The Histopathology of Vitiligo in Brown Skin

Vitiligo is characterized histopathologically by loss of melanocytes in the basal layer which eventually results in the absence of melanin in the epidermis. Only few studies have been conducted in brown skin, and most of our knowledge on the pathologic changes in the epidermis and dermis are based on studies done involving an assortment of races and skin phototypes. The role of cellular immunity in vitiligo pathogenesis has been pointed out by the use of immunohistochemistry to identify the cellular components of vitiligo lesions. Common clinical and histological differential diagnosis of vitiligo in brown skin includes diseases presenting with hypo- and depigmentation. These include idiopathic guttate hypomelanosis, pityriasis alba, postinflammatory pigmentary alteration, hypopigmented mycosis fungoides (MF), and tuberculoid leprosy. More studies on the histopathology of vitiligo in brown skin should be conducted to identify prominent features and further highlight the cellular immune elements which potentially drive the unique inflammatory responses.