A 10-year-old boy with Vogt-Koyanagi-Harada syndrome had loss of pigment cells in the skin, the halo nevi, the retina, and probably the leptomeninges. The amount of inflammation that accompanied destruction of pigment cells varied greatly and seemed to determine whether the patient had symptoms from his vitiligo. This patient exhibited symptoms associated with loss of pigment cells in his skin and leptomeninges, but not from the destruction of the pigment cells in his eyes. We suggest that vitiligo is a disease that can be manifested in any tissue containing pigment cells and has a variable clinical expression.