Mise à Jour Sur les Traitements Existants et Émergents Pour les Patients Atteints de Vitiligo
Résumé
Le vitiligo est caractérisé par des taches dépigmentées chroniques dues à une perte sélective de mélanocytes. La prévalence du vitiligo serait d’environ 0,5 à 2 % à l’échelle mondiale. Outre ses répercussions considérables sur le plan cosmétique, cette affection peut aussi causer une détresse psychologique majeure.
Selon son emplacement clinique, le vitiligo est divisé en vitiligo segmentaire (VS) et en vitiligo non segmentaire (VNS). Selon la répartition des lésions , le VNS est par ailleurs subdivisé en cinq catégories distinctes, soit vulgaire, généralisé, palmo-plantaire, accro-facial et muqueux.
La pathogenèse du vitiligo implique une interaction complexe de facteurs auto-immuns, de malformations intrinsèques des mélanocytes, de stress neural et oxydatif. Sur le plan immunologique, une réponse immunitaire de type I serait responsable du développement du vitiligo.
Ces dernières années, de grands progrès ont été réalisés dans la compréhension de la pathogenèse du vitiligo aux niveaux moléculaire et génétique. À la lumière de ces développements, l’avenir du traitement des patients atteints de vitiligo semble prometteur, car plusieurs nouveaux agents topiques et systémiques en sont à diverses phases de développement. Ces futurs traitements pourraient même prévenir la récurrence de la maladie, ce qui était auparavant un objectif impensable pour le vitiligo, car les modèles mécanistes ont permis d’élucider les cibles par lesquelles les cellules T mémoires peuvent être modifiées dans des modèles animaux.
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