Vitiligo Universalis: Case Report and Management Options

Abstract

Vitiligo is an acquired pigmentary disorder of the skin and mucous membranes, and it is characterized by
circumscribed, depigmented macules and patches. Vitiligo is a progressive disorder in which some, or all of the
melanocytes in the affected skin are selectively destroyed. It affects 0.5-2% of the world's population, and the
average age of onset is 20 years. The diagnosis of vitiligo is mostly clinical and has significant effect on the
quality of life of patients in view of the striking colour contrast from surrounding skin, especially in the dark
skinned population. It may carry similar stigma with Hansen's disease. Types of vitiligo documented include
acral, peri-orificial, localised, lip-tip, segmental and generalised. We present an unusual case of vitiligo (vitiligo
universalis) in a 30 year old Nigerian lady, which started as acrofacial vitiligo and later progressed to affect all
body surfaces including the oral mucosa and hair. Her pregnancy appeared to have precipitated the progression
from the acrofacial vitiligo to vitiligo universalis. The management for vitiligo universalis involves the use of
total depigmenting agents, rather than conventional repigmentation agents. This modality of treatment will be
highlighted.
Keywords: vitiligo universalis, total depigmentation, depigmenting agents, monobenzyl ether of
hydroquinone (MBEH)