VITILIGO: A REVIEW OF ETIOLOGY AND ITS TREATMENT

Ankita Jatkar*, Aniket Malshikare, Shrikant Chopade, Nachiket Patil and Prof Vikranti Koli

Vitiligo is an autoimmune condition affecting the skin that specifically targets melanocytes, the cells responsible for producing pigment, leading to areas of depigmentation that appear as white patches. Recent research has significantly advanced our understanding of the mechanisms underlying this disease. Autoreactive cytotoxic CD8+ T cells interact with melanocytes and drive disease progression by producing IFN-γ locally, which in turn prompts surrounding keratinocytes to secrete IFN-γ-induced chemokines, further attracting T cells to the skin in a positive-feedback manner. Treatments, both topical and systemic, that inhibit IFN-γ signaling have proven to be effective in reversing vitiligo in patients; however, recurrences are frequent once treatment is discontinued. The recurrence is attributed to autoreactive resident memory T cells, and novel therapeutic approaches are being developed to eliminate these cells for lasting benefits. This article reviews various basic, translational, and clinical studies that shed light on the pathogenesis of vitiligo and how this knowledge has informed the development of new targeted therapies. Vitiligo results from the damaging or malfunctioning of melanocytes, the cells that generate melanin, and is thought to stem from intricate interactions among genetic, autoimmune, and environmental factors. While vitiligo does not pose a direct threat to life, it can profoundly affect an individual’s psychological and social well-being due to its noticeable appearance. Treatments involve topical corticosteroids, phototherapy, skin depigmentation, and newer therapies aimed at either restoring pigmentation or slowing disease progression. Despite continued research, a definitive cure remains elusive, and the focus of management is on enhancing the quality of life for those affected.