Vitiligo in Ibadan, Nigeria. Incidence, presentation, and problems in management

The incidence of vitiligo at the University College Hospital, Ibadan, Nigeria, was 6% for the period from 1980-1983. Approximately 70% were not older than 30 years of age. Sixty-three percent of the lesions were in exposed areas. No family history was obtained. Leucoderma from cosmetics needs to be differentiated from vitiligo. Mercuric iodide-containing "germicidal" soap, antiseptics with phenolic derivatives, and hydroquinone-containing cosmetics have become endemic and are contributing to the former type of hypomelanosis. More worrisome is the use of topical corticosteroids as adjuncts with hydroquinone for lightening the skin tone. Oral and topical psoralens are not available in Nigeria, and management of this already complex disease with other modalities of treatment remains unsatisfactory.