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Although the exact mechanisms involved in the causation of primary depigmentation of the skin are not known, the hypothesis of the participation of the nervous system has been considered by many writers, on the basis of indirect clinical evidence. Some cases of vitiligo show absolute (mirror image) bilateral symmetry. This distribution is difficult to explain except on the basis of central nervous system participation, that is, segmental-dermatomal arrangement. However, since the involvement of any one dermatome is usually very incomplete, the fact of dermatomal involvement has not been readily proved. The case reported here brings no final proof but does present what appears to be strong clinical evidence to support the idea that the central nervous system plays a role in the pathogenesis of vitiligo.
REPORT OF A CASE
A 28-year-old white American shoemaker, C. D., was first seen in October, 1949, presenting a large area of pigment loss involving
SCHOLTZ JR, WILLIAMSON C. VITILIGO IN (APPARENT) DERMATOMAL DISTRIBUTION. AMA Arch Derm Syphilol. 1951;64(3):366–369. doi:10.1001/archderm.1951.01570090113017
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