Vitiligo & Alopecia

Key points

• Vitiligo: autoimmune depigmentation (well-demarcated white patches); associations — thyroid disease, type 1 diabetes, Addison's, pernicious anaemia (autoimmune cluster).
• Wood's lamp accentuates vitiligo; management — potent topical steroids/tacrolimus, phototherapy, camouflage.
• Alopecia areata: well-demarcated non-scarring patches of hair loss; 'exclamation mark' hairs at the edge.
• Alopecia areata associations: atopy, autoimmune disease, Down's syndrome.
• Scarring alopecias (discoid lupus, lichen planopilaris) destroy follicles — biopsy early.

Decision points in this pathway

• Scarring features (loss of follicular openings)?

The full step-by-step algorithm, including what to do at each branch, opens in the app for approved members.