Which clinical finding in a vitiligo patch carries the worst prognosis for spontaneous or treatment-induced repigmentation?

• A Presence of leucotrichia within the patch ✓
• B Location over the face
• C Duration less than 6 months
• D Marginal hyperpigmentation around the patch

Explanation

Leucotrichia, or white hair within a depigmented patch, indicates destruction of the melanocyte reservoir in the hair follicle, which is the main source of repigmenting cells during phototherapy. Its presence predicts poor response to medical treatment and often necessitates surgery. Facial lesions respond best, recent onset favours repigmentation, and marginal hyperpigmentation is not a poor prognostic sign.

Reference: Rook's Textbook of Dermatology, 9th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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