Pentachrome vitiligo in a segmental pattern

We describe a 22-year-old male with a pigmentary disorder that first appeared when he was 5 years of age. Examination revealed that these lesions were distributed in a segmental pattern on the left side of his trunk. Five shades of colors--white, tan, medium brown, dark brown, and black--were present. The patient told us there had been no preceding inflammation in the affected areas. A biopsy specimen from the inguinal region showed a complete absence of melanocytes, whereas most of the hyperpigmented areas were characterized by increased amounts of epidermal pigment and numbers of melanocytes. Based on the clinical appearance, pentachrome vitiligo in a segmental type was diagnosed.