An adolescent white patient presents with a 7-month history of spots of loss of coloration of her skin that are becoming larger and more numerous. They denied the use of any medications, either topical or systemic, as well as any illnesses predating the onset of skin lesions. The lesions were not pruritic. They do not tan, although the surrounding skin appears to tan normally. Examination reveals generalized depigmented macules and patches on the chest, abdomen, back, and extremities. Scaling is absent. Borders are sharply defined. Woods lamp examination accentuates the depigmentation, but fluorescence is not observed. The patient is diagnosed with vitiligo. Which condition are they most at risk of developing? A. Squamous cell carcinoma B. Hashimoto thyroiditis C. Basal cell carcinoma D. Hearing loss
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