Assessing Disease Activity in a 54-Year-Old Woman With Vitiligo

A 54-year-old woman with a history of vitiligo presents for follow-up due to recent changes in her hand lesions. She reports noticing new lighter spots over the past 3–4 months with gradual enlargement of existing patches. She denies pain or pruritus. Physical examination of the dorsal hands reveals depigmented patches with surrounding hypopigmented zones, scattered pinpoint-to-small macules at the advancing edges, and ill-defined borders. No erosions, trauma marks, or scarring are noted. She has not been on vitiligo-directed therapy for the past year. She is quite distressed about her vitiligo.

Image Credit: Iltefat Hamzavi, MD