Vitiliginous Lesions During Contact Immunotherapy for Alopecia in a Patient with Autoimmune Thyroiditis

    July 2014 in “ Our Dermatology Online ”
    Yasunobu Kato, Toshiyuki Yamamoto
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    TLDR Contact immunotherapy can cause vitiligo in patients with autoimmune conditions.
    A 60-year-old female with autoimmune thyroiditis developed vitiliginous lesions after two months of topical squaric acid dibutylester (SADBE) treatment for alopecia. Despite initial hair regrowth, depigmentation spread beyond the application areas, suggesting an autoimmune response rather than contact leucoderma. Laboratory tests showed normal liver and renal function but elevated anti-thyroid antibodies. A skin biopsy revealed decreased melanocytes and CD8-positive T-cell infiltration. SADBE therapy was discontinued, and topical corticosteroids led to significant improvement within nine months. The case highlighted the need for caution when using contact immunotherapy in patients with autoimmune conditions.
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