Vitiligo

Vitiligo is a common depigmenting autoimmune disease affecting 0.1–2% of the population worldwide. The characteristic white patches are due to the selective loss of melanocytes, which frequently affects the face and other visible areas of the body. Sometimes, the pigmented cells in the eyes and ears are also affected. This can be psychologically devastating and can impose a considerable burden on daily life, including stigmatization and social isolation, as observed in cases of other skin diseases, such as psoriasis and atopic dermatitis. Vitiligo may be associated with other organ-specific autoimmune diseases, such as thyroid disease (Hashimoto’s thyroiditis and Graves’ disease), Addison’s disease, pernicious anemia, insulin-dependent diabetes mellitus, and alopecia areata. Until recently, only limited treatments were available for vitiligo. The therapeutic alternatives relied on drugs that nonspecifically target inflammatory and immune responses, such as topical and systemic steroids or topical calcineurin inhibitors, with or without ultraviolet light, to stimulate melanocyte regeneration, and several surgical techniques for resistant cases that have offered significant benefits to patients. Sometimes, the only alternative to treating generalized vitiligo with minimal pigmentation spots is to depigment the remaining pigmented epidermis. In August 2022, for the first time, the Food and Drug Administration approved ruxolitinib, a JAK 1 and 2 inhibitor, as a topical medication indicated for vitiligo. This was a breakthrough in the field of dermatology and increased the hope of finding efficient medications for this persistent disease.