ethnic group. Quadrichrome vitiligo is characterized by the presence of a fourth color (dark brown) at sites of perifollicular repigmentation. Trichrome vitiligo, in which patients have 3 zones of different colors; these range from the central achromic zone, to its surrounding hypochromic zone, to the outermost peripheral normal colored skin zone. Wnt1 protein belongs to the Wnt signaling pathway. Follicular repigmentation in vitiligo is fairly well understood, as the perifollicular pigment is formed by upward migration of activated melanoblasts in the outer root sheath. Vitiligo is related to leprosy or skin cancer. Ortonne J. Vitiligo and other 2007; 143(5):578-584. Typical macule of vitiligo has a chalky or milky white colour, but The re-pigmentation response was correlated with the duration of The natural progression of the disease is unpredictable, ranging from insidious to rapid in onset. Wnt1 protein belongs to the Wnt signaling pathway. Researchers into pigmentary disorders of which vitiligo is the most common talk about the melanocyte reservoir . It's an excess of melanin. The residual perifollicular On healing, all the lesions of vitiligo showed perifollicular pigmentation in hairy areas and perilesional repigmentation in non hairy areas. Randomized Double-blind Trial of Treatment of VitiligoEfficacy of PsoralenUV-A Therapy vs NarrowbandUV-B Therapy Level III 56 patients Volume 12, Number 6, 565-8, November - December 2002, Thrapie vitiligo are the readily This pattern is not seen in other disorders of Wnt1 induction is linked with melanocyte stem cell differentiation in hair follicles on lentigo solaris, which is a hyperpigmentation skin disorder in sun-exposed area. Superficial Vitiligo is an autoimmune skin disorder with a 0.52.0% incidence worldwide without sex or age. This density of perifollicular infiltrate was not found in cases with white hair follicles Vitiligo can appear at sites of trauma or sunburn (Koeb-ners phenomenon). plus estimated percent of perifollicular In FFA, hairline recession, scalp pruritus, perifollicular erythema, and eyebrow loss are common at presentation. This is a myth. Digital epiluminescence dermoscopy (microscopy) is usually employed to examine melanomas and other pigmented lesions. Some cases of vitiligo may involve genetic mutations or autoimmune disorders. Alopecia with areas of perifollicular erythema and hyperpigmentation with reduced follicular openings were present on the eyebrows and anterior forehead. J Am Acad Dermatol 76 (6):1054-1060.e1. It is characterized by hypopigmented macules and patches due to dysfunction of melanocytes. it typically occurs in a perifollicular pattern. A skin biopsy is not routinely done but can be We constructed a vitiligo road map, consisting of basic science, clinical, and treatment components, in order to better portray our current understanding of vitiligo pathogenesis and reflect upon novel biomarkers and therapeutic targets for future Vitiligo is detected worldwide, with a prevalence of around 0.1% to 2%. vitiligo, expressing cytotoxic/apoptotic factors to induce melanocytic destruction [10,11]. positive family history. Methods : This clinical pre-experimental study used one group pre test-post test design. Vitiligo is an acquired depigmentation skin disease caused by immune-mediated death of melanocytes. This article discusses the surgical management of vitiligo. Dermoscopy has been reported to be beneficial in the diagnosis of early vitiligo and blue vitiligo, assessment of the disease stage and treatment response, and differentiation of idiopathic guttate hypomelanosis from guttate vitiligo. Is hyperpigmentation the same as vitiligo? "Hypopigmentation" is a general term to describe a reduction in skin pigmentation, which can be present at birth or develop later in life from illness, injury, or certain medications. However, within 4 weeks multiple florid vitiligenous lesions with Various cutaneous pigmentary alterations have been described in SSc , including a diffuse, generalized hyperpigmentation with accentuation in sun-exposed areas, a vitiligo-like What is vitiligo? ISRN Dermatol. After 180 days, this control group had a predominantly perifollicular pigmentation pattern. Many patients are poorly educated about their illness. These were further treated with PUVA/PUVASOL. Vitiligo is a common, acquired multifactorial skin disease. While in their report, clinical suspicion of vitiligo was confirmed on dermoscopic observation of depigmentation with preserved perifollicular pigment; in our case, PFD over a background of reticular hyperpigmentation from the hyperpigmented forehead spot was an incidental and unexpected finding. Vitiligo dermoscopy: a milky white structureless area with a diffuse white glow due to the absence of a pigment network. Quadrichrome vitiligo is characterized by the presence of a fourth color (dark brown) at sites of perifollicular repigmentation. The fact that re-pigmentation tends to occur mainly in those areas of skin where there are still hairs containing colour points to the significance of hair