[Vitiligo-update on pathogenesis, diagnostics and therapy].

Abstract

Vitiligo is a common skin disease leading to depigmentation that is associated with progressive destruction of melanocytes. The main subtype, nonsegmental vitiligo (NSV), is considered a chronic autoimmune disease leading to activation of melanocyte-specific CD8+ lymphocytes and development of a cutaneous immune memory. Vitiligo can result in significant impairment of quality of life and is associated with a number of comorbidities. Despite the existence of national guidelines and international treatment recommendations, there is a strong need for improved health care for patients with vitiligo. The options in the treatment algorithm for vitiligo are similar and consisted until recently of only topical and systemic corticosteroids, topical calcineurin inhibitors, phototherapy, and surgical interventions. New insights into the pathobiological role of the interferon signature in vitiligo have most recently contributed to the approval of the first vitiligo-specific therapy with the topical Janus kinase 1/2 inhibitor ruxolitinib for patients with NSV.