Vitiligo is usually asymptomatic, but because the depigmented skin is very sensitive to sunlight, patients may complain of sunburn (Fig. 65-1). Periorificial depigmentation is observed early in the course (Fig. 65-2). Acral areas are commonly affected. Depigmented areas are sharply demarcated from adjacent, normally pigmented skin. Vitiligo can occur at any age, but most commonly during adolescence or young adulthood. The disease is believed to be the result of an autoimmune disorder that targets the melanocyte, and it is not uncommon for patients to have associated autoimmune disorders, such as thyroiditis, pernicious anemia, and alopecia areata.