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Vitiligo — SCE Dermatology MCQ

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ModerateGeneral dermatology & dermatology in primary health careVitiligoSCE Dermatology

A 33-year-old woman has sharply demarcated depigmented macules around the mouth and on the dorsal hands. Wood lamp examination accentuates the lesions, and there is no scale or sensory loss. Her mother has autoimmune thyroid disease. What is the most appropriate investigation?

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Correct answer: C — Thyroid function and thyroid autoantibody testing

The best answer is “Thyroid function and thyroid autoantibody testing”. Vitiligo management includes camouflage, photoprotection, topical therapy, phototherapy and psychological support; irreversible depigmentation is reserved for exceptional extensive disease after specialist counselling. The alternatives “Fungal microscopy from depigmented skin”, “Skin biopsy for acid-fast bacilli”, “Serum copper and caeruloplasmin”, “Patch testing to cosmetics” are clinically adjacent possibilities, but they do not fit the defining morphology, distribution, histopathology, risk signal or management sequence in this stem.

Reference: BAD vitiligo guideline 2021: https://academic.oup.com/bjd/article/186/1/18/6593593