Content

»	Pigmentary Disorders and Vitamin Deficiencies
	»	Vitiligo
	»	Melasma (Chloasma)
	»	Erythema Dyschromicum Perstans (Ashy Dermatosis)
	»	Erythema Ab Igne
»	Cutaneous Manifestations of Systemic Diseases
	»	Paraneoplastic Cutaneous Manifestations
	»	Cutaneous Signs in Select Internal Dieases

Pigmentary Disorders and Vitamin Deficiencies

Figure 3.46
A: Vitiligo
(Courtesy of Dr. Paul Getz)
B: Melasma
(Courtesy of Dr. Paul Getz)
C: Erythema ab igne
(Courtesy of Dr. Sophie M.
Worobec)

Vitiligo (Figure 3.46A)

Acquired pigmentary disorder of skin and mucous membranes with multifactorial etiology (genetic and non-genetic), likely due to autoimmune destruction of melanocytes in affected skin
Presents with depigmented macules or patches surrounded by normal skin; ↑ accentuation with Wood’s lamp; predilection for periorifical facial areas, bony prominences and sites with ↑ trauma; may be classified into
- Localized: focal, unilateral, and mucosal
- Generalized: wide distribution, acrofacial, and mixed
- Universal: near complete to complete depigmentation
Treatment: NBUVB, PUVA, topical corticosteroid, topical calcineurin inhibitor, pseudocatalase, excimer laser, surgical therapy
May be associated with autoimmune endocrinopathy such as thyroid dysfunction (Graves’ disease, Hashimoto’s thyroiditis) and polyglandular dysfunction; anecdotal reports with pernicious anemia and Addison’s disease