Onset of vitiligo following contact dermatitis from eyeliner application in a 20-year-old female

Sep 30, 2026

Vitiligo is an autoimmune disorder marked by melanocyte destruction and development of depigmented skin patches. Allergic contact dermatitis, triggered by cosmetic allergens, can initiate local immune activation and may evolve into broader immune dysregulation in genetically susceptible individuals. This case report examines how allergic contact dermatitis arising after eyeliner use may trigger vitiligo, and it outlines potential biological mechanisms connecting the two conditions.

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Introduction

Case Report

Dermatology Reports 2025; volume 17:10220 Onset of vitiligo following contact dermatitis from eyeliner application in a 20-year-old female Eugenia Veronica Di Brizzi,1 Gaetano Licata,2 Nicola Maria Giorgio,1 Giuseppe Argenziano,1 Caterina Mariarosaria Giorgio1 1Dermatology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania “Luigi Vanvitelli”, Naples; 2Dermatology Unit, San Antonio Abate Hospital, Trapani, Italy Abstract Vitiligo is an autoimmune condition characterized by the destruction of melanocytes, leading to depigmented skin patches. Allergic contact dermatitis, triggered by allergens in cosmetics, can initiate localized immune responses that may progress to systemic immune dysregulation in genetically predisposed individuals. This case explores the potential role of allergic contact dermatitis in triggering vitiligo and proposes mechanisms underlying this association. Correspondence: Eugenia Veronica Di Brizzi, MD, Dermatology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania “Luigi Vanvitelli”, via Pansini, 5, 80131 Naples, Italy. E-mail: [eugeniaveronica.dibrizzi@gmail.com](eugeniaveronica.dibrizzi@gmail.com) Key words: vitiligo; eyelid depigmentation; contact dermatitis; Wood’s light examination; cosmetic-induced vitiligo. Conflict of interest: the authors have no conflict of interest to declare. Ethics approval and consent to participate: no ethical committee approval was required for this case report by the Department because this article does not contain any studies with human participants or animals. Informed consent was obtained from the patient included in this study. Consent for publication: the patient provided written informed consent for the publication of her case details and any accompanying images. Availability of data and materials: all data underlying the findings are fully available. Received: 12 December 2024. Accepted: 11 April 2025. This work is licensed under a Creative Commons AttributionNonCommercial 4.0 International License (CC BY-NC 4.0) . ©Copyright: the Author(s), 2025 Licensee PAGEPress, Italy Dermatology Reports 2025; 17:10220 doi:10.4081/dr.2025.10220 Publisher's note: all claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and thereviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher. Introduction A 20-year-old female presented with hypopigmented patches on her upper eyelids following the use of a new eyeliner. Initially, she experienced redness, swelling, and irritation consistent with allergic contact dermatitis, which resolved after discontinuing the product. However, within two weeks, persistent depigmentation developed in the affected areas. Examination confirmed vitiligo through Wood’s light fluorescence, while patch testing revealed positive reactions to paraphenylenediamine (PPD) and nickel, common allergens in cosmetics. This case suggests a possible link between allergic contact dermatitis and the onset of vitiligo, potentially mediated by systemic immune modulation and immune memory sensitization. We hypothesize that the allergic reaction initiated a localized immune response, which evolved into a broader immune dysregulation, unmasking a latent predisposition to vitiligo. The mechanism may involve activation of memory T cells anda “pro-inflammatory microenvironment”, leading to sustained melanocyte destruction. The eyelid area, with its thin skin and heightened permeability, may be particularly susceptible to immune-mediated damage. This phenomenon corresponds with the Koebner effect, wherein localized trauma induces vitiligo in predisposed individuals.1 This case underscores the importance of patch testing for allergen identif

FAQs

What condition was identified in the patient after eyeliner application?

The patient developed vitiligo on the upper eyelids, confirmed by Wood’s light fluorescence under ultraviolet light.

Which allergens were found on patch testing?

Patch testing showed positive reactions to paraphenylenediamine (PPD) and nickel, both common cosmetic allergens.

How quickly did depigmentation appear after stopping the eyeliner?

Redness and irritation consistent with allergic contact dermatitis resolved after discontinuation, but persistent depigmentation developed within about two weeks in the previously affected areas.

Sep 30, 2026

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