Segmental vitiligo with segmental morphea: An autoimmune link?

Abstract

An 18-year old girl with segmental vitiligo involving the left side of the trunk and left upper limb with segmental morphea involving the right side of trunk and right upper limb without any deeper involvement is illustrated. There was no history of preceding drug intake, vaccination, trauma, radiation therapy, infection, or hormonal therapy. Family history of stable vitiligo in her brother and a history of type II diabetes mellitus in the father were elicited. Screening for autoimmune diseases and antithyroid antibody was negative. An autoimmune link explaining the co-occurrence has been proposed. Cutaneous mosiacism could explain the presence of both the pathologies in a segmental distribution.

Autoimmunity in Segmental Vitiligo

“…One case was excluded due to doubt about the clinical diagnosis of segmental vitiligo based on the clinical picture. Combining both searches, 38 reports could be included describing patients with SV and a comorbid disorder comprising 21 patients with auto-immune disorders, 5 cases of drug-induced vitiligo, 5 cases with benign or malignant pigment disorders, 3 cases with neurological disorders, and 6 other cases A remarkable number of case-reports with morphea and lichen sclerosus have been published (39,40,44,70). 11 different reports were found which makes it by far the most frequently observed comorbidity [57.1% (12/21 patients) of reported patients with autoimmune comorbidities].…”

“…11 different reports were found which makes it by far the most frequently observed comorbidity [57.1% (12/21 patients) of reported patients with autoimmune comorbidities]. In most cases, the morphea lesions affected the same body area as the SV, although multifocal morphea was also documented (36)(37)(38)(39)(40)(41)(42)(43)(44)(45)(46). Cases with lichen striatus are interesting because of the striking similar pathogenesis (48) (Figure 1).…”

Concomitant appearance of morphea and vitiligo in a patient with autoimmune thyroiditis

“…The relation of vitiligo with autoimmune diseases, and detection of organ-specific autoantibodies in vitiligo patients, also the association of particular alleles of the multilocus major histocompatibility complex (MHC) with susceptibility to vitiligo hypothetically suggest that vitiligo is an autoimmune disorder [ 3 , 12 , 13 ]. Although both morphea and vitiligo are autoimmune diseases, concurrent appearance of these entities have rarely been reported [ 7 , 9 , 10 , 14 , 15 ]. Few reports in the literature have presented cases with MAS [ 10 ], cirrhosis [ 7 ] and Hashimoto's thyroiditis [ 9 ] in patients with both vitiligo and morphea.…”

Concurrence of Circumscribed Morphea and Segmental Vitiligo: A Case Report

“…Segmental vitiligo is a distinct form of vitiligo, a common acquired pigmentation disorder, with dermatomal distribution or distribution of lesions along the Blaschko's lines. A few reports have previously noted the concurrent presentation of morphea and vitiligo at distinctly separate sites in the same patient 1 2 3 4 5 6 7 8 . However, it is extremely rare that these two diseases occur at the same site in a patient.…”