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Year : 2014  |  Volume : 1  |  Issue : 1  |  Page : 28-30

Novel dermoscopic findings of perifollicular depigmentation and evolving leukotrichia in areas of clinically unaltered pigmentation: An early predictive sign of impending vitiligo!

1 The Skin Clinic and Research Centre, Gurgaon, Haryana, India
2 Departments of Dermatology and STD,Maulana Azad Medical College and LN Hospital, New Delhi, India
3 Departments of Dermatology and STD, University College of Medical Sciences and GTB Hospital, University of Delhi, New Delhi, India

Correspondence Address:
Sidharth Sonthalia
The Skin Clinic and Research Centre, C 2246 (Ground Floor), 'Suhridaya,' Sushant Lok 1, Block C, Gurgaon 122 009, Haryana
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2349-5847.135438

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Dermoscopy is a simple noninvasive technique that aids in the diagnosis of disorders of hyperpigmentation. However, its role in diagnosis of vitiligo is relatively infantile with only few published reports. We report the case of a young man who sought consultation for diffuse facial hyperpigmentation suggestive of photomelanosis. Dermoscopy from a pigmented forehead lesion revealed perifollicular depigmentation (PFD) without leukotrichia, in a background of reticular hyperpigmentation. There was no clinical evidence or past history of vitiligo. Family history of early-onset recalcitrant vitiligo was positive in mother. The patient developed rapidly progressive vitiligo with leukotrichia within the next 4 weeks. Dermoscopic re-evaluation from the same region revealed a reduction in hyperpigmentation, widening of PFD, leukotrichia of few hairs and rarefaction and pigment reduction of other hair shafts suggestive of impending leukotrichia. He developed the treatment-refractory disease over the next 6-8 months. 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. positive family history. This case has been documented to highlight the role of dermoscopy and the sign of PFD in early detection of vitiligo.

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