Vitiligo

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Abstract
Vitiligo is a disorder that affects 1 to 2 million Americans.1The obvious manifestations are asymptomatic white spots on the skin. However, often the eyes and, at times, the leptomeninges may be involved. In addition, numerous disorders may be associated with vitiligo. Treatment of the loss of pigment in the skin is prolonged, difficult, and requires a sustained effort by the patient and the physician. Most physicians incorrectly advise their patients that there is little hope or need to treat the condition. That advice is well-meaning but misguided and discouraging for the patient. The cosmetic disfigurement has a substantial impact on a person's social and professional relationships.2 Vitiligo is caused by the destruction of pigment cells. Vitiligo develops in half of the patients it affects before the age of 18 years and in one fourth of the patients before the age of 8 years. Depigmentation begins most frequently