A Rare Case of Congenital Vitiligo with Leukotrichia in an Infant

A 7-month-old developmentally normal female infant presented with multiple, well-defined, depigmented patches on the skin over the trunk, face, scalp, and limbs, ranging in size from 1 cm to 5cm, since birth [Figure 1a]. It was progressively increasing in size and number. The lesions showed chalky white accentuation under Wood’s lamp examination. She also had patchy areas of leukotrichia [Figure 1b]. There was no history of vitiligo in the family. Her systemic examinations and laboratory investigations including complete hemogram, autoimmune profiles, and immunodeficiency panels revealed no abnormality. The parents did not give consent for skin biopsy. The differentials for hypopigmented to depigmented lesions in an infant include nevus depigmentosus, hypomelanosis of Ito, Waardenburg syndrome, piebaldism, hypomelanotic macules of tuberous sclerosis, and oculocutaneous albinism. All of these were excluded due to the presence of multiple, well-defined, discrete, nonblaschkoid lesions with the absence of white forelock, any ocular involvement, any cutaneous features of tuberous sclerosis, any neurological symptoms, or any other systemic symptoms. The infant was diagnosed with nonsegmental generalized congenital vitiligo based on its classical appearance, distribution, onset at birth and woods lamp examination. The infant was started on topical fluticasone propionate and sirolimus ointment with good response. Genetic testing could not be done because of financial constraints. Most cases of vitiligo are acquired and present during the young adult life.[1] Vitiligo manifesting at birth is a very rare occurrence.[2] Congenital vitiligo suggests more toward the genetic origin.[3] Exact etiopathogenesis of congenital vitiligo is still unknown.Figure 1: (a) Multiple depigmented patches with a well-defined border over the face, trunk, and limbs. (b) Multiple depigmented patches with a well-defined border over the face, trunk, and scalp, along with leukotrichiaDeclaration of patient consent The authors certify that they have obtained all appropriate patient consent forms. In the form, the legal guardian has given his consent for images and other clinical information to be reported in the journal. The guardian understands that name and initials will not be published and due efforts will be made to conceal the patient’s identity, but anonymity cannot be guaranteed. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.