10.5826/dpc.1203a107
text/xml
2160-9381
1889
en
Yin-Shuo Chang
https://creativecommons.org/licenses/by-nc/4.0
Dermatology Practical & Conceptual
Inflammatory Vitiligo
Text.Serial.Journal
https://dpcj.org/index.php/dpc
Image Letter
2022-07-28
2021-07-15
2022-07-28
2022-09-15
e2022107
Dermatol Pract Concept
Yin-Shuo Chang
2022/07/28
10.5826/dpc.1203a107
e2022107
Department of Dermatology, Taipei Medical University Hospital, Taipei, Taiwan
2160-9381
en
e2022107
Rodrigues M, Ezzedine K, Hamzavi I, Pandya AG, Harris JE. Current and emerging treatments for vitiligo. J Am Acad Dermatol. 2017;77(1):17-29. DOI: 10.1016/j.jaad.2016.11.010. PMID: 28619557.
Inflammatory Vitiligo
https://dpcj.org/index.php/dpc/article/download/1889/1690
                                         Inflammatory Vitiligo
                             Hua-Ching Chang1,2, Chun-Yu Lai1, Yin-Shuo Chang1


1 Department of Dermatology, Taipei Medical University Hospital, Taipei, Taiwan
2 Department of Dermatology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan



Citation: Chang HC, Lai CY, Chang YS. Inflammatory Vitiligo. Dermatol Pract Concept. 2022;12(3):e2022107.
DOI: https://doi.org/10.5826/dpc.1203a107
Accepted: October 29, 2021; Published: July 2022
Copyright: ©2022 Chang 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: Yin-Shuo Chang, MD, Department of Dermatology, Taipei Medical University Hospital, Address: No. 252,
Wuxing St, Xinyi District, Taipei City, 110, Taiwan Tel: 886-2-27372181 ext 8285 E-mail: ckshuo@gmail.com




Case Presentation                                                       Teaching Point
A 65-year-old man presented with multiple asymptomatic                  The patterns of active and progressive vitiligo include in-
depigmented patches of varying sizes with an erythema-                  flammatory vitiligo, Koebner phenomenon, trichrome le-
tous annular border over the upper back and shoulders for               sions, and confetti-like depigmentation. Inflammatory
one week (Figure 1A). Histopathology from the border of                 vitiligo is rare and characterized by erythema, scales, and
one lesion revealed vacuolar interface changes and moder-               pruritus at the border. Although the inflammatory phase is
ate perivascular lymphocytes with pigment incontinence in               usually transient, it can cause rapid depigmentation [1]. Oral
the superficial dermis. SOX10 staining revealed a reduction             steroids are frequently used to stabilize rapidly progressive
in epidermal melanocytes (Figure 1B). These findings were               vitiligo, and ultraviolet phototherapy is another suitable
consistent with inflammatory vitiligo. After 2 weeks of 40              treatment [2].
mg/day of oral prednisolone with a tapering dosage, the
­erythematous border had almost disappeared.




Image Letter | Dermatol Pract Concept. 2022;12(3):e2022107                                                                          1
Figure 1. (A) Multiple asymptomatic depigmented patches with erythematous annular border over the upper back and bilateral shoulders.
(B) Pathology with immunohistochemistry with SOX10 (100X): the right half of the figure from the erythematous border of the skin lesion
shows the relatively normal distribution of epidermal melanocytes compared with reduced epidermal melanocytes in the left half of the figure
from the depigmented area of the skin lesion.



References                                                               2. Rodrigues M, Ezzedine K, Hamzavi I, Pandya AG, Harris
                                                                            JE. Current and emerging treatments for vitiligo. J Am Acad
1. Rodrigues M, Ezzedine K, Hamzavi I, Pandya AG, Harris                    ­Dermatol. 2017;77(1):17-29. DOI: 10.1016/j.jaad.2016.11.010.
   JE. New discoveries in the pathogenesis and classification of             PMID: 28619557.
   ­vitiligo. J Am Acad Dermatol. 2017;77(1):1-13. DOI: 10.1016
    /j.jaad.2016.10.048. PMID: 28619550.




2                                                                              Image Letter | Dermatol Pract Concept. 2022;12(3):e2022107
