HIV-Associated Vitiligo Totalis with Minimal Repigmentation and Alopecia Areata Diffusa During Immune-Reconstitution

Sack, Jason E.; Rojhirunsakool, Salinee; Bhawan, Jag; Rünger, Thomas M.

HIV-Associated Vitiligo Totalis with Minimal Repigmentation and Alopecia Areata Diffusa During Immune-Reconstitution

Jason E. Sack^{*, 1}, Salinee Rojhirunsakool¹, Jag Bhawan^{1, 2}, Thomas M. Rünger¹

¹ Department of Dermatology, Boston University School of Medicine, USA

² Dermatopathology Section, Department of Dermatology, Boston University School of Medicine, USA

Article Information

Identifiers and Pagination:

Year: 2008
Volume: 2
First Page: 90
Last Page: 92
Publisher ID: TODJ-2-90
DOI: 10.2174/1874372200802010090

Article History:

Received Date: 13/08/2008
Revision Received Date: 08/09/2008
Acceptance Date: 08/09/2008
Electronic publication date: 7/10/2008
Collection year: 2008

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© 2008 Sack et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

^* Address correspondence to this author at the Sudbury Skin Clinic, 885 Regent Street, Suite 300, Sudbury, ON P3E 5M4, Canada; Tel: 705 669 0002; Fax: 705 669 1771; E-mail :jasonsack55@hotmail.com

Background:

Cutaneous findings in the setting of HIV infection encompass a broad spectrum of diseases. Only few cases of vitiligo or alopecia areata have been described in HIV/AIDS patients and it remains unclear whether there is a causal relationship between HIV/AIDS and these two conditions.

Observations:

Our patient initially presented with diffuse generalized pruritic hypo- and depigmented macules and patches. She was diagnosed with advanced HIV/AIDS at that time. There was progression to vitiligo totalis followed by partial repigmentation and generalized alopecia areata diffusa with immune-reconstitution.

Conclusions:

This is, to our knowledge, the first case of rapidly progressing vitiligo totalis in a patient with advanced HIV/AIDS. We conclude that this, together with the observation of repigmentation during immune-reconstitution, suggests a causal relation between vitiligo and HIV/AIDS. The different time course of the also observed alopecia areata diffusa, with first manifestation during immune-reconstitution, may be due to differences in the immune-pathogenesis between vitiligo and alopecia areata.

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RESEARCH ARTICLE

HIV-Associated Vitiligo Totalis with Minimal Repigmentation and Alopecia Areata Diffusa During Immune-Reconstitution

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Abstract

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