Follicular Vitiligo: A Rare and Under Recognized Variant

Follicular vitiligo (FV) is a rare variant of vitiligo characterized by selective depigmentation of hair shafts while sparing the surrounding skin. This case study reports a 23-year-old female with FV presenting as progressive whitening of hair on her forearms, with no associated skin depigmentation or history of autoimmune diseases. Unique findings included a reverse pigment network on dermoscopy and bluish-white fluorescence of hair shafts under Wood’s lamp, suggesting biochemical alterations in follicular melanocytes. Histopathology showed reduced melanin in the follicular epithelium, indicating functional impairment rather than complete melanocyte depletion. The patient was treated with oral tofacitinib and topical corticosteroids, highlighting the importance of early detection and potential for repigmentation.