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Recent Advances in the Diagnosis, Pathogenesis and Treatment of Vitiligo: A Review

Year 2025, Volume: 8 Issue: 2, 90 - 105, 28.08.2025

Abstract

Vitiligo is a condition that affects approximately 1-2 out of every 100 people in the general population and can lead to significant psychosocial burdens. Both genetic and environmental factors are implicated in its etiology. While genetic factors are estimated to account for about 75% of disease development, the remaining portion is attributed to environmental influences. Vitiligo is generally classified as either segmental or non-segmental. Segmental vitiligo is less common, tends to remain stable, and is more resistant to treatment. Non-segmental vitiligo, on the other hand, is more progressive and more frequently encountered. Clinically, vitiligo is characterized by depigmented macules and patches. Although diagnosis is typically made clinically, additional methods such as Wood’s lamp examination, dermoscopy, and biopsy may occasionally be employed. Vitiligo must be differentiated from other conditions that cause depigmented or hypopigmented lesions, which can usually be distinguished through further evaluation by a dermatologist. A wide range of treatment options are available, with topical and systemic medications and phototherapy being the most commonly used approaches. In addition to long-established and evidence-based therapies, various novel treatments are currently under investigation. As our understanding of the disease continues to grow, it is clear that innovative therapies will emerge to improve vitiligo management.

References

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Vitiligo Patogenez, Tanı ve Tedavisinde Güncel Gelişmeler: Bir Gözden Geçirme

Year 2025, Volume: 8 Issue: 2, 90 - 105, 28.08.2025

Abstract

Vitiligo, toplumda ortalama 100 kişiden 1-2’sini etkileyen ve ciddi psikososyal yüklere neden olabilen bir hastalıktır. Klinik olarak depigmente makül ve yamalarla karakterizedir. Etiyolojisinde genetik ve çevresel faktörler suçlanmaktadır. Vitiligo genel olarak segmental ve non-segmental olarak sınıflandırılır. Segmental vitiligo daha nadir görülen, stabil kalma eğiliminde olan ve tedaviye daha zor yanıt veren türdür. Non-segmental vitiligo ise daha ilerleyici olan ve sık görülen alt tiptir. Tanısı genelde klinik olarak konulmakla birlikte Wood incelemesi, dermatoskopi, biyopsi gibi yöntemlere de nadiren başvurulabilmektedir. Vitiligo, depigmente bazen de hipopigmente lezyonlara sebep olan birçok hastalık ile ayırıcı tanıya girmektedir. Tedavide birçok farklı seçenek bulunmaktadır. Topikal ve sistemik ilaçlar ve fototerapi en sık kullanılanlardır. Uzun süredir kullanılan ve etkileri kanıtlanmış tedaviler dışında günümüzde hala çalışmaları devam eden birçok farklı ilaç bulunmaktadır. Özellikle son yıllarda topikal ve sistemik JAK inhibitörleri ile ilgili çok sayıda çalışma yapılmaktadır. Artan bilgi birikimi ile birlikte vitiligo tedavisinde ilerleme sağlanacak yeniliklerin geliştirileceği açıktır.

References

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  • 2. Zhang Y, Cai Y, Shi M, Jiang S, Cui S, Wu Y, et al. The Prevalence of Vitiligo: A Meta-Analysis. PLoS One. 2016; 11: e0163806.
  • 3. Perez-Bootello J, Cova-Martin R, Naharro-Rodriguez J, Segurado-Miravalles G. Vitiligo: Pathogenesis and New and Emerging Treatments. Int J Mol Sci. 2023; 24: 17306.
  • 4. Bergqvist C, Ezzedine K. Vitiligo: A Review. Dermatology. 2020; 236: 571-592.
  • 5. Millington GWM, Levell NJ. Vitiligo: The historical curse of depigmentation. Int J Dermatol. 2007; 46: 990-995.
  • 6. Seneschal J. Clinical Features of Vitiligo and Social Impact on Quality of Life. Dermatol Pract Concept. 2023; 13: e2023312S.
  • 7. Villegas-Calzada MF, Acatitla-Acevedo GA, Anda-Ortiz ND, Morales-Sánchez MA. Prognostic factors in childhood vitiligo. Bol Med Hosp Infant Mex. 2024; 81: 73-78.
  • 8. Vora RV, Patel BB, Chaudhary AH, Mehta MJ, Pilani AP. A Clinical Study of Vitiligo in a Rural Set up of Gujarat. Indian J Community Med. 2014; 39: 143-146.
  • 9. Ramot Y, Rosenberg V, Zhou L, Harbers S. Epidemiology and Treatment Patterns of Patients with Vitiligo: A Real- World Analysis. Adv Ther. 2024; 41: 2890-2906.
  • 10. Marchioro HZ, Silva de Castro CC, Fava VM, Sakiyama PH, Dellatorre G, Miot HA. Update on the pathogenesis of vitiligo. An Bras Dermatol. 2022; 97: 478-490.
  • 11. Spritz RA, Santorico SA. The Genetic Basis of Vitiligo. J Invest Dermatol. 2021; 141: 265-273.
  • 12. Iwanowski T, Kołkowski K, Nowicki RJ, Sokołowska- Wojdyło M. Etiopathogenesis and Emerging Methods for Treatment of Vitiligo. Int J Mol Sci. 2023; 24: 9749.
  • 13. Jin Y, Andersen G, Yorgov D, Ferrara TM, Ben S, Brownson KM, et al. Genome-wide association studies of autoimmune vitiligo identify 23 new risk loci and highlight key pathways and regulatory variants. Nat Genet. 2016; 48: 1418-1424.
  • 14. Gawkrodger DJ. Pseudocatalase and narrowband ultraviolet B for vitiligo: clearing the picture. Br J Dermatol. 2009; 161: 721-722.
  • 15. Katz EL, Harris JE. Translational Research in Vitiligo. Front Immunol. 2021; 12: 624517.
  • 16. Alikhan A, Felsten LM, Daly M, Petronic-Rosic V. Vitiligo: a comprehensive overview Part I. Introduction, epidemiology, quality of life, diagnosis, differential diagnosis, associations, histopathology, etiology, and work-up. J Am Acad Dermatol. 2011; 65: 473-491.
  • 17. Al-smadi K, Imran M, Leite-Silva VR, Mohammed Y. Vitiligo: A Review of Aetiology, Pathogenesis, Treatment, and Psychosocial Impact. Cosmetics. 2023; 10: 84.
  • 18. Boukhedouni N, Martins C, Darrigade AS, Drullion C, Rambert J, Barrault C, Garnier J, Jacquemin C, Thiolat D, Lucchese F, Morel F, Ezzedine K, Taieb A, Bernard FX, Seneschal J, Boniface K. Type-1 cytokines regulate MMP- 9 production and E-cadherin disruption to promote melanocyte loss in vitiligo. JCI Insight. 2020; 5: e133772.
  • 19. Montes LF, Abulafia J, Wilborn WH, Hyde BM, Montes CM. Value of histopathology in vitiligo. Int J Dermatol. 2003; 42: 57-61.
  • 20. Dwivedi M, Laddha NC, Begum R. The Immunogenetics of Vitiligo: An Approach Toward Revealing the Secret of Depigmentation. Adv Exp Med Biol. 2022; 1367: 61-103.
  • 21. Frisoli ML, Harris JE. Vitiligo: Mechanistic insights lead to novel treatments. J Allergy Clin Immunol. 2017; 140: 654- 662.
  • 22. Kang P, Wang Y, Chen J, Chang Y, Zhang W, Cui T, Yi X, Li S, Li C. TRPM2-dependent autophagy inhibition exacerbates oxidative stress-induced CXCL16 secretion by keratinocytes in vitiligo. J Pathol. 2024; 262: 441-453.
  • 23. Schmidt C. Temprian Therapeutics: Developing a genebased treatment for vitiligo. Nature. 2020 Jun 30.
  • 24. Zhao C, Wang D, Wang X, Mao Y, Xu Z, Sun Y, Mei X, Song J, Shi W. Down-regulation of exosomal miR-200c derived from keratinocytes in vitiligo lesions suppresses melanogenesis. J Cell Mol Med. 2020; 24: 12164-12175.
  • 25. Dong Li, Ting Zhou, et al. Circulating Exosomal miR-493-3p Affects Melanocyte Survival and Function by Regulating Epidermal Dopamine Concentration in Segmental Vitiligo. Journal of Investigative Dermatology. 2022; 142: 3262- 3273.e11.
  • 26. Li W, Pang Y, He Q, Song Z, Xie X, Zeng J, Guo J. Exosomederived microRNAs: emerging players in vitiligo. Front Immunol. 2024; 15: 1419660.
  • 27. Lu L, He H, Feng J, Hu Z, Zhang S, Yang L, Liu Y, Wang T. Post-translational modification in the pathogenesis of vitiligo. Immunol Res. 2024; 72: 1229-1237.
  • 28. Bergqvist C, Ezzedine K. Vitiligo: A focus on pathogenesis and its therapeutic implications. J Dermatol. 2021; 48: 252-270.
  • 29. Eltaweel AI, Salem RM, Abdelrahman AM, Hegazy HA. Provocating factors of vitiligo. Benha Journal of Applied Sciences. 2021.
  • 30. Silverberg JI, Silverberg NB. Vitiligo disease triggers: psychological stressors preceding the onset of disease. Cutis. 2015; 95: 255-262.
  • 31. Cupertino F, Niemeyer-Corbellini JP, Ramos ES. Psychosomatic aspects of vitiligo. Clin Dermatol. 2017; 35: 2927-2937.
  • 32. Liu X, Liu J. Vitiligo: are microbes to blame? Biosci Microbiota Food Health. 2025; 44: 16-25.
  • 33. Plensdorf S, Livieratos M, Dada N. Pigmentation Disorders: Diagnosis and Management. Am Fam Physician. 2017; 96: 797-804.
  • 34. Sosa JJ, Currimbhoy SD, Ukoha U, Sirignano S, O'Leary R, Vandergriff T, Hynan LS, Pandya AG. Confetti-like depigmentation: A potential sign of rapidly progressing vitiligo. Journal of the American Academy of Dermatology. 2015; 73: 272-275.
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There are 87 citations in total.

Details

Primary Language Turkish
Subjects Medical Education
Journal Section Review
Authors

Ahmet Kerim Demirbaş 0009-0008-3031-6766

Burcu Bektaş This is me 0009-0005-0108-1812

Çiçek Hocaoğlu 0000-0001-6613-4317

Publication Date August 28, 2025
Submission Date March 30, 2025
Acceptance Date June 23, 2025
Published in Issue Year 2025 Volume: 8 Issue: 2

Cite

EndNote Demirbaş AK, Bektaş B, Hocaoğlu Ç (August 1, 2025) Vitiligo Patogenez, Tanı ve Tedavisinde Güncel Gelişmeler: Bir Gözden Geçirme. Ege Tıp Bilimleri Dergisi 8 2 90–105.

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