This clinical photograph shows the profile of a 31-year-old female patient with dermatological manifestations often associated with Vogt-Koyanagi-Harada (VKH) syndrome. Visible on the neck and upper clavicular region are several well-circumscribed, depigmented (achromic) patches characteristic of vitiligo. The lesions vary in size, with discrete macules on the neck and more confluent patches near the shoulder. Additionally, the hair at the scalp margin exhibits localized depigmentation, consistent with poliosis (white hair). The clinical significance of these visual findings, when combined with the patient's history of panuveitis and auditory symptoms, supports the diagnosis of an autoimmune multi-system disorder affecting melanocyte-containing tissues. This image serves as a clinical example of the integumentary signs in systemic autoimmune disease, targeted at medical students and dermatology residents specializing in pigmentary disorders and their extra-cutaneous associations.

Clinical photograph of a patient's face and neck, shown in bilateral lateral profiles, illustrating features of drug-induced vitiligo. The image displays multiple sharply demarcated, achromic (depigmented) macules and patches. These lesions are distributed symmetrically across the cheeks, preauricular areas, ears, and lateral neck. A significant finding is leukotrichia, where the depigmentation extends to involve the hair follicles along the temporal hairline and sideburns, resulting in localized white hair. The surrounding skin appears normally pigmented, creating a high-contrast border characteristic of vitiligo. This visual demonstrates common cutaneous side effects associated with targeted cancer therapies like ribociclib and letrozole. The clinical presentation is essential for medical students and dermatologists to distinguish between primary vitiligo and drug-induced leukoderma in oncological patients.

This composite clinical photograph displays dermatological and trichological manifestations of Vogt-Koyanagi-Harada (VKH) syndrome in a pediatric patient. Figure (a) illustrates cutaneous hypopigmentation, consistent with vitiligo, appearing as irregular, milky-white depigmented patches on the neck that contrast with the surrounding normally pigmented skin. Figure (b) shows poliosis (graying of the hair), characterized by a localized patch of depigmented, white/gray hair shafts amidst otherwise dark terminal scalp hair. These findings represent the integumentary phase of VKH syndrome, a multi-system autoimmune disorder targeting melanocytes. Educational focus is on identifying systemic clinical signs—such as vitiligo, poliosis, and alopecia—that occur alongside granulomatous panuveitis in the diagnosis of complete or incomplete VKH syndrome. These visible markers are essential for clinical classification and monitoring treatment response to immunosuppressive therapy.