Vitiligo

By Dr. Pascal Bafteh · last updated 09/2026

Overview

• Autoimmune disease with anti-melanocyte autoantibodies and CD8+ T-cell infiltration.
• Repigmentation preferentially periorificial (perioral, periocular) and in flexures.

Overview

• General Information: Segmental, focal, or generalized (more common). Onset usually between 10–30 years of age. Association: Hashimoto's, genetics, UV, radiation, stress.
• Pathophysiology: Destruction/absence of melanocytes by Th1 cells (IFNγ, TNFα, CXCL10).
• Clinical Presentation/Diagnostics: Koebner phenomenon (40%), hyperpigmented border, leukotrichia. Labs: ANA, TSH, Anti-TPO. Wood's light: cold blue-white.
• Associated autoimmune diseases (part of the initial work-up!): most frequently autoimmune thyroiditis (Hashimoto), further Graves' disease, type 1 diabetes mellitus, pernicious anaemia, alopecia areata, Addison's disease and coeliac disease; the coincidence of several endocrine autoimmune diseases is called polyglandular autoimmune syndrome. Screening therefore with TSH and anti-TPO plus fasting glucose/HbA1c, plus a full blood count and, depending on the clinical picture, ANA.

Differential diagnoses

• Nevus depigmentosus
• Albinism
• Hypomelanosis of Ito
• Pityriasis alba
• Piebaldism
• Lichen sclerosus
• Pityriasis versicolor
• Pinta

Sources (selection)

1. Böhm et al. S1 Guideline Vitiligo 2022

Note: This page is intended for medical education and does not replace diagnosis or treatment decisions in individual cases. Treatment and follow-up content is available in the app.