Vitiligo: An Update on Pathophysiology and Treatment Options

Reinhart Speeckaert; Nanja van Geel


Am J Clin Dermatol. 2017;18(6):733-744. 

In This Article


Non-segmental vitiligo is a multifactorial skin disorder with an immune-mediated melanocyte destruction as the main underlying mechanism. The involvement of immunity is confirmed by genome-wide association studies pointing to an elaborate interplay between immunoregulatory genes and melanocyte-specific genes. In contrast, segmental vitiligo is most likely a mosaic genetic skin disorder and is less frequently associated with other autoimmune disorders. Treatment includes topical corticosteroids and topical immunodulators and the first-line treatment for repigmentation remains NB-UVB. Recent progression in the establishment of the core outcome measures for vitiligo, new measurement instruments, and biomarkers pave the way for a new generation of targeted treatments, which will likely be tested in the coming years. Nonetheless, combination treatments still offer the highest chance for successful repigmentation.