follicles. patches. Systemic autoimmune diseases are less frequently associated compared to non-segmental vitiligo (NSV), but localized skin disorders in particular linear morphea have been repeatedly observed in patients with SV. On healing, all the lesions of vitiligo showed perifollicular pigmentation in hairy areas and perilesional repigmentation in non hairy areas. Repigmentation of vitiligo depends on available melanocytes from three possible sources: from the hair follicle unit which is the main provider of pigment cells, from the border of vitiligo lesions, and from unaffected melanocytes within depigmented areas; pigment cells at these locations originate a perifollicular, border spreading and a diffuse repigmentation pattern. Symptoms of Vitiligo. The fact that re-pigmentation tends to occur mainly in those areas of skin where there are still hairs containing colour points to the significance of hair follicles. Vitiligo may have a significant psychological impact and clinicians Arch Dermatol. Vitiligo is an autoimmune skin pigmentation disorder that develops when the immune system destroys melanocytes. clear white, faint, multi-dot, and perifollicular for the inside, and sharp, blunt, confetti, and trichrome for the border. Demonstration of residual perifollicular pigmentation in localized vitiligoa reverse and novel application of digital epiluminescence dermoscopy Computerized Medical Imaging and Graphics, 2004 Antonio Chuh Vitiligo is a skin pigmentation disorder, marked by chalky white patches on the skin and mucosa, and characterized histologically by the lack of melanocytes (melanin pigment formation cell). Tahir M.A. Their study varied from ours, they included all types of vitiligo (evolving, stable and Therefore, though perifollicular pigmentation is preserved in the lesional skin in most cases of vitiligo, PFD seen on dermoscopy may paradoxically indicate impending vitiligo especially in a high-risk case e.g. 5. Although multiple theories trunk and bilateral arms ; lesions on the arms seemed to demonstrate a perifollicular predominance. 1. Vitiligo Update Rebat M. Halder, MD, and Johnathan L. Chappell, MD Vitiligo is an acquired dyschromia of the skin in which there is a loss of epidermal refers to the additional presence of marginal or perifollicular hyperpigmentation. AN ALL ITALIAN DISCOVERY, IT IS CALLED BIOSKIN EVOLUTION THE LATEST COLD-LIGHT MICROPHOTOTHERAPY FOR THE CARE AND THE TREATMENT OF THE VITILIGO.. WHAT IS THE BIOSKIN EVOLUTION THERAPY. Vitiligo patches usually show residual perifollicular pigmentation, which is absent in other conditions. Perifollicular hyperpigmentation is seen in lichen planus pigmentosus and melanoderma in the elderly , . Vitiligo can be focal, segmental, or, rarely, generalized. These were further treated with 15 This residual perifollicular pigmentation had been observed in (91.9%) of patients with progressing vitiligo and (62.9%) of those with stable vitiligo, 16 and this can be considered as characteristic for vitiligo A decrease in the number of melanocytes (e.g. After the healing, 82.5% of hairy sites and 81.3% of non hairy sites showed repigmentation. It is more often encountered in patients with darker skin phototypes. So I want to share 3 examples of vitiligo recovery based on my own personal experience. Quadrichrome vitiligo is another variant of vitiligo, a cutaneous condition, which reflects the presence of a fourth color (dark brown) at sites of perifollicular repigmentation. A decrease in the Since localized treatment for vitiligo is as essential as systemic treatment, a reliable instrument for target evaluation is needed besides those for whole body evaluation. Possible mechanisms by which topical 5-fluorouracil and dermabrasion could induce pigment spread in vitiligo skin: an experimental study. Dear Editor: Vitiligo is traditionally divided into two Since no particular therapy demonstrated its absolute superiority over others, various with perifollicular Vitiligo is the most frequent pigmentary disorder ( Bagherani et al., 2011; Nazer et al., Their study showed that with clobetasol, perifollicular islands of pigment were observed A recent study using lineage tracing mice shows that hair follicle mela-nocyte stem cells (HF-McSCs) give rise to epidermal melanocytes after injury or UVB treatment [9]. Melanocytes are the cells responsible for producing skin pigment called melanin, which gives skin its colour and protects it from UV rays. Falabella 14 explained these patterns and described three possible Vitiligo is the most common cause for depigmentation and it affects 0.1 to 2.0% of the general population. Loss of pigment may not be apparent in fair-skinned individuals but may be disfiguring in blacks. Rarely, patients may experience spontaneous repigmentation. Herein, we present a unique case of a patient with vitiligo universalis that had remained untreated and stable for >20years until she developed repigmentation shortly after initiation of dialysis. 6. Abstract: Vitiligo is a depigmenting disorder stemming from melanocyte loss or dysfunction. However, residual perifollicular pigmentation was non seen in the 79 patients with non-vitiligo depigmentation. In other words the ways in which pigment actually returns to previously depigmented skin. Whether or not the margins are consistent with a total loss of pigmentation associated with vitiligo, and if there are borders which are raised and red (normally associated with marginal Vitiligo is in-fact an auto-immune disease wherein our own immune system attacks the pigment forming cells Vitiligo is an acquired disorder of pigmentation characterized by the development of white macules and patches on the skin. We have not seen perifollicular repigmentations in vitiligo as a side-effect of systemic 5-FU therapy before, and topical 5-FU has been suggested as a means by which to Starburst appearance, altered pigment network, and comet tail appearance, were also noted, and these were typical of progressive vitiligo. "Hypopigmentation" is a general term to describe a reduction in skin pigmentation, which can be present at birth or develop later in life from illness, injury, or certain medications. Summary. Quadrichrome vitiligo. Vitiligo may appear at any time from birth to senescence, although the onset is most commonly observed in persons aged 10-30 years. It is characterised by progressive depigmentation of the epidermis in circumscribed areas, typically without erythema or scaling. A pattern of depigmentation with residual reservoirs of perifollicular pigment is considered characteristic signifying focally active or repigmenting vitiligo. There may be no changes to skin or re-pigmentation for This type has been observed in a patient with postinflammatory hyperpigmentation who then developed vitiligo. Changes of hyperpigmentation and depigmentation in PSS have been mentioned in medical literature since 1898[] but their relationship to the pathogenesis of the underlying condition is poorly understood.The pigmentary alterations seen in PSS are vitiligo-like depigmentation with perifollicular pigment retention, diffuse hyperpigmentation with accentuation in sun exposed Although the perifollicular re-pigmentation pattern of vitiligo has been the subject to intensive investigation, little attention has been paid to formation of the marginal re-pigmentation pattern, in which unaffected melanocytes bordering the depigmented skin may be activated, allowing them to migrate into the leukoderma areas. Management It is paramount to consider and address the burden of illness in patients with vitiligo. doi: 10.1016/j.jaad.2017.02.049. Vitiligo occurs in equal proportions regardless of age, sex, or ethnicity. The histology of vitiligo shows a normal epidermis with loss of melanocytes. A normal reticulate pigment network is due to melanocytes in the rete ridges. 2 Residual perifollicular pigmentation was more abun-dant in progressive -stage patients than in stable -stage patients, Vitiligo, an acquired, idiopathic disorder, is a long-term skin disease Quadrichrome vitiligo is another variant of vitiligo, a cutaneous condition, which reflects the presence of a fourth color (dark brown) at sites of perifollicular repigmentation. Surgery for vitiligo is a good option for a patient who is not responding to medical treatment. Demonstration of residual perifollicular pigmentation in localized vitiligo--a reverse and novel application of digital epiluminescence dermoscopy. + Titanium pigmentation + Deposits of corticosteroids in the dermis + Ochronosis + Colloid milium + Vitiligo + Hypomelanosis guttata + Pityriasis alba + Albinism + Melasma, chloasma Perifollicular fibroma: Perifollicular fibroma, HE 40x (2431) On healing,all the lesions of vitiligo showed perifollicular pigmentation in hairy areas and perilesional repigmentation in non hairy areas. usually occurs around the hairs in a perifollicular pattern. Meanwhile, Njoo et al. Lesions with the clear vitiligo). pigment is not overall, although a common sequence, as some vitiligo patients can present with merely leukotrichia over normal looking pigmented skin surface with persistence of epidermal It is more often encountered in patients with darker skin Although the disease does not produce direct physical impairment, the effects of vitiligo may be cosmetically and psychologically deva- Mild pruritus may be present. papilla, clinically giving rise to perifollicular hyper-pigmentation. This pattern is not seen in other disorders of depigmentation. Age. We report its reverse application in assisting the early diagnosis of a depigmentation condition-localized vitiligo. Vitiligo is an acquired, autoimmune disease characterized by depigmented macules and patches on the skin, which occur secondary to melanocyte destruction. Segmental vitiligo is a subtype of vitiligo with a specific unilateral distribution. Dermoscopy appears to be It is mostly diffuse, but reticular, blotchy and perifollicular forms are seen. 2. [1] Pigment Network | Pigment Network 1 (2022) Vitiligo is related to leprosy or skin cancer. 13 observed perifollicular repigmentation only in vitiligo lesions treated with NB-UVB therapy.