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Recent Advances in Pathogenesis and Medical Management of Vitiligo

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Pigmentary Skin Disorders

Part of the book series: Updates in Clinical Dermatology ((UCD))

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Abstract

Vitiligo is a common pigmentary disorder characterised by the loss of functioning melanocytes from the basal layer of epidermis, leaving behind depigmented patches on the skin. It has a complex aetiopathology. Even though there are various theories describing the pathomechanisms of melanocyte loss, the initial trigger for melanocyte directed attack and the final steps causing melanocyte destruction is still speculative. The poor understanding of a common pathway causing melanocyte loss reflects in the lack of a targeted therapy in the medical management of vitiligo in this era of biologicals. The unravelling of interferon (IFN)-γ/CXCL10 axis in the causation of melanocyte directed attack and the observation of clinical usefulness of tofacitinib, which blocks the same pathway, give new hope in the direction of targeted therapy in vitiligo. In vitiligo, unlike psoriasis, the physician needs to address not only the issue of halting the inflammatory cascade causing the overt manifestation of the disease but also that of reviving the lost melanocytes, to regain normal skin colour. This chapter discusses the recent advances in the understanding of vitiligo pathogenesis and includes an update on the conventional and newer modalities in the medical management of vitiligo. A brief overview of the approach to the medical management of vitiligo is given at the end of the chapter.

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Acknowledgement

Authors are indebted to Dr. Raihan Ashraf, MBBS and Dr. Rajsmita Bhattacharjee, MD for the English language editing.

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  1. Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India

    Muhammed Razmi T & Davinder Parsad

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Correspondence to Muhammed Razmi T .

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  1. Department of Dermatology, Fiona Stanley Hospital and University of Western Australia, Perth, Western Autralia, Australia

    Prasad Kumarasinghe

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Razmi T, M., Parsad, D. (2018). Recent Advances in Pathogenesis and Medical Management of Vitiligo. In: Kumarasinghe, P. (eds) Pigmentary Skin Disorders. Updates in Clinical Dermatology. Springer, Cham. https://doi.org/10.1007/978-3-319-70419-7_8

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