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Dermatology247 papers

Deafness, vitiligo, achalasia syndrome

Last edited: 4/14/2026

Overview

Vitiligo is an acquired autoimmune disorder characterized by the loss of melanocytes leading to depigmented patches on the skin. It can be associated with other autoimmune conditions and may be triggered or exacerbated by certain medications, including immunosuppressants and antineoplastic drugs 1518.

Diagnosis

  • Clinical Presentation: Depigmented macules on the skin 18.
  • Wood's Lamp Examination: Useful for initial assessment and monitoring disease stability 20.
  • Differential Diagnosis: Distinguish from nevus depigmentosus using Mexameter for differential diagnosis 37.
  • Laboratory Tests: No specific lab tests; assess for associated autoimmune conditions 1033.

    • Management

  • First-Line Treatments:
    • - Topical Corticosteroids: For localized vitiligo 30. - Phototherapy: Including narrowband UVB 29.
  • Adjunctive Treatments:
    • - Janus Kinase (JAK) Inhibitors: In combination with phototherapy 1314. - Ruxolitinib Cream: Phase 3 trials show efficacy in repigmentation 14. - Calcipotriol and Betamethasone Dipropionate Ointment: Open trial suggests potential benefit 30.
  • Other Approaches:
    • - Surgery: For stable, resistant patches (e.g., epidermal grafting) 35. - Dietary Interventions: Limited evidence; systematic review ongoing 9.

    Special Populations

  • Pediatrics: Vitiligo onset often between 8-12 years 38.
  • Comorbidities: Increased risk of metabolic syndrome and anxiety comorbidity 2115.
  • Pregnancy: Limited data; management should consider potential teratogenic effects of treatments 310.

    • Key Recommendations

  • Use Phototherapy and Topical Corticosteroids as First-Line Treatments for localized vitiligo (Evidence: Moderate 2930).
  • Consider JAK Inhibitors in Combination with Phototherapy for Patients with Stable Vitiligo (Evidence: Moderate 1314).
  • Monitor for Associated Autoimmune Conditions and Metabolic Syndrome in patients with vitiligo (Evidence: Moderate 1021).
  • Evaluate Disease Stability Using Wood's Lamp Before Considering Surgical Interventions (Evidence: Expert opinion 20).
  • Address Psychological Impact through counseling and support groups due to high anxiety comorbidity (Evidence: Moderate 15).

    • References

    1 Jia Y, Xie H, Yang Y, Cui B, Wang J, Xiao Z. Vitiligo secondary to immunosuppressants: a pharmacovigilance study of the FDA Adverse Event Reporting System. Frontiers in immunology 2026. link 2 Hamid A, Turner K, Elbuluk N. National Institutes of Health Funding for Vitiligo Research: Trends from 1985 to 2024. Journal of drugs in dermatology : JDD 2025. link 3 Shen N, Fang Q, Wu Y, Lan L, Ma F. Drug-induced vitiligo: a real-world pharmacovigilance analysis of the FAERS database. PloS one 2025. link 4 Lu L, Feng J, Zhang S, He H, Hu Z, Yang L et al.. Vitiligo associated with type 2 immune inhibitors: FAERS analysis and literature review. The Journal of dermatology 2025. link 5 Yang Y, Xie H, Li D, Jia Y, Cui B, Zou J et al.. Real world pharmacovigilance study of antineoplastic drug related vitiligo risks. Scientific reports 2025. link 6 Kibret G, Haile AT, Abebe Y, Admassu E, Haile RG. Proportion Of vitiligo and associated factors among patients visiting dermatology opd in tibebe ghion specialized hospital and addisalem primary hospital, bahirdar city, Ethiopia,2023. BMC research notes 2024. link 7 Fakih A, Tannous R, Lajnef M, Seneschal J, Andreu N, Tran VT et al.. Stigma in vitiligo: associated factors and severity strata of the Patient Unique Stigmatization Holistic tool in Dermatology (PUSH-D) score. The British journal of dermatology 2024. link 8 Murao K, Hori Y, Endo R, Iwawaki A, Kubo Y. A case of vitiligo that followed the path of a varicose vein in the lower leg. The journal of medical investigation : JMI 2024. link 9 Hadi Z, Kaur R, Parekh Z, Khanna S, Khalil ABB, Abbasi HQ et al.. Exploring the impact of diet and nutrition on vitiligo: A systematic review of dietary factors and nutritional interventions. Journal of cosmetic dermatology 2024. link 10 Lee JH, Ju HJ, Seo JM, Almurayshid A, Kim GM, Ezzedine K et al.. Comorbidities in Patients with Vitiligo: A Systematic Review and Meta-Analysis. The Journal of investigative dermatology 2023. link 11 LeWitt T, Tauscher R, Obiofuma G, Peterson J, Haddadin R, Kundu RV. Ocular manifestations of vitiligo: a systematic review. BMC ophthalmology 2023. link 12 Chernyshov PV, Tomas-Aragones L, Manolache L, Pustisek N, Salavastru CM, Marron SE et al.. Quality of life measurement in vitiligo. Position statement of the European Academy of Dermatology and Venereology Task Force on Quality of Life and Patient Oriented Outcomes with external experts. Journal of the European Academy of Dermatology and Venereology : JEADV 2023. link 13 Phan K, Phan S, Shumack S, Gupta M. Repigmentation in vitiligo using janus kinase (JAK) inhibitors with phototherapy: systematic review and Meta-analysis. The Journal of dermatological treatment 2022. link 14 Rosmarin D, Passeron T, Pandya AG, Grimes P, Harris JE, Desai SR et al.. Two Phase 3, Randomized, Controlled Trials of Ruxolitinib Cream for Vitiligo. The New England journal of medicine 2022. link 15 Liu J, Tang R, Xiao Y, Luo M, Shi Y, Deng Q et al.. Meta-Analytic Review of High Anxiety Comorbidity among Patients with Vitiligo. BioMed research international 2021. link 16 van Geel N, Hamzavi I, Kohli I, Wolkerstorfer A, Lim HW, Bae JM et al.. Standardizing serial photography for assessing and monitoring vitiligo: A core set of international recommendations for essential clinical and technical specifications. Journal of the American Academy of Dermatology 2020. link 17 Dellatorre G, Antelo DAP, Bedrikow RB, Cestari TF, Follador I, Ramos DG et al.. Consensus on the treatment of vitiligo - Brazilian Society of Dermatology. Anais brasileiros de dermatologia 2020. link 18 Anthony N, Bourneau-Martin D, Ghamrawi S, Lagarce L, Babin M, Briet M. Drug-induced vitiligo: a case/non-case study in Vigibase. Fundamental & clinical pharmacology 2020. link 19 Tkachenko E, Refat MA, Balzano T, Maloney ME, Harris JE. Patient satisfaction and physician productivity in shared medical appointments for vitiligo. Journal of the American Academy of Dermatology 2019. link 20 Wang YJ, Chang CC, Cheng KL. Wood's lamp for vitiligo disease stability and early recognition of initiative pigmentation after epidermal grafting. International wound journal 2017. link 21 Ataş H, Gönül M. Increased Risk of Metabolic Syndrome in Patients with Vitiligo. Balkan medical journal 2017. link 22 Seneschal J, Boniface K. A Score with a VESted Interest in Vitiligo. The Journal of investigative dermatology 2016. link 23 van Geel N, Lommerts J, Bekkenk M, Wolkerstorfer A, Prinsen CAC, Eleftheriadou V et al.. Development and Validation of the Vitiligo Extent Score (VES): an International Collaborative Initiative. The Journal of investigative dermatology 2016. link 24 Salman A, Kurt E, Topcuoglu V, Demircay Z. Social Anxiety and Quality of Life in Vitiligo and Acne Patients with Facial Involvement: A Cross-Sectional Controlled Study. American journal of clinical dermatology 2016. link 25 Garner ML, McShane DB, Burkhart CN, Morrell DS. Isotretinoin and vitiligo: can chronic cheilitis cause koebnerization?. Pediatric dermatology 2015. link 26 Tung R, Le Poole IC. Vitiligo treatment demystified: a flowchart for stratified treatment approaches. Experimental dermatology 2014. link 27 Ingordo V, Cazzaniga S, Medri M, Raone B, Digiuseppe MD, Musumeci ML et al.. To what extent is quality of life impaired in vitiligo? A multicenter study on Italian patients using the dermatology life quality index. Dermatology (Basel, Switzerland) 2014. link 28 Lotti TM, Hercogová J, Schwartz RA, Tsampau D, Korobko I, Pietrzak A et al.. Treatments of vitiligo: what's new at the horizon. Dermatologic therapy 2012. link 29 Alghamdi KM, Khurram H, Taïeb A. Survey of dermatologists' phototherapy practices for vitiligo. Indian journal of dermatology, venereology and leprology 2012. link 30 Xing C, Xu A. The effect of combined calcipotriol and betamethasone dipropionate ointment in the treatment of vitiligo: an open, uncontrolled trial. Journal of drugs in dermatology : JDD 2012. link 31 Ezzedine K, Gauthier Y, Léauté-Labrèze C, Marquez S, Bouchtnei S, Jouary T et al.. Segmental vitiligo associated with generalized vitiligo (mixed vitiligo): a retrospective case series of 19 patients. Journal of the American Academy of Dermatology 2011. link 32 Hossani-Madani AR, Halder RM. Topical treatment and combination approaches for vitiligo: new insights, new developments. Giornale italiano di dermatologia e venereologia : organo ufficiale, Societa italiana di dermatologia e sifilografia 2010. link 33 AlGhamdi KM. A survey of vitiligo management among dermatologists in Saudi Arabia. Journal of the European Academy of Dermatology and Venereology : JEADV 2009. link 34 Lotti T, Gori A, Zanieri F, Colucci R, Moretti S. Vitiligo: new and emerging treatments. Dermatologic therapy 2008. link 35 Parsad D, Gupta S. Standard guidelines of care for vitiligo surgery. Indian journal of dermatology, venereology and leprology 2008. link 36 Aydin F, Senturk N, Sahin B, Bek Y, Yuksel EP, Turanli AY. A practical method for the estimation of vitiligo surface area: a comparison between the point counting and digital planimetry techniques. European journal of dermatology : EJD 2007. link 37 Park ES, Na JI, Kim SO, Huh CH, Youn SW, Park KC. Application of a pigment measuring device--Mexameter--for the differential diagnosis of vitiligo and nevus depigmentosus. Skin research and technology : official journal of International Society for Bioengineering and the Skin (ISBS) [and] International Society for Digital Imaging of Skin (ISDIS) [and] International Society for Skin Imaging (ISSI) 2006. link 38 Al-Mutairi N, Sharma AK, Al-Sheltawy M, Nour-Eldin O. Childhood vitiligo: a prospective hospital-based study. The Australasian journal of dermatology 2005. link 39 Chuh AA, Zawar V. Demonstration of residual perifollicular pigmentation in localized vitiligo--a reverse and novel application of digital epiluminescence dermoscopy. Computerized medical imaging and graphics : the official journal of the Computerized Medical Imaging Society 2004. link 40 Ongenae K, Van Geel N, De Schepper S, Vander Haeghen Y, Naeyaert JM. Management of vitiligo patients and attitude of dermatologists towards vitiligo. European journal of dermatology : EJD 2004. link 41 Njoo MD, Bossuyt PM, Westerhof W. Management of vitiligo. Results of a questionnaire among dermatologists in The Netherlands. International journal of dermatology 1999. link 42 Kim SM, Lee HS, Hann SK. The efficacy of low-dose oral corticosteroids in the treatment of vitiligo patients. International journal of dermatology 1999. link 43 Chatain C, Ring J, Schallreuter KU. Total serum immunoglobulins and atopic symptoms in patients with vitiligo. Dermatology (Basel, Switzerland) 1994. link 44 Mutzhas MF, Hölzle E, Hofmann C, Plewig G. A new apparatus with high radiation energy between 320-460 nm: physical description and dermatological applications. The Journal of investigative dermatology 1981. link

    Original source

    1. [1]
      Vitiligo secondary to immunosuppressants: a pharmacovigilance study of the FDA Adverse Event Reporting System. — Jia Y, Xie H, Yang Y, Cui B, Wang J, Xiao Z Frontiers in immunology (2026)
    2. [2]
      National Institutes of Health Funding for Vitiligo Research: Trends from 1985 to 2024. — Hamid A, Turner K, Elbuluk N Journal of drugs in dermatology : JDD (2025)
    3. [3]
      Drug-induced vitiligo: a real-world pharmacovigilance analysis of the FAERS database. — Shen N, Fang Q, Wu Y, Lan L, Ma F PloS one (2025)
    4. [4]
      Vitiligo associated with type 2 immune inhibitors: FAERS analysis and literature review. — Lu L, Feng J, Zhang S, He H, Hu Z, Yang L et al. The Journal of dermatology (2025)
    5. [5]
      Real world pharmacovigilance study of antineoplastic drug related vitiligo risks. — Yang Y, Xie H, Li D, Jia Y, Cui B, Zou J et al. Scientific reports (2025)
    6. [6]
      Proportion Of vitiligo and associated factors among patients visiting dermatology opd in tibebe ghion specialized hospital and addisalem primary hospital, bahirdar city, Ethiopia,2023. — Kibret G, Haile AT, Abebe Y, Admassu E, Haile RG BMC research notes (2024)
    7. [7]
      Stigma in vitiligo: associated factors and severity strata of the Patient Unique Stigmatization Holistic tool in Dermatology (PUSH-D) score. — Fakih A, Tannous R, Lajnef M, Seneschal J, Andreu N, Tran VT et al. The British journal of dermatology (2024)
    8. [8]
      A case of vitiligo that followed the path of a varicose vein in the lower leg. — Murao K, Hori Y, Endo R, Iwawaki A, Kubo Y The journal of medical investigation : JMI (2024)
    9. [9]
      Exploring the impact of diet and nutrition on vitiligo: A systematic review of dietary factors and nutritional interventions. — Hadi Z, Kaur R, Parekh Z, Khanna S, Khalil ABB, Abbasi HQ et al. Journal of cosmetic dermatology (2024)
    10. [10]
      Comorbidities in Patients with Vitiligo: A Systematic Review and Meta-Analysis. — Lee JH, Ju HJ, Seo JM, Almurayshid A, Kim GM, Ezzedine K et al. The Journal of investigative dermatology (2023)
    11. [11]
      Ocular manifestations of vitiligo: a systematic review. — LeWitt T, Tauscher R, Obiofuma G, Peterson J, Haddadin R, Kundu RV BMC ophthalmology (2023)
    12. [12]
      Quality of life measurement in vitiligo. Position statement of the European Academy of Dermatology and Venereology Task Force on Quality of Life and Patient Oriented Outcomes with external experts. — Chernyshov PV, Tomas-Aragones L, Manolache L, Pustisek N, Salavastru CM, Marron SE et al. Journal of the European Academy of Dermatology and Venereology : JEADV (2023)
    13. [13]
      Repigmentation in vitiligo using janus kinase (JAK) inhibitors with phototherapy: systematic review and Meta-analysis. — Phan K, Phan S, Shumack S, Gupta M The Journal of dermatological treatment (2022)
    14. [14]
      Two Phase 3, Randomized, Controlled Trials of Ruxolitinib Cream for Vitiligo. — Rosmarin D, Passeron T, Pandya AG, Grimes P, Harris JE, Desai SR et al. The New England journal of medicine (2022)
    15. [15]
      Meta-Analytic Review of High Anxiety Comorbidity among Patients with Vitiligo. — Liu J, Tang R, Xiao Y, Luo M, Shi Y, Deng Q et al. BioMed research international (2021)
    16. [16]
      Standardizing serial photography for assessing and monitoring vitiligo: A core set of international recommendations for essential clinical and technical specifications. — van Geel N, Hamzavi I, Kohli I, Wolkerstorfer A, Lim HW, Bae JM et al. Journal of the American Academy of Dermatology (2020)
    17. [17]
      Consensus on the treatment of vitiligo - Brazilian Society of Dermatology. — Dellatorre G, Antelo DAP, Bedrikow RB, Cestari TF, Follador I, Ramos DG et al. Anais brasileiros de dermatologia (2020)
    18. [18]
      Drug-induced vitiligo: a case/non-case study in Vigibase — Anthony N, Bourneau-Martin D, Ghamrawi S, Lagarce L, Babin M, Briet M Fundamental & clinical pharmacology (2020)
    19. [19]
      Patient satisfaction and physician productivity in shared medical appointments for vitiligo. — Tkachenko E, Refat MA, Balzano T, Maloney ME, Harris JE Journal of the American Academy of Dermatology (2019)
    20. [20]
      Wood's lamp for vitiligo disease stability and early recognition of initiative pigmentation after epidermal grafting. — Wang YJ, Chang CC, Cheng KL International wound journal (2017)
    21. [21]
      Increased Risk of Metabolic Syndrome in Patients with Vitiligo. — Ataş H, Gönül M Balkan medical journal (2017)
    22. [22]
      A Score with a VESted Interest in Vitiligo. — Seneschal J, Boniface K The Journal of investigative dermatology (2016)
    23. [23]
      Development and Validation of the Vitiligo Extent Score (VES): an International Collaborative Initiative. — van Geel N, Lommerts J, Bekkenk M, Wolkerstorfer A, Prinsen CAC, Eleftheriadou V et al. The Journal of investigative dermatology (2016)
    24. [24]
      Social Anxiety and Quality of Life in Vitiligo and Acne Patients with Facial Involvement: A Cross-Sectional Controlled Study. — Salman A, Kurt E, Topcuoglu V, Demircay Z American journal of clinical dermatology (2016)
    25. [25]
      Isotretinoin and vitiligo: can chronic cheilitis cause koebnerization? — Garner ML, McShane DB, Burkhart CN, Morrell DS Pediatric dermatology (2015)
    26. [26]
      Vitiligo treatment demystified: a flowchart for stratified treatment approaches. — Tung R, Le Poole IC Experimental dermatology (2014)
    27. [27]
      To what extent is quality of life impaired in vitiligo? A multicenter study on Italian patients using the dermatology life quality index. — Ingordo V, Cazzaniga S, Medri M, Raone B, Digiuseppe MD, Musumeci ML et al. Dermatology (Basel, Switzerland) (2014)
    28. [28]
      Treatments of vitiligo: what's new at the horizon. — Lotti TM, Hercogová J, Schwartz RA, Tsampau D, Korobko I, Pietrzak A et al. Dermatologic therapy (2012)
    29. [29]
      Survey of dermatologists' phototherapy practices for vitiligo. — Alghamdi KM, Khurram H, Taïeb A Indian journal of dermatology, venereology and leprology (2012)
    30. [30]
      The effect of combined calcipotriol and betamethasone dipropionate ointment in the treatment of vitiligo: an open, uncontrolled trial. — Xing C, Xu A Journal of drugs in dermatology : JDD (2012)
    31. [31]
      Segmental vitiligo associated with generalized vitiligo (mixed vitiligo): a retrospective case series of 19 patients. — Ezzedine K, Gauthier Y, Léauté-Labrèze C, Marquez S, Bouchtnei S, Jouary T et al. Journal of the American Academy of Dermatology (2011)
    32. [32]
      Topical treatment and combination approaches for vitiligo: new insights, new developments. — Hossani-Madani AR, Halder RM Giornale italiano di dermatologia e venereologia : organo ufficiale, Societa italiana di dermatologia e sifilografia (2010)
    33. [33]
      A survey of vitiligo management among dermatologists in Saudi Arabia. — AlGhamdi KM Journal of the European Academy of Dermatology and Venereology : JEADV (2009)
    34. [34]
      Vitiligo: new and emerging treatments. — Lotti T, Gori A, Zanieri F, Colucci R, Moretti S Dermatologic therapy (2008)
    35. [35]
      Standard guidelines of care for vitiligo surgery. — Parsad D, Gupta S Indian journal of dermatology, venereology and leprology (2008)
    36. [36]
      A practical method for the estimation of vitiligo surface area: a comparison between the point counting and digital planimetry techniques. — Aydin F, Senturk N, Sahin B, Bek Y, Yuksel EP, Turanli AY European journal of dermatology : EJD (2007)
    37. [37]
      Application of a pigment measuring device--Mexameter--for the differential diagnosis of vitiligo and nevus depigmentosus. — Park ES, Na JI, Kim SO, Huh CH, Youn SW, Park KC Skin research and technology : official journal of International Society for Bioengineering and the Skin (ISBS) [and] International Society for Digital Imaging of Skin (ISDIS) [and] International Society for Skin Imaging (ISSI) (2006)
    38. [38]
      Childhood vitiligo: a prospective hospital-based study. — Al-Mutairi N, Sharma AK, Al-Sheltawy M, Nour-Eldin O The Australasian journal of dermatology (2005)
    39. [39]
      Demonstration of residual perifollicular pigmentation in localized vitiligo--a reverse and novel application of digital epiluminescence dermoscopy. — Chuh AA, Zawar V Computerized medical imaging and graphics : the official journal of the Computerized Medical Imaging Society (2004)
    40. [40]
      Management of vitiligo patients and attitude of dermatologists towards vitiligo. — Ongenae K, Van Geel N, De Schepper S, Vander Haeghen Y, Naeyaert JM European journal of dermatology : EJD (2004)
    41. [41]
      Management of vitiligo. Results of a questionnaire among dermatologists in The Netherlands. — Njoo MD, Bossuyt PM, Westerhof W International journal of dermatology (1999)
    42. [42]
      The efficacy of low-dose oral corticosteroids in the treatment of vitiligo patients. — Kim SM, Lee HS, Hann SK International journal of dermatology (1999)
    43. [43]
      Total serum immunoglobulins and atopic symptoms in patients with vitiligo. — Chatain C, Ring J, Schallreuter KU Dermatology (Basel, Switzerland) (1994)
    44. [44]
      A new apparatus with high radiation energy between 320-460 nm: physical description and dermatological applications. — Mutzhas MF, Hölzle E, Hofmann C, Plewig G The Journal of investigative dermatology (1981)
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