ultrastructural study of epidermal-melanin unit in vitiligo

The use of electron microscopy to define the cellular changes in vitiligo might prove to be a useful investigative procedure to clarify the pathogenic mechanism of this disease. Examination of vitiligenous skin taken from the margin and center of the depigmented lesions revealed ultrastructural changes in the form of cytoplasmic vacuoles in basal and suprabasal keratinocytes and deposits of extra-cellular granular material in between the keratinocytes in lower epidermis. Melanocytes and melanosomes were completely absent, while Langerhans' cells showed highly vacuolated cytoplasm. There was marked increased in degenerated Langerhans' cells in the center of the vitiligenous lesions. It seems logical to propose that degenerative changes in vitiligo do not only involve the melanocytes, but also keratinocytes and Langerhans' cells i.e. the whole epidermal- melanin unit