Which statement best describes vitiligo on physical examination?

Which statement best describes vitiligo on physical examination?

• A. Depigmented patches that are white or light pink
• B. Hyperpigmented patches with thick scaling
• C. Vesicular lesions on mucosa
• D. Erythematous plaques with silvery scale

Answer: (A)

Vitiligo shows loss of pigment due to destruction of melanocytes, so on exam you see patches that are completely depigmented—white or very pale pink—with sharp, well-defined borders. The surrounding skin typically looks normal in texture and there is no scaling or surrounding inflammation. Hair within the patches may turn white (poliosis), and patches can be symmetric or progressive. This depigmented appearance distinguishes vitiligo from conditions that produce pigmented or scaly lesions; hyperpigmented patches with thick scaling suggest psoriasis or fungal dermatitis, vesicular lesions on mucosa point to viral or blistering diseases, and erythematous plaques with silver scales are classic for psoriasis.

Vitiligo shows loss of pigment due to destruction of melanocytes, so on exam you see patches that are completely depigmented—white or very pale pink—with sharp, well-defined borders. The surrounding skin typically looks normal in texture and there is no scaling or surrounding inflammation. Hair within the patches may turn white (poliosis), and patches can be symmetric or progressive. This depigmented appearance distinguishes vitiligo from conditions that produce pigmented or scaly lesions; hyperpigmented patches with thick scaling suggest psoriasis or fungal dermatitis, vesicular lesions on mucosa point to viral or blistering diseases, and erythematous plaques with silver scales are classic for psoriasis.