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This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the authors' clinical recommendations.
A healthy 25-year-old brunette woman reports a 12-month history of skin depigmentation. She first noticed patches of skin whitening on her hips; her physician prescribed an imidazole cream for a presumed fungal infection, but there was no improvement. After a vacation at the beach, she noticed additional depigmented patches on her elbows, shins, upper eyelids, and lower chin. A dermatologist made a
The Clinical Problem
Strategies and Evidence
Evaluation
Diagnosis
Assessment
Treatment
Ultraviolet Light
Topical Therapies
Surgery
Other Therapies
Areas of Uncertainty
Guidelines
Conclusions and Recommendations
Source Information
From the Department of Dermatology and Pediatric Dermatology, National Reference Center for Rare Skin Diseases, Centre Hospitalier Universitaire of Bordeaux, Bordeaux, France (A.T.); and San Gallicano Dermatological Institute, Rome (M.P.).
An audio version of this article is available at NEJM.org.
Address reprint requests to Dr. Taïeb at the Department of Dermatology, Hôpital Saint André, 1 rue Jean Burguet, 33075 Bordeaux, France, or at alain.taieb@chu-bordeaux.fr.
Related Letters:
Vitiligo
Naldi L., Sassi F., Taïeb A., Picardo M.
Extract |
Full Text |
PDF
N Engl J Med 2009;
360:1788, Apr 23, 2009.
Correspondence
This article has been cited by other articles:
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