Emerging treatments for vitiligo: gaining insight from pathogenesis

Vitiligo is an under-recognized, devastating autoimmune skin disease with limited treatment options. There are currently no Food and Drug Administration-approved treatments for vitiligo that reverse the course of disease, and standard off-label treatments are limited in efficacy. Furthermore, the mechanisms of current treatments are largely unknown, although general, nontargeted immunosuppression is most likely. Indeed, lack of significant success in treatment is often the reason for a pessimistic outlook by both the treating physician and the patient, highlighting the need for better treatment options. Over the past three decades, vitiligo has been the focus of advanced translational research that will guide the development of new treatments, which will ultimately benefit patients. Evidence is accumulating that, as we better understand the pathogenesis of vitiligo, targeted therapy will be possible, with the ability to repurpose existing medications and even create new ones.