Skin Depigmentation Research Articles

Multiple Abnormal Cutaneous Findings in a Patient With Hypomelanosis of Ito Undergoing General Anesthesia

Hypomelanosis of Ito (HI), a neurocutaneous syndrome, is characterized by skin depigmentation and skeletal, muscular, central nervous system, cardiac, and renal manifestations. A wide variety of cutaneous manifestations besides depigmentation have been reported. Herein we describe a 23-year-old woman with HI whose extracutaneous symptoms included severe mental and motor impairment, convulsions, and deformity of the orofacial region. She also had severe obesity, asthma, multiple allergies, and skin hypersensitivity. Although no extracutaneous manifestations were problematic during perioperative management of dental procedures under general anesthesia, erythema developed at 3 time points: during induction, during emergence, and in recovery. We speculated that mechanical stimuli to the skin and administration of multiple drugs likely caused histamine release, leading to the 3 episodes of erythema. Because patients with HI often have hypersensitivity reactions in the skin, both cutaneous and extracutaneous manifestations should be considered in the anesthetic management of patients with HI.

The Perianal Mirage: Case of Primary Perianal Paget’s Disease

Background: Paget’s disease is rare and arises from the apocrine glands of skin. Perianal Paget’s disease is very rare form of extramammary Paget’s disease. Method and Results: Patient presented with complaints of perianal itching which on examination had patchy depigmented nodular skin in perianal region. Biopsy showed Paget’s cells, and immunohistochemical staining was positive for CK7, CEA and GCDFP-15, confirming the diagnosis of primary perianal Paget’s disease. Further, patient was staged and was planned for surgery and underwent wide local excision of perianal skin preserving internal and external anal sphincters. Reconstruction of the defect was completed with a local flap. Conclusions: Surgery remains most effective and only curative option for perianal Paget’s disease. As it is a rare disease, a high degree of suspicion is required for early diagnosis and treatment.

Valorisation of Winery By-Products: Revealing the Polyphenolic Profile of Grape Stems and Their Inhibitory Effects on Skin Aging-Enzymes for Cosmetic and Pharmaceutical Applications.

Grape (Vitis vinifera L.) stems, a by-product of winemaking, possess significant potential value due to their rich polyphenolic composition, which allows their exploitation for cosmetic and pharmaceutical applications. This presents a promising opportunity for valorisation aimed at developing innovative products with potential health-promoting effects. In this study, the polyphenolic profile of extracts from grape stems of seven white grape varieties was determined using spectrophotometric and chromatographic methods, specifically high-performance liquid chromatography coupled with a photodiode array detector and electrospray ionization multi-stage mass spectrometry (HPLC-PDA-ESI-MSn), as well as on their ferric-reducing antioxidant power (FRAP) and radical scavenging capacity, using 2,2-diphenyl-1-picrylhydrazyl (DPPH●) and 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid (ABTS●+) radicals. This study also evaluated the anti-aging activity and skin depigmenting activity of these extracts. These findings revealed a diverse polyphenolic profile, encompassing proanthocyanidins and catechin derivatives (PCDs), phenolic acids, and flavonols. Among the varieties studied, 'Códega do Larinho' exhibited the highest concentrations of six distinct polyphenols and the highest total phenolic content. It also demonstrated the highest results for antioxidant capacity and elastase and tyrosinase inhibition. Pearson's correlation analysis showed a significant positive correlation between certain PCDs with both FRAP and DPPH assays, as well as between the identified flavonols and anti-elastase activity. These results underscore the potential health benefits of grape stem extracts and emphasize the importance of their polyphenolic composition in enhancing antioxidant and anti-aging properties, thus supporting their application in different industries.

Topical 5-aminolevulinic acid photodynamic therapy for genital vitiligo

Vitiligo is an acquired chronic depigmentary skin disorder which results from the destruction of melanocytes. The clinical characteristic of vitiligo is the development of white macules due to the loss of functioning melanocytes in the skin or hair. Vitiligo in the genital area brings about a serious psychological impact on individuals. However, the choices of treatment for genital vitiligo are scarce. This study sheds light on the leverage of 5-ALA (5-Aminolevulinic Acid) Photodynamic Therapy (PDT) for the management of genital vitiligo. Nine patients with genital vitiligo who underwent 20 % ALA-PDT treatment were reported. The results revealed that the treatment protocol simulated melanocyte regeneration in the patients effectively. ALA-PDT exerts significant anti-inflammatory effects by reducing pro-inflammatory cytokines and inducing regulatory T cells, which may help suppress the autoimmune response involved in vitiligo pathogenesis. Notably, five patients who were defined as responders showed moderate to excellent improvement in repigmentation and the treatment was well tolerated in all cases. Our findings suggest that ALA-PDT is a potential treatment option for genital vitiligo.

Inverse relationship between polygenic risk burden and age of onset of autoimmune vitiligo.

Vitiligo is a common autoimmune disease characterized by patches of depigmented skin and overlying hair due to destruction of melanocytes in the involved regions. We investigated the relationship between vitiligo risk and vitiligo age of onset (AOO) using a vitiligo polygenic risk score that incorporated the most significant SNPs from genome-wide association studies. We find that vitiligo genetic risk and AOO are strongly inversely correlated; subjects with higher common-variant polygenic risk tend to develop vitiligo at an earlier age. Nevertheless, the correlation is not simple. In individuals who carry a single high-risk major histocompatibility complex class II haplotype, the effect of additional polygenic risk on vitiligo AOO is reduced. Particularly among those with early-AOO vitiligo (onset ≤12 years of age), genetic risk can reflect contributions from high common-variant burden but also rare variants of high effect and sometimes both. While the heritability of vitiligo is relatively high, and we here show that genetic risk factors predict vitiligo AOO, vitiligo is never congenital, and thus environmental triggers also play an important role in disease onset.

Early poliosis- and vitiligo-like depigmentation as an indicator of treatment response in patients with uveal melanoma under tebentafusp therapy.

We report novel findings of early vitiligo- and poliosis-like depigmentation of skin and hair in three patients with uveal melanoma under tebentafusp therapy, which are associated with a good treatment response to tebentafusp.

Decreased Neutrophil-to-lymphocyte Ratio in Patients with Vitiligo: National Data Analysis.

Vitiligo is characterized by depigmented skin lesions involving melanocyte defects and immune dysregulation. Haematological markers like neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been explored in various skin disorders. Given vitiligo's proposed pathogenesis, we hypothesized differences in NLR and PLR in vitiligo patients compared to controls. In a national retrospective cohort study (2005-2020) in Israel, blood count data from patients diagnosed with vitiligo (ICD-10 codes) were analysed, excluding patients with recent infections, surgeries, or malignancies. Controls matched for age and sex were selected. Sub-analyses examined age groups, treatment type, and matched controls. Children (n = 3,796) and adults (n = 38,608) with vitiligo showed significant differences in gender distribution, cell counts, and ratios. Vitiligo patients (n = 38,358) exhibited lower NLR, decreased neutrophils and platelets, and increased lymphocytes compared with controls. Non-systemically treated vitiligo patients (n = 33,871) displayed lower NLR and neutrophils compared with matched controls. Systemically treated vitiligo patients (n = 4,487) showed lower NLR, higher PLR, and reduced lymphocytes. Logistic regression identified associations between increased lymphocyte and platelet counts and being systemically treated. This study highlights significant haematological differences in vitiligo patients, emphasizing the potential utility of NLR as an accessible tool for vitiligo assessment. Further investigations are warranted to elucidate the roles of neutrophils and lymphocytes in vitiligo pathogenesis.

The role of aryl hydrocarbon receptor agonists in the treatment of vitiligo.

Vitiligo is a chronic autoimmune disorder characterized by progressive skin depigmentation. Vitiligo significantly impacts patients' quality of life, contributing to psychological and social burdens. Despite readily available therapeutic options, many cases remain refractory to treatment, highlighting the critical need for safer and more effective therapies. Currently, ruxolitinib is the only FDA-approved medication for vitiligo; however, it carries a black box warning for serious adverse effects, including infections, malignancy, and major cardiovascular events, limiting its use. Recent studies have identified the aryl hydrocarbon receptor (AhR) as a promising therapeutic target, suggesting that AhR agonists could address the multifaceted pathogenesis of vitiligo. Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we conducted a comprehensive search to analyze the role of AhR agonists in the treatment of vitiligo on PubMed, Cochrane, Embase, MEDLINE, and Web of Science databases on April 15, 2024. Fourteen studies met the inclusion criteria, comprising two clinical trials, two case reports, and nine basic science studies. Our search revealed that culturing AhR agonists with melanocytes upregulates melanin-synthesizing enzymes, reduces reactive oxygen species, and modulates pro-inflammatory cytokines such as IL-17A and IL-22. Tapinarof, a topical AhR agonist used commonly for the treatment of psoriasis, demonstrated clinical efficacy in repigmentation with a favorable safety profile compared to long-term steroid use. Although limited by the number of clinical studies, this review underscores the potential of using AhR agonists, such as tapinarof, as a transformative approach to vitiligo management. Future clinical trials are necessary to evaluate the safety, efficacy, and long-term outcomes of AhR agonists.

The Effect of Ginkgo Biloba Extract on Oxidative Stress, Anti-Inflammatory and Antiapoptotic in Vitiligo Treated with Topical Desoxymethasone

Vitiligo is a progressive and multifactorial condition of skin, mucosa, and hair depigmentation. Loss of functional melanocytes leads to the appearance of white macules on the skin, often affecting the lips and genitalia. The impact extends to psychological stress, decreased quality of life, and risk of psychiatric morbidity. Various therapeutic strategies have been designed to inhibit the immune response in vitiligo to reduce melanocyte damage while increasing melanocyte repopulation. There is no standardized method of evaluating treatment outcomes in vitiligo patients. Herbal medicines several studies have shown that GB also has many benefits for health and healing skin diseases, one of which is used in treating vitiligo. Therefore, this study aimed to evaluate the potential of Ginkgo biloba extract as a therapeutic supplement in enhancing the positive effects of desoxymethasone on vitiligo. Using a double-blind randomized control trial clinical trial research design, 26 subjects were divided into treatment and control groups. The control group received standard vitiligo therapy with topical desoxymethasone and placebo, while the treatment group received topical desoxymethasone plus Ginkgo biloba extract. Melanin index, VASI score, MDA, TNF-α, CD8 expression, and caspase 3 were measured before and after treatment. The results showed that the administration of Ginkgo biloba extract had a significant effect in reducing MDA, TNF-α, CD8 expression, and caspase 3 levels, and improving melanin index and erythema in vitiligo patients who received topical desoxymethasone therapy. These findings demonstrate the positive potential of Ginkgo biloba extract as an adjunct to vitiligo therapy, resulting in favorable clinical and molecular impacts in patients undergoing combination treatments.

Evaluation of Tissue and Serum Levels of Interleukin-15 in Non-Segmental Vitiligo

Abstract Background Vitiligo is a common autoimmune disease of skin depigmentation. The disease presents with many challenges, such as progression, resistance to treatment and recurrence. Recent studies reported a possible role of IL-15 in the pathogenesis, activity and recurrence of the disease. Objective Evaluation of tissue and serum levels of IL-15 in non-segmental vitiligo patients. Methods This Case-control study included 31 participants; 20 vitiligo patients and 11 controls. In patient group, we took serum samples and three punch biopsies (3mm) from active and recurrent vