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The question
Two years after a single depigmented patch appeared along the right side of the forehead and upper eyelid of a 20-year-old student, it has not changed in size and no new patches have appeared anywhere; the eyelashes in the patch are white. She has used tacrolimus ointment, a potent topical steroid and 6 months of targeted excimer light with almost no repigmentation. There is no family history of vitiligo or thyroid disease, and her thyroid function and TPO antibodies are normal. She wants a lasting cosmetic result before her wedding. What is the most appropriate next step?
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