Analysis of the lymphocytic infiltrate in a case of vitiligo

We report a case of vitiligo notable for a degree and pattern of lymphocytic inflammation. Hypopigmentation and subsequent depigmentation developed in a 65-year-old man. Initial skin biopsy specimen from the border of a patch of hypopigmentation revealed a moderately dense perivascular and interstitial infiltrate of lymphocytes with exocytosis into epidermis and follicular epithelium. The pattern of the infiltrate suggested the diagnosis of cutaneous T-cell lymphoma or connective-tissue disease. Immunophenotypic analysis revealed a mature T-cell population with retention of pan-T-cell markers. Analysis of the T-cell receptor genome did not identify a rearranged clone. Six months later, the clinical and histologic findings were typical in a noninflamed lesion of vitiligo.