Vitiligo is a chronic patchy depigmenting skin condition due to T-cell-mediated melanocyte destruction.

Suggested approach to vitiligo osce station

Describing lesions

• Areas of depigmentation
  • ‘There are multiple well-demarcated patches of depigmentation in a generalised distribution.’
  • ‘They range in size from 1-4cm and have irregular borders.’
  • ‘These lesions are flat and there are no secondary features.’
  • ‘These lesions are consistent with vitiligo.’

Differential diagnosis

• Tinea versicolor
• Post-inflammatory hypopigmentation
• Pityriasis alba
• Scarring
• Tuberculoid leprosy

Management

• General: avoid sun and use strong sun cream (sun-exposed areas will not tan but will burn), avoid skin trauma
• Screen for other autoimmune diseases
  • Thyroid disease
  • Pernicious anaemia
  • Diabetes
  • Addison’s disease
• Cosmetic camouflage creams
• Topical corticosteroids (e.g. clobetasol, mometasone)
• Topical calcineurin inhibitors (e.g. tacrolimus)
• Phototherapy

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Dermatological skin exam OSCE station

1. Dermatological skin exam
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