Skin depigmentation b/L chronic uveitis and tinitus are features of –
First, I need to recall the key features of each option. The correct answer is likely a syndrome that includes these three symptoms. Let's break down each symptom. Skin depigmentation could be due to vitiligo, but vitiligo alone isn't enough. Chronic uveitis is inflammation of the uvea, which can be part of autoimmune conditions. Tinnitus is ringing in the ears, which might relate to inner ear issues or systemic conditions.
Now, thinking of syndromes that link these three. One that comes to mind is Vogt-Koyanagi-Harada (VKH) syndrome. VKH is an autoimmune disorder characterized by uveitis, skin changes like vitiligo, and neurological symptoms. But does it include tinnitus? Wait, VKH can also affect the inner ear, leading to hearing loss and tinnitus. That fits. So the triad here would be uveitis, vitiligo, and sensorineural hearing loss with tinnitus.
Other options could include other autoimmune or systemic conditions. For example,白癜风 (vitiligo) alone doesn't have the other two. Lupus might have skin and uveitis but not typically tinnitus. Sarcoidosis can have uveitis and skin lesions but tinnitus isn't a classic feature. So the key is to connect all three symptoms to a single syndrome.
Now, the distractors: Option A might be another condition like lupus, which has skin and uveitis but not tinnitus. Option B could be sarcoidosis, which has uveitis and skin lesions but tinnitus isn't common. Option C might be a different autoimmune condition. The correct answer is D, which is VKH.
Clinical pearl: Remember the acronym VKH for Vogt-Koyanagi-Harada. The classic triad is uveitis, vitiligo, and sensorineural hearing loss. Tinnitus is part of the hearing loss component. This is a high-yield fact for exams like NEET and USMLE.
**Core Concept**
This question tests knowledge of **Vogt-Koyanagi-Harada (VKH) syndrome**, a systemic autoimmune disorder characterized by **uveitis**, **vitiligo**, and **sensorineural hearing loss**. The triad reflects immune-mediated inflammation in the eye, skin, and inner ear.
**Why the Correct Answer is Right**
VKH syndrome is a **T-cell-mediated autoimmune disease** targeting melanin-containing cells. Chronic uveitis results from intraocular inflammation, while skin depigmentation (vitiligo) occurs due to destruction of melanocytes. Tinnitus and hearing loss arise from **cochlear inflammation**, part of the central nervous system and auditory system involvement in VKH. The classic triad includes uveitis, vitiligo, and sensorineural hearing loss, making this the most specific diagnosis.
**Why Each Wrong Option is Incorrect**
**Option A:** *Lupus erythematosus* can cause uveitis and skin rashes but does not typically feature tinnitus or sensorineural hearing loss.
**Option B:** *Sarcoidosis* may present with uveitis