Ultrastructural Studies of Vitiligo With Inflammatory Raised Borders

Ultrastructural studies of vitiligo with inflammatory raised borders were performed. A 41‐year‐old Japanese female had developed vitiligo on the back and cervical region about six months previously and it gradually increased. Slightly elevated red borders were observed on the periphery of some of the vitiligo lesions. Electron microscopic findings showed a few melanocytes with decreased and irregular melanosomes in the basal layer and dissociation of keratinocytes in the spinous layers. Melanosomes in keratinocytes were markedly decreased. Lymphocytes were frequently observed intraepidermally, and the process by which lymphocytes passed to the basal lamina from the dermis was also observed. Lymphocytes were seen in apposition to some melanocytes in the basal layer. These melanocytes, as a result, may degenerate. The formation of many vacuoles in the cytoplasm was observed. Many typical Langerhans cells with many racket bodies were observed in the upper spinous layers. On the other hand, in the basal layer, Langerhans cells with only a few racket bodies were generally observed. These Langerhans cells were also frequently in contact with lymphocytes. The cause of this inflammatory reaction with a raised border is not known. However, these ultrastructural findings firmly suggested a relationship to some type of immunological mechanism for this occurrence of vitiligo.