Clinical photograph of the forehead and periocular region of a patient with segmental vitiligo. The image demonstrates well-demarcated, irregularly shaped depigmented (white) macules and patches localized to the upper left quadrant of the face. A large, prominent patch of depigmentation is visible on the central-left forehead, extending toward the hairline. Scattered throughout and adjacent to the depigmented areas are smaller hyperpigmented macules, characteristic of repigmentation clusters following medical or surgical intervention (such as punch grafting). On the left upper eyelid, a cluster of dark, pigmented macules is evident within a localized area of skin alteration, possibly indicating the site of a therapeutic procedure or localized inflammation. The clinical presentation illustrates the dermatological manifestations of vitiligo and the resulting pigmentary variations during treatment monitoring in a dermatology setting.

This clinical photograph shows a close-up frontal view of a patient's face, demonstrating extensive, well-demarcated patches of depigmentation. The condition is identified as drug-induced vitiligo secondary to carbamazepine. Large, milk-white depigmented macules and patches are most prominent on the forehead, right cheek, and extending along the preauricular region into the hairline. The distribution is asymmetrical, with notable involvement of the right temple and upper cheek, while the left side shows milder, mottled hypopigmentation. Perioral involvement is also visible, with depigmentation appearing at the vermilion border of the lower lip. The surrounding skin exhibits normal pigmentation, creating a sharp contrast with the affected areas. There is no evidence of secondary changes such as scaling, crusting, or ulceration. This image serves as a clinical example of chemically induced leucoderma, highlighting the importance of medication history in the evaluation of rapid-onset pigmentary disorders.

Clinical photography of a living patient displaying segmental vitiligo on the face. Frontal close-up of the forehead and periorbital/temporal region shows patches of depigmentation with sharply defined borders, ranging from pearl to porcelain white, and limited to a unilateral facial dermatomal distribution. Affected areas are hypopigmented to depigmented with uniform color loss and no visible scale or erythema. The surrounding skin shows mild hyperpigmentation at the lesion margins and subtle perifollicular pigment. The imaging modality is standard white-light dermatologic photography; no dermoscopic magnification or fluorescent staining is used. This presentation is typical for segmental vitiligo, an autoimmune melanocyte destruction pattern that often follows a dermatomal distribution and tends to progress rapidly before stabilization. The image demonstrates key diagnostic features including crisp lesion borders and absence of pigment in the epidermis on histology would be expected, but is not visible here. Clinically, vitiligo patches are often more conspicuous in darker skin types and are prone to Koebner phenomenon with friction or trauma. Relevance includes differential diagnosis against post-inflammatory hypopigmentation, pityriasis alba, and fungal hypopigmentation, and relevance for therapeutic planning such as topical corticosteroids, calcineurin inhibitors, photoprotection, and consideration of light therapy. Documented patch stability and follow-up imaging inform treatment decisions effectively.