CHEMICAL VITILIGO: A LITERATURE REVIEW

Abstract

Chemical vitiligo is an underdiagnosed form of skin depigmentation caused by repeated chemical agent exposure, affecting both adults and children. Chemical vitiligo is also called chemical leucoderma, contact vitiligo, and/or occupational vitiligo. Most of the implicated chemical agents are derivates of phenol and catechol, which have melanotoxic effects in individuals with genetic susceptibility. The diagnosis of chemical vitiligo is based on the medical history and patch testing, as histopathology is usually inconclusive and cannot differentiate chemical from idiopathic vitiligo. Patients typically report multiple exposures to specific melanotoxic or depigmenting chemical substances, either in the household or at the workplace, followed by the appearance of diffuse confetti-like and/or pea-sized hypopigmented macules, usually on the face, hands, and feet. The widespread distribution of hypopigmented macules is often the result of sensitization, autotransfer, or heterotransfer of the chemical agent from the primary site of contact. Later, the clinical suspicion of chemical vitiligo can be confirmed with the patch test. Once the diagnosis is established, the patient should be advised to avoid the incriminated chemical agent. In some cases, when spontaneous repigmentation does not occur, additional treatments are recommended, such as ultraviolet B phototherapy, photochemotherapy, and topical immunosuppressants.