Explanation

This patient has well-demarcated depigmented macules consistent with vitiligo. Vitiligo is caused by regional destruction of melanocytes, most likely due to an autoimmune etiology. Genetic and environmental factors may also play a role. It can occur as an isolated disorder but is often associated with other autoimmune conditions (eg, autoimmune thyroid disease, rheumatoid arthritis, pernicious anemia, primary adrenal insufficiency). The course is highly variable, although the condition is usually slowly progressive.
The diagnosis of vitiligo is usually made on clinical grounds. Biopsy can be considered in uncertain cases and will show loss of melanocytes, often with scattered lymphocytes at the lesion border. When treatment is desired, topical or systemic corticosteroids are the most common first-line intervention.
Educational objective: Vitiligo is caused by regional destruction of melanocytes, most likely due to an autoimmune etiology. It is often associated with other autoimmune conditions and is usually slowly progressive. The diagnosis is made on clinical grounds, and topical or systemic corticosteroids are the most common first-line intervention.
(Choices E) Post-inflammatory hypopigmentation is characterized by patchy involvement in areas of prior trauma or inflammation. The lesions in these disorders are hypopigmented rather than completely depigmented, as in vitiligo.