ABSTRACT
Vitiligo is a chronic depigmentary disorder with a polyfactorial etiopathogenesis, a complex interplay between genetics, stress, infections, and a dysregulated immune system. A common cause for psychosocial morbidity, this is an ever-evolving field in terms of research and pathogenesis, and topical and systemic therapy. Systemic therapy includes established therapies—corticosteroids and immunomodulators including cyclophosphamide and cyclosporine, and newer modalities. The latter include botanical extracts like anapsos, placental extracts as an intramuscular injection, and an alpha-melanocyte stimulating hormone analog (afamelanotide). As a newer indication, older drugs like clofazimine and apremilast have also found usage in this autoimmune disorder. Recent research has been done in the field of Janus kinase inhibitors, namely ruxolitinib and tofacitinib, and their utility in gaining control and stability in unstable disease, as well as for repigmentation in stable vitiligo.
