Vitiligo on Hands of a 33-Year-Old Man

August 28, 2012

This is classic vitiligo, an autoimmune disease in which anti-melanocyte antibodies develop. Phototherapy or topical calcineurin inhibitors may be beneficial.

A 33-year-old man was concerned about the appearance of discolored spots on his hands. He had a few similar areas on the ankles. He was not exposed to chemicals at his desk job in a bank.

Key point: The lesions consist of variable-shaped areas of absolute depigmentation. This is classic vitiligo, an autoimmune disease in which anti-melanocyte antibodies develop.

Treatment: Vitiligo is difficult to manage. Phototherapy with specific wavelengths of ultraviolet light may be beneficial. Some areas also improve following application of topical calcineurin inhibitors, such as pimecrolimus or tacrolimus.

Note: The prognosis worsens with increasing extent and duration of disease, and with increasing age of the patient. Vitiligo of the hands and feet is particularly challenging to re-pigment.