Vitiligo: What’s old, what’s new

Abstract

Vitiligo is an acquired pigmentary disorder afflicting 0.5-2% of the world population for both sexes and all races with a capricious and unpredictable course. It has a complex etiology and varies in its manifestation, progression and response to treatment. Even if the precise aetiology and pathobiology of the disease are complex and still debated, recent evidence supports that vitiligo is a T CD8+ cell-mediated autoimmune disease triggered by oxidative stress. To date no clinical, biological and histological criteria allow us to establish the prognosis with certainty. The choice of the best therapy for adult and childhood vitiligo is based on various factors, such as the patient’s age, psychological condition and expectations, distribution and extension of skin lesions, type of vitiligo (stable or not) and availability and cost of therapeutic options. Since vitiligo has a deep psychological impact on patients and their quality of life, treating the disease is very important. As dermatologists, we have important goals in the treatment of vitiligo patients: stabilization of the disease progression, repigmentation of the lesions and especially the persistence of the aforementioned repigmentation. Although several medical and surgical therapeutic options have been proposed, no definite cure has yet been developed and the long-term persistence of repigmentation is unpredictable. We review the different therapeutic options with particular attention on the recurrence rate.

Vitiligo-like Lesions and COVID-19: Case Report and Review of Vaccination- and Infection-Associated Vitiligo

“…Vitiligo is a common autoimmune skin disease involving approximately 0.5–2% of the world population [ 20 ], ranging from 0.38% in the Danish peninsula and 0.49% in the USA to 1.9% in China and 2.28% in a remote area of Romania, with no differences between adults and children [ 21 ].…”

Efficacy of using oral methotrexate with phototherapy in the treatment of vitiligo in comparison with single phototherapy treatment: A double‐blinded randomized controlled trial

“…Vitiligo is an acquired depigmentation skin disorder, affecting people with no ethnic, racial, or socioeconomic priority 1 . The global prevalence of vitiligo is estimated to be approximately 0.5%–2% with equal involvement of both genders 2–4 . Although vitiligo may present at any age, it usually occurs between the ages of 10 and 30 years 5 …”

“…The main pathogenesis of vitiligo is still vague, but multiple theories suggest the association of the disease with genetic, environmental, biochemical, metabolic, neural, and cytotoxic factors and oxidative stress. However, vitiligo is considered an autoimmune disorder due to backup evidence, such as CD8+ T‐cell‐mediated involvement, association with other autoimmune disorders, and therapies with immune‐modulating effects on repigmentation 2–4,9 . Although there is no definite treatment to thoroughly cure vitiligo, various therapeutic methods are used, including topical corticosteroids, vitamin D derivatives, and calcineurin inhibitors, such as tacrolimus, phototherapy, and photochemotherapy, like UVA, PUVA (psoralen plus UVA) and narrowband UVB, excimer laser, surgical treatments, topical prostaglandin E2 (PGE2), and systemic therapy.…”

“…In vitiligo, a selective loss of melanocytes occurs, resulting in symmetrical, nonscaly, white macules with sharp margins that are surrounded by normal skin and can involve both the skin and mucous membranes 2–4 …”

Sudden onset of vitiligo after COVID‐19 vaccine

“…Since vitiligo is a common pigmentary disorder afflicting 0.5%–2% of the world population 8 and COVID vaccination nowadays is a common practice, the possibility that the onset of vitiligo after vaccination is just a coincidence should also be considered. However, the temporal relationship between the vaccine and development of the disease and the instances of autoimmune phenomena manifesting after COVID‐19 vaccination, 1 , 2 , 5 , 6 suggest that the vaccine could play a role in triggering vitiligo.…”