Multidisciplinary approach leading to a diagnosis of Vogt – Koyanagi Harada Disease with a Cutaneous Presentation: A Case report

Abstract

Vogt-Koyanagi Harada Disease (VKHD) is a rare multisystem autoimmune inflammatory condition targeting melanocytes, causing dermatological, neurological, ophthalmological, and auditory manifestations. Severe bilateral granulomatous panuveitis is the primary clinical feature that characterizes VKH (inflammation throughout the uveal tract in the eye).

Cutaneous features such as vitiligenous patches, alopecia, and whitening of the hair (poliosis) can be observed. Meningism (meningitis symptoms without inflammation), hearing loss, and tinnitus are examples of neurological characteristics. Prodromal and constitutional symptoms such as fatigue, malaise, low-grade fever, and headache may precede the classic picture. VKHD is reported in darker skin populations in addition to Asian and Mediterranean origins. VKHD has four stages: prodromal, acute, chronic convalescent, and chronic recurrent. There are three categories of VKH: complete, incomplete, and probable. VKHD is treated aggressively with a systemic corticosteroid to suppress the inflammatory response and prevent further ocular complications. We report a 43-year-old male patient referred by an ophthalmologist with a diagnosis of Uveitis who developed hypopigmented patches over the face and mid trunk, poliosis, and alopecia in addition to headache, neck stiffness, and auditory abnormalities.