Your patient complains of a progressive loss of pigment in various patches on the body. Affected skin surfaces are otherwise normal (i.e., no scaling, vesicles, elevation, or other changes). The most likely cause is:

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Vitiligo is characterized by the loss of skin pigment, resulting in white patches on the skin. Unlike the other conditions listed, vitiligo does not involve scaling, vesicles, or elevation of the skin, fitting the description provided.

Your Patient Complains of a Progressive Loss of Pigment in Various