Chronic Actinic Damage in Pigmented and Depigmented Skin of Hispanic Patients with Vitiligo: Clinical and Histological Differences

Vitiligo is a common depigmentary disorder, with loss of epidermal Melanocytes as its hallmark. This absence of melanin hypothetically makes skin more susceptible to Chronic Actinic Damage (CAD) and skin cancer development. However, various studies have shown no increased incidence of skin cancer and some point to decreased actinic damage in skin with vitiligo. We studied 14 patients with vitiligo and analyzed clinical and histological markers of chronic actinic damage both in depigmented skin with vitiligo and in normal skin. We found fewer markers of clinical CAD in depigmented skin than in normally pigmented skin. When we analyzed histological, we found that in most patient’s depigmented skin had increased hyperkeratosis, which is a previously reported finding, as well as atrophy, elastosis and telangiectasias. There are various hypotheses to explain these findings. Further studies are needed to establish if vitiligo provides protection against CAD, either by structural changes or a better immunosurveillance process in the skin affected by it.