A 23-year-old Hispanic woman with Fitzpatrick type IV skin presented with vitiligo vulgaris affecting 75% of her face, including complete depigmentation of the eyelids, chin, cheeks, and perioral skin. This had developed progressively over a 2-year period. As is the standard practice of our vitiligo clinic, thyroid function testing, blood cell counts, and vitamin B12 levels were taken; all were within normal limits. Mometasone furoate ointment was applied twice daily for 3 months with no signs of follicular repigmentation either on visual examination or with the use of the Wood light.
A 24-year-old man with Fitzpatrick type II skin presented with a history of vitiligo vulgaris for 12 years. At the time of presentation, he had depigmentation of 60% of his body surface area, including the eyelids, chin, axillae, elbows, hips, knees, and back. Thyroid function findings, blood cell counts, and vitamin B12 levels were all within normal limits. Topical mometasone furoate cream was applied to the eyelids twice daily for 4 months, during which the patient also underwent a course of narrowband UV-B irradiation to the entire body. Despite these therapies, no repigmentation occurred, even under Wood light examination. We believe this was owing to the use of protective eyewear in the phototherapy booth.
A 10-year-old African American boy with Fitzpatrick type VI skin had a history of microcephaly, absence of the radii bilaterally, and learning disabilities. Eight months prior to presentation, he began to develop rapid depigmentation of the forehead, forearms, chest, back, and calves. Thyroid function findings, blood cell counts, and vitamin B12 levels were all within normal limits. Triamcinolone acetonide ointment (0.1%) was tried for 3 months with no repigmentation.