A figurate papulosquamous variant of inflammatory vitiligo

The classic description of inflammatory vitiligo is an erythematous rim at the periphery of a patch of hypopigmented or depigmented skin. The histological correlate is a superficial perivascular infiltrate of mononuclear cells. However, we observed a 61-year-old patient with inflammatory vitiligo who had thin solid pink scaly plaques as well as serpiginous lesions with fine scale. Histologically, a lichenoid infiltrate was seen as was a thickened stratum corneum with parakeratosis. In a review of the literature, scattered case reports of similar findings were identified, either in the Japanese and French literature or from over 25 years ago. The clinical and histological spectrum of inflammatory vitiligo should be expanded to include solid and annular papulosquamous plaques as well as lichenoid infiltrates with exocytosis.