METHODS Decreased sensitization and elicitation of contact allergens in vitiliginous skin has been described. This may be related to altered epidermal Langerhans cell migration with bound hapten to dermis and draining lymph nodes. The aim of the present study was to detect the potential ability of vitiliginous skin to respond to an in vivo immunologic stimulus such as intradermal injections of interferon gamma (IFN-gamma). Vitiliginous and normal pigmented skin of each patient was injected intradermally with 10 micrograms of recombinant IFN-gamma diluted in 0.1 mL of sterile water for 3 consecutive days. On day 5, punch biopsy specimens were obtained from the injected sites. Histologic and immunohistochemical staining was performed on all sections. The cryostat sections were stained with adenosine triphosphatase as well as with the indirect immunoperoxidase technique employing murine monoclonal antibodies to HLA-DR, ICAM-1, CD1, CD11a, and CD18. RESULTS HLA-DR and ICAM-1 expression by epidermal cells, combined with perivascular accumulation of mononuclear cells with CD11a and CD18 expression, was observed in all sites injected with IFN-gamma. However, absence of an effect on the epidermal Langerhans cell population was noted only on the vitiliginous skin. CONCLUSIONS The reactivity of depigmented and pigmented skin was found to be different after IFN-gamma administration, with fewer CD1-positive cells in the depigmented skin. As adenosine triphosphatase staining also showed fewer positive cells, it may be concluded that no effect on the migration of epidermal Langerhans cells was noted in the involved skin. This may shed light on the immunologic aberration seen in vitiliginous skin.