Vitiligo differential diagnosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Differentiating Vitiligo from other Diseases
- Annular lichenoid dermatitis of youth
- Chemical leukoderma
- Certain chemicals, particularly aromatic derivatives of phenols and catechols, can destroy melanocytes, resulting in chemical leukoderma that may be differentiated from vitiligo by the history of toxin exposure, lesions with bizarre borders and scale, a “confetti-like” distribution, and symptomatic pruritus.
- Discoid lupus erythematosus
- Guttate hypomelanosis
- Presents with hypopig- mented macules in a photodistribution on a background of actinic damage primarily on the arms and legs; unlike vitiligo, the macules are usually 5 mm in diameter or less.
- Halo nevus
- Hypopigmented mycosis fungoides
- Idiopathic guttate hypomelanosis
- Leprosy
- Lichen sclerosus
- Mycosis fungoides
- Nevus anemicus
- Nevus depigmentosus
- Nevoid hypomelanosis
- Onchocerciasis
- Photodistributed vitiligo-like drug reaction in HIV patients
- Piebaldism
- Pinta
- Pityriasis alba
- Common in children with atopy; also may have fine scale, but lesions retain some pigment and are less sharply demarcated.
- Postinflammatory depigmentation
- Postinflammatory hypopigmentation
- A history of trauma or inflammation of the affected area will precede the loss of pigment.
- Sarcoidosis
- Scleroderma-related leukoderma
- Tinea versicolor
- May be differentiated by the presence of fine scale, positive potassium hydroxide preparation, and distribution primarily on the trunk and neck.
- Topical steroid leukoderma
- Tuberous sclerosis
- Accompanied by angiofibromas, periungual fibromas, connective tissue nevi, and possibly neurological sequelae.
- Vogt–Koyanagi–Harada syndrome