Vitiligo: A Review of Pathogenesis and Treatments, Including New Therapies on the Horizon

Abstract

Vitiligo is an acquired depigmentation skin disease caused by the immune-mediated death of melanocytes. It is the most common cause of depigmentation with an estimated worldwide prevalence of 1% but has shown insufficient response to current therapies. The latest research in vitiligo pathogenesis has translated into finding new molecular targets [type I interferon and Janus kinase signal transducers and transcription activators (JAK STAT) pathways], with new therapies generating promising results, such as JAK inhibitors. Other therapeutic strategies include phototherapy, surgical treatment, and complementary options such as micropigmentation, microneedling, and lasers. This review aimed to discuss the mechanisms involved in the development of the disease and the new therapeutic options that have become available, as well as the evidence on complementary therapies. For this purpose, a review of the evidence was conducted using the PubMed database. Based on this review, it was concluded that the progress in understanding the pathophysiology of vitiligo has allowed for the consideration of new molecular targets, with JAK inhibitors showing particular promise in both systemic and topical applications. Nonetheless, further investigation is required to assess the safety of JAK inhibitors and to determine the optimal regimen and dosage for administering these drugs. Complementary treatments should be considered on a case-by-case basis.

Keywords: Janus kinase inhibitors; melanocytes; molecular target; pigmentation disorders; vitiligo.