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Subjects/Dermatology/Pigmentary Disorders
Pigmentary Disorders
medium
hand Dermatology

A 30-year-old female presents with progressively enlarging, well-demarcated, milky-white patches on her face, hands, and trunk. Wood's lamp examination accentuates the lesions. Which of the following is the most likely underlying pathological mechanism?

A. A. Increased melanin synthesis by hyperactive melanocytes
B. B. Accumulation of homogentisic acid in the dermis
C. C. Autoimmune destruction of melanocytes
D. D. Proliferation of Langerhans cells in the epidermis

Explanation

The clinical presentation of well-demarcated, milky-white patches, accentuated by Wood's lamp, is classic for vitiligo. Vitiligo is an acquired depigmentary disorder characterized by the loss of functional melanocytes in the epidermis due to an autoimmune process. Option A describes hyperpigmentation. Option B is characteristic of ochronosis. Option D is not directly related to vitiligo's primary pathology.

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