Dermatology: Practical and Conceptual


Image Letter | Dermatol Pract Concept. 2022;12(3):e2022107 1

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

A 65-year-old man presented with multiple asymptomatic 

depigmented patches of varying sizes with an erythema-

tous annular border over the upper back and shoulders for 

one week (Figure 1A). Histopathology from the border of 

one lesion revealed vacuolar interface changes and moder-

ate perivascular lymphocytes with pigment incontinence in 

the superficial dermis. SOX10 staining revealed a reduction 

in epidermal melanocytes (Figure 1B). These findings were 

consistent with inflammatory vitiligo. After 2 weeks of 40 

mg/day of oral prednisolone with a tapering dosage, the 

 erythematous border had almost disappeared.

Teaching Point

The patterns of active and progressive vitiligo include in-

flammatory vitiligo, Koebner phenomenon, trichrome le-

sions, and confetti-like depigmentation. Inflammatory 

vitiligo is rare and characterized by erythema, scales, and 

pruritus at the border. Although the inflammatory phase is 

usually transient, it can cause rapid depigmentation [1]. Oral 

steroids are frequently used to stabilize rapidly progressive 

vitiligo, and ultraviolet phototherapy is another suitable 

treatment [2].



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

References

1. Rodrigues M, Ezzedine K, Hamzavi I, Pandya AG, Harris 

JE. New discoveries in the pathogenesis and classification of 

 vitiligo. J Am Acad Dermatol. 2017;77(1):1-13. DOI: 10.1016 

/j.jaad.2016.10.048. PMID: 28619550.

2. 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.

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.