Although neither lethal nor symptomatic, the effects of vitiligo can be cosmetically and psychologically devastating. We found only one retrospective study dealing with prognostic issues. The course of the disease is fairly unpredictable, but often progressive (in more than 80% of patients).9 Periods of slow or rapid enlargement of the lesions, arrest in depigmentation, and spontaneous or partial repigmentation can occur. Spontaneous repigmentation, probably sunlight induced, is usually also a sign that the patient will respond to medical therapy. On the other hand, as the main reservoir of vital melanocytes is the hair follicle, glabrous skin and hair-bearing skin in which terminal hairs are clearly depigmented does not respond to medical therapies.

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