Vitiligo Pathogenesis and Emerging Treatments

Dermatol Clin. 2017 Apr;35(2):257-265. doi: 10.1016/j.det.2016.11.014.


The pathogenesis of vitiligo involves interplay between intrinsic and extrinsic melanocyte defects, innate immune inflammation, and T-cell-mediated melanocyte destruction. The goal of treatment is to not only halt disease progression but also promote repigmentation through melanocyte regeneration, proliferation, and migration. Treatment strategies that address all aspects of disease pathogenesis and repigmentation are likely to have greatest efficacy, a strategy that may require combination therapies. Current treatments generally involve nontargeted suppression of autoimmunity, whereas emerging treatments are likely to use a more targeted approach based on in-depth understanding of disease pathogenesis, which may provide higher efficacy with a good safety profile.

Keywords: Autoimmunity; Cellular stress; Chemokines; Melanogenesis; Targeted therapy; Vitiligo.

Publication types

  • Review

MeSH terms

  • Adaptive Immunity / immunology
  • Antioxidants / therapeutic use
  • Autoimmunity / immunology*
  • Humans
  • Immunity, Innate / immunology
  • Immunosuppressive Agents / therapeutic use
  • Melanocytes / immunology*
  • Melanocytes / metabolism
  • Oxidative Stress
  • Phototherapy
  • Regeneration
  • Self Tolerance / immunology
  • T-Lymphocytes, Cytotoxic / immunology*
  • Vitiligo / immunology*
  • Vitiligo / therapy


  • Antioxidants
  • Immunosuppressive Agents