Department of Dermatology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Dermatology. 2024;240(3):474-486. doi: 10.1159/000537810. Epub 2024 Feb 28.
Treatment of vitiligo seeks to achieve three goals: cessation of disease progression, regeneration of pigmentation, and prevention of recurrence.
Number of nonsurgical interventions are available that suppress the autoimmune response and regenerate the melanocytes from the reservoir: phototherapy including psoralen and ultraviolet A, narrowband ultraviolet B, and 308-nm excimer and 311-nm Titanium:Sapphire lasers; topical agents including topical calcineurin inhibitors, topical corticosteroids, and topical 5-fluorouracil; and systemic agents including corticosteorids, mycophenolate mofetil, cyclosporine, methotrexate, minocycline, afamelanotide, and antioxidants. In recent years, a great advance has been made in the understanding of pathogenesis of vitiligo, and JAK inhibitors are being investigated as a new treatment. Minimally invasive procedures such as fractional lasers or microneedling can help achieve the optimal treatment outcome when used properly.
Our review describes various treatment modalities for vitiligo based on their molecular mechanism of action. Bridging the gap between molecular mechanisms and therapeutic options would be a valuable reference for physicians in clinical practice.
白癜风的治疗旨在实现三个目标：停止疾病进展、再生色素、预防复发。
有许多非手术干预措施可用于抑制自身免疫反应并从储备库中再生黑素细胞：光疗包括补骨脂素和紫外线 A、窄带紫外线 B 以及 308nm 准分子和 311nm 钛：蓝宝石激光；局部药物包括局部钙调磷酸酶抑制剂、局部皮质类固醇和局部 5-氟尿嘧啶；以及全身药物包括皮质类固醇、霉酚酸酯、环孢素、甲氨蝶呤、米诺环素、阿法美拉汀和抗氧化剂。近年来，人们对白癜风发病机制的认识取得了重大进展，JAK 抑制剂作为一种新的治疗方法正在被研究。当正确使用时，诸如分束激光或微针之类的微创程序可以帮助实现最佳的治疗效果。
我们的综述根据其作用的分子机制描述了白癜风的各种治疗方法。在分子机制和治疗选择之间架起桥梁将是临床医生的宝贵参考。
