New Insights in Segmental Vitiligo

Case Report and Review of Theories

N. van Geel; I. Mollet; L. Brochez; M. Dutré; S. De Schepper; E. Verhaeghe; J. Lambert; R. Speeckaert

Disclosures

The British Journal of Dermatology. 2012;166(2):240-246. 

In This Article

Case Report

A 25-year-old healthy white man presented with alopecia areata on the scalp and beard region (Figs 1 and 2). These lesions had been present for 4 months. The alopecia was subsequently successfully treated with local steroids (betamethasone dipropionate 0·064% gel). The patient had an atopic constitution with frequent flares of allergic rhinitis. Furthermore, he mentioned the sudden development of a localized white area on the right side of the trunk at the age of 2 years. This depigmented area did not change for many years. He could not remember any triggering events in the past such stress or sunburn. At Wood's light examination, a well-delineated unilateral depigmentation on the right hemithorax was observed corresponding to segmental vitiligo (Figs 3 and 4). No clinical signs of a Koebner phenomenon were visible. However, a halo naevus was observed on the contralateral side of the back (Fig. 5). He could not remember the time of onset of this lesion in relation to the development of the vitiligo lesions. Family history revealed that his brother also had a halo naevus, while no family members were affected by vitiligo or other autoimmune diseases. Two years after his initial presentation, an erythematosquamous eruption appeared on the scalp, clinically corresponding to psoriasis (Fig. 6).

Figure 1.

Alopecia areata on the scalp.

Figure 2.

Alopecia areata on the beard region.

Figure 3.

Segmental vitiligo on the right hemithorax.

Figure 4.

Segmental vitiligo on the right hemithorax, ventral side.

Figure 5.

Halo naevus on the back.

Figure 6.

Psoriasis on the scalp.

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