An Update on Existing & Emerging Treatments for Vitiligo
Abstract
Vitiligo is characterized by chronic depigmented patches due to selective loss of melanocytes. The estimated prevalence of vitiligo is about 0.5 to 2% worldwide and, in addition to its significant cosmetic effect, it may cause major psychological distress.
Based on clinical distribution, vitiligo is divided into segmental vitiligo (SV) and non-segmental vitiligo (NSV). NSV is further sub-categorized based on the distribution of lesions into five distinct categories: vulgaris, generalized, acral, acrofacial and mucosal vitiligo.
The pathogenesis of vitiligo involves a complex interplay of autoimmune factors, intrinsic melanocyte defects, neural and oxidative stress. Immunologically, a type I immune response is believed to be responsible for the development of vitiligo.
In the last few years, there have been great strides made in understanding the pathogenesis of vitiligo at both the molecular and genetic level. In light of these developments, the future for vitiligo treatment looks promising as several new topical and systemic agents are in various phases of development. These future treatments may even prevent disease recurrence, once an unthinkable aim for vitiligo, as mechanistic models have elucidated targets by which memory T-cells can be altered in animal models.
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