Pentachrome vitiligo.

The term "trichrome vitiligo" has been used to describe lesions of vitiligo that have an intermediate level of color between the achromic center and the peripheral unaffected skin. We describe a 12-year-old black girl with a generalized pigmentary disorder that first appeared when she was 3 years of age. Five shades of colors--white, tan, medium brown (unaffected skin), dark brown, and black--were present. Biopsy specimens of the depigmented areas showed a complete absence of melanocytes, whereas the most hyperpigmented areas were characterized by an increase in epidermal pigment and number of melanocytes. The lack of any preceding inflammation in the affected areas and the subsequent widespread spontaneous depigmentation that occurred within 1 year pointed to a diagnosis of "pentachrome vitiligo."