10.5826/dpc.1201a07
text/xml
2160-9381
1724
en
Somesh Gupta
https://creativecommons.org/licenses/by-nc/4.0
Dermatology Practical & Conceptual
Vitiligo Co-localized Over a Patch of Alopecia Areata in Two Patients: More Than a Coincidence? 
Text.Serial.Journal
https://dpcj.org/index.php/dpc
Image Letter
2022-02-02
2021-03-16
2022-02-02
2022-02-09
e2022007
Dermatol Pract Concept
Somesh Gupta
2022/02/02
10.5826/dpc.1201a07
e2022007
Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
2160-9381
en
e2022007
Rork JF, Rashighi M, Harris JE. Understanding autoimmunity of vitiligo and alopecia areata. Curr Opin Pediatr. 2016;28(4):463-469. DOI: 10.1097/MOP.0000000000000375. PMID: 27191524. PMCID: PMC4957563.
Vitiligo Co-localized Over a Patch of Alopecia Areata in Two Patients: More Than a Coincidence? 
https://dpcj.org/index.php/dpc/article/download/1724/1481
    Vitiligo Co-Localized Over a Patch of Alopecia
  Areata in Two Patients: More Than a Coincidence?
                                   Rashi Pangti1, Iftekhar Khan1, Somesh Gupta1


1 Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India



Citation: Pangti R, Khan I, Gupta S. Vitiligo co-localized over a patch of alopecia areata in two patients: more than a coincidence?
Dermatol Pract Concept. 2022;12(1):e2022007. DOI: https://doi.org/10.5826/dpc.1201a07
Accepted: April 25, 2021; Published: January 2022
Copyright: ©2022 Pangti et al. This is an open-access article distributed under the terms of the Creative Commons Attribution-
NonCommercial License (BY-NC-4.0), https://creativecommons.org/licenses/by-nc/4.0/, which permits unrestricted noncommercial use,
distribution, and reproduction in any medium, provided the original authors and source are credited.
Funding: None.
Competing interests: None.
Authorship: All authors have contributed significantly to this publication.
Corresponding author: Somesh Gupta, Professor, Department of Dermatology & Venereology, All India Institute of Medical Sciences,
New Delhi, India. E-mail: someshgupta@hotmail.com




Case Presentation                                                        pathogenesis; however, it has also been argued that this
                                                                         might be just a coincidence. An interferon (IFN)-γ-driven im-
A 17-year-old boy and an 8-year-old boy presented to us                  mune response is proposed in both diseases whereby IFN-γ is
with discrete patches of smooth, non-scarring alopecia co-­              required for the recruitment of CD8+ cytotoxic lymphocytes
localized with depigmentation over the scalp (Figure 1, A                to the sites of inflammation [2]. Class II human leukocyte
and B). In the first case, alopecia areata followed vitiligo,            antigen (HLA) and other non-HLA genes have also been im-
while it was the opposite in the second case. On dermoscopy              plicated in both diseases [1]. In alopecia areata, the initial
of the alopecic patches, black dots, broken hairs, and vel-              targets for autoimmunity are hair follicle melanocytes (along
lus hairs were appreciated. We made a diagnosis of alopecia              with keratinocytes, and dermal papilla cells) while in vitil-
areata co-localized with vitiligo based on clinical and dermo-           igo the initial target is epidermal melanocytes [1]. When this
scopic findings.                                                         compartmentalization is blurred, both epidermal and hair
                                                                         follicle melanocytes are destroyed by autoimmunity, leading
                                                                         to co-localization.
Teaching Point
There are few previous reports of co-localization of alope-
cia areata and vitiligo [1,2]. They seem to share common




Image Letter | Dermatol Pract Concept. 2022;12(1):e2022007                                                                             1
Figure 1. (A) Patient 1: Development of vitiligo over 1 out of the 3 patches of alopecia areata. (B) Patient 2: Development of alopecia areata
over both patches of vitiligo. Inset shows the patches individually.




References                                                                2. Rork JF, Rashighi M, Harris JE. Understanding autoimmunity
                                                                             of vitiligo and alopecia areata. Curr Opin Pediatr. 2016;28(4):
1. Krishnaram A S, Saigal A, Adityan B. Alopecia areata - Vitiligo           463-469. DOI: 10.1097/MOP.0000000000000375. PMID:
   overlap syndrome: An emerging clinical variant. Indian J Derma-           27191524. PMCID: PMC4957563.
   tol Venereol Leprol. 2013;79(4):535-537. DOI: 10.4103/0378-
   6323.113100. PMID: 23760330.




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