The most common type is generalized vitiligo, in which there is widespread distribution of white macules, often in a remarkably symmetrical array. Typical macules occur in the fingers, elbows, knees, lower back, and genital area. The segmental type, which is uncommon, is characterized by one of several macules on one hand or one side of the body. This type is not usually associated with vitiligo macules in other parts of the body, and new vitiligo spots do not appear. The diagnosis of vitiligo can usually be made on clinical examination of a patient with progressive, acquired, chalk-white macules in typical sites.
Few conditions are as patterned and symmetrical as vitiligo.
Sometimes the spots match on both extemities in a mirror-image. Diagnosis can usually be established on clinical grounds alone. In certain difficult cases, a skin biopsy may be required to exclude some of the above. A defining feature is that pigment cells in the skin are absent in vitiligo. Vitiligo is sometimes associated with general diseases.