Possible atomoxetine-induced vitiligo: a case report

Vitiligo is a chronic skin disease characterized by the appearance of white depigmented lesion due to a loss of melanocytes. The etiopathogenesis of vitiligo is not clear, but according to the neural theory of vitiligo, the direct and indirect effects of monoamine neurotransmitters cause melanocyte destruction and various studies have supported this theory. Many drugs have been related to the development of vitiligo, and the melanocytotoxic effects of the some of these drugs are thought to be related due to their effects on the monoaminergic system. Furthermore, a recent article reported the development of a localized loss of pigmentation after the application of a methylphenidate patch in a patient with attention-deficit/hyperactivity disorder (ADHD). Atomoxetine is an inhibitor of norepinephrine reuptake sites and is a drug that has been used for the treatment of ADHD. Here, we present a school-aged child with ADHD who displayed a vitiligo lesion following the initiation of atomoxetine. We further discuss the possible impact of the ADHD drugs on the development of vitiligo.