Vitiligo: Current Scientific Perspectives

Definition and Prevalence

Vitiligo is a chronic skin disorder characterized by the development of depigmented (white) patches on the skin. It affects approximately 0.5–2% of the global population, regardless of sex, age, or ethnicity . Initial signs often appear at a young age, but the condition may develop at any stage of life.

Pathogenesis

Modern research shows that vitiligo is a multifactorial disease involving several mechanisms:

1. Autoimmune factor — the immune system attacks melanocytes, the cells responsible for producing the pigment melanin .

2. Genetic predisposition — dozens of genes have been identified that increase the risk of developing vitiligo .

3. Oxidative stress — accumulation of free radicals damages skin cells .

4. Neurogenic factors — disturbances in the nervous system may contribute to triggering the condition .

These mechanisms often act simultaneously, which explains the diversity of clinical manifestations.

Clinical Manifestations

The main symptom is the appearance of well-defined white patches on the skin. The most common areas are the face, hands, feet, and around major joints. Hair in the affected regions may also lose its pigment . The course of the disease varies: in some patients the patches remain stable, while in others they gradually expand or new lesions appear.

Diagnosis

Diagnosis is made by a dermatologist through clinical examination. In uncertain cases, Wood’s lamp, dermoscopy, or skin biopsy may be used . It is important to rule out other conditions that cause depigmentation (such as lichen or post-inflammatory changes).

Treatment Approaches

Currently, there is no universal cure for vitiligo. However, several therapeutic strategies can significantly improve skin appearance and slow disease progression:

• Phototherapy (narrowband UV-B at 311 nm) is considered one of the most effective treatments .

• Topical immunomodulators (corticosteroids, calcineurin inhibitors) are widely used .

• Surgical methods — melanocyte or skin grafting in selected cases .

• Experimental approaches — antioxidants and immunomodulating drugs show promise .

Psychological Impact

Vitiligo does not pose a direct threat to physical health, but it has a significant impact on quality of life, self-esteem, and psychological well-being . Therefore, modern recommendations emphasize not only medical treatment but also psychological support.

Conclusion

Vitiligo is a complex condition requiring a multidisciplinary approach. Modern science continues to explore its mechanisms and develop new therapies. With proper diagnosis and comprehensive management, long-term remission and significant improvement in quality of life are possible.

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References

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