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Disorders of Keratinization and Other Genodermatoses
Published in Ayşe Serap Karadağ, Lawrence Charles Parish, Jordan V. Wang, Roxburgh's Common Skin Diseases, 2022
Roselyn Stanger, Nanette Silverberg
Clinical presentation: In addition to generalized vitiligo, which may have been present for a while, inflammation of tissues with melanocytes can occur, including panuveitis, sensorineural hearing loss, vertigo, and tinnitus. The standard VKHS begins with headaches, malaise, and eye pain for a few days accompanied by acute neurologic symptoms, such as transverse myelitis, cranial nerve palsies, hemiparesis, and optic neuritis. The second stage involves acute uveitis, the third stage involves extensive depigmentation that is rapid in onset and spread, and the fourth stage involves chronic relapsing uveitis in which retinal fibrosis can occur. Alopecia and poliosis can also be noted.
Special Groups
Published in Vineet Relhan, Vijay Kumar Garg, Sneha Ghunawat, Khushbu Mahajan, Comprehensive Textbook on Vitiligo, 2020
Sandipan Dhar, Sahana M. Srinivas
Leukotrichia is seen in 3.7%–25% of childhood vitiligo cases [12]. Localized hair follicles of scalp can be involved, leading to poliosis, and this is more commonly seen in segmental vitiligo (Figure 15.2.4). Poliosis has been observed in 55.55% of children with vitiligo [9]. Scalp leukotrichia is a common finding in children with family history of vitiligo and other autoimmune disorders. Premature graying was found to be more common among first- and second-degree relatives of children with vitiligo. In a study by Jaisankar et al., 4.4% of vitiligo children had premature graying of hair [15]. Some children manifest with total depigmentation of scalp hair, eyebrows, and eyelashes. Poliosis has also been reported to occur in nevus depigmentosus and needs to be differentiated from vitiligo [16].
Tuberous Sclerosis Complex
Published in Dongyou Liu, Handbook of Tumor Syndromes, 2020
Joana Jesus Ribeiro, Filipe Palavra, Flávio Reis
Hypomelanotic macules are observed in about 90% of patients and may be the presenting sign of TSC [2,73,74]. They typically appear at birth or infancy, and become less apparent in late adulthood [2,74]. Poliosis is considered a variant presentation of hypomelanosis and is included in the count of hypomelanotic macules [2,74].
Eyelash poliosis associated with Vogt-Koyanagi Harada disease
Published in Clinical and Experimental Optometry, 2023
Gladys Rodrigues, Teena Mendonca
Poliosis is the absence or reduction in melanin content in hair anywhere in the body. Poliosis can be caused by a spectrum of benign, autoimmune or neoplastic conditions.1 Vogt-Koyanagi-Harada (VKH) is an autoimmune disease with multisystem involvement2 and can cause poliosis in late stages. VKH predominantly affects tissues with melanocytes such as the skin, central nervous system, eyes and inner ears. Most patients present with acute onset loss of vision, bilateral panuveitis and exudative retinal detachment. The disease has a variable presentation and diagnosis is aided by investigations such as fundus fluorescein angiography and optical coherence tomography. Skin changes such as vitiligo and poliosis are late manifestations and help in making a diagnosis of complete Vogt-Koyanagi-Harada (ocular with neurological and integumentary).3 Early and complete treatment results in resolution of exudative detachment and associated visual recovery. However, pigmentary changes in the choroid, poliosis and skin changes usually persist despite therapy.
Vogt-Koyanagi-Harada Relapse after COVID-19 Vaccination
Published in Ocular Immunology and Inflammation, 2022
Massimo Accorinti, Maria Carmela Saturno, Priscilla Manni
It begins with a prodromal stage, lasting few days, characterized by a viral-like illness, frequently associated with headache, neck stiffness, meningismus, tinnitus, and auditory loss, followed by the acute uveitis stage, when a bilateral diffuse choroiditis, papillitis, and exudative retinal detachment, with or without signs of inflammation in anterior chamber, appear. The natural course of the disease comprises the progression to the convalescent stage, with nummular chorioretinal depigmented scars and retinal pigment epithelium clumping and migration. Subsequently, a chronic recurrent stage may develop, with multiple uveitis recurrences, either located in the anterior or posterior segment of the eye. Usually, during the convalescent or chronic recurrent stages, skin manifestations may appear, namely, vitiligo and poliosis.1–3
Ophthalmic complications of immune checkpoint inhibitors
Published in Orbit, 2022
Edward J. Wladis, Madhavi L. Kambam
An enhanced vigilance on the part of clinicians regarding these potential complications certainly facilitates appropriate surveillance and communication with patients regarding their development. As noted by Abdel-Rahman et al, patients should also be informed of the potential of immune checkpoint inhibitors to yield ophthalmic side effects.3 Ideally, cognizance of the possible toxicities will yield early reporting, leading to better management of these issues. Ediriwickrema et al recently associated poliosis after combination therapy with ipilimumab and nivolumab. Given the association of poliosis with Vogt-Kayonagi-Harada syndrome, oncologists should be aware of this rare association, and, upon detection, may wish to consider referral for an examination for uveitis.28