Vitiligo is a chronic, acquired skin disorder characterized by well-defined areas of depigmentation resulting from the loss or dysfunction of melanocytes, the cells responsible for producing skin pigment. It can affect people of all ages and skin types and is not contagious. Although it does not usually pose a direct physical health risk, it may have significant psychological and social effects. Causes and Pathogenesis The exact cause of vitiligo is not fully understood. However, current evidence suggests an autoimmune mechanism in which the immune system attacks melanocytes in genetically susceptible individuals. Genetic factors and environmental triggers, including skin injuries in some people, may contribute to the development of the condition. Vitiligo may also be associated with other autoimmune diseases, particularly thyroid disorders. Clinical Features Vitiligo typically presents as white or pale patches with well-defined borders and a smooth surface. Commonly affected areas include the face, hands, elbows, knees, and regions around body openings. Hair within affected areas may also turn white. The distribution and progression of the patches vary among individuals. Some patches remain stable, while others enlarge or new patches develop. Diagnosis The diagnosis of vitiligo is usually based on clinical examination and assessment of the appearance and distribution of the skin patches. A Wood’s lamp examination can help highlight areas of depigmentation more clearly. Additional investigations may be considered when the diagnosis is uncertain or when an associated autoimmune disease is suspected. Treatment and Management Treatment is individualized according to the patient’s condition and the extent of the affected skin. Options may include topical corticosteroids or calcineurin inhibitors for selected areas, as well as phototherapy, such as narrowband ultraviolet B (Narrowband UVB), for more extensive disease. In selected cases, systemic treatments or newer targeted therapies may be considered under specialist supervision. Sun protection, cosmetic camouflage products, and psychological support are also beneficial. Treatment may help restore some skin pigmentation; however, responses vary among patients, and depigmentation may recur. Conclusion Vitiligo is a non-contagious skin disorder characterized by the loss of pigmentation. Its clinical course and response to treatment vary from person to person. Early evaluation by a healthcare professional helps confirm the diagnosis, discuss appropriate treatment options, and address the psychological and social effects associated with the condition. Note: Illustrative images are intended to demonstrate clinical features and should not be used to diagnose an individual. Al Mustaqbal University The First University in Iraq