Investigations
1st investigations to order
clinical diagnosis
Test
There are no initial investigations; diagnosis is usually clinical.
Result
features of vitiligo
Investigations to consider
Wood’s lamp examination
Test
Wood’s lamp accentuates the contrast between affected and unaffected skin (enhancement) while fluorescence is a characteristic bluish tint typical of vitiligo.
[Figure caption and citation for the preceding image starts]: Accentuation of clinical features by Wood's lamp examinationFrom Dr Bernhard Ortel's personal collection [Citation ends].
Result
enhancement and fluorescence with UV-A exposure
skin biopsy
Test
Rarely needed to make a diagnosis.
Fontana-Masson stain highlights melanin pigment in the epidermis, although melanocytes are best identified using special stains. Dihydroxy-phenylalanine stain of frozen sections may reveal unpigmented melanocytes by showing tyrosinase activity.
Immunohistochemistry identifies molecular markers of melanocytes (e.g., Sox10, tyrosinase, HMB 45, NKI/beteb, Mel-5, or MITF).
Result
absent melanocytes from lesional skin
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