By Gary M. White, MD
Vogt-Koyanagi-Harada Syndrome (VKHS) is the combination of alopecia, poliosis or vitiligo along with ocular disease and neurologic problems.
- Patients may experience a gradual loss of vision.
Vitiligo unilaterally along with poliosis of the eyelashes and/or eyebrows is seen. Alopecia areata may be associated [JAAD 1992;26;496]. A prodromal generalized erythroderma has been noted [Dermatology 1999;198;65].
Criteria for diagnosing Vogt-Koyanagi-Harada (VKH) Syndrome were adopted in 1978 by the American Uveitis Society. They are 1) no history of ocular trauma or surgery and 2) at least 3 of the 4 following signs:
- Bilateral chronic iridocyclitis
- Posterior uveitis: exudative retinal detachment, disk hyperemia or edema, and "sunset-glow" fundus
- Neurological signs of meningism, headache, CSF pleocytosis, cranial nerve or central nervous system problems, tinnitus and hearing loss
- Cutaneous findings of alopecia, poliosis or vitiligo.
Treatment of individual problems should be carried out by both a dermatologist and ophthalmologist. For vitiligo lesions, topical tacrolimus and clobetasol can be beneficial, as with typical vitiligo [PD 2017;34;204].
University of Iowa
A 14-year-old boy presented with 3 months of depigmented macules and patches on the face, hands and scrotum. One hear before, he had experienced rapid onset of headaches, nausea, vomiting, bilateral eye pain and blurry vision. Panuveitis and bullous serous retinal detachments were found [PD 2017;34;204].
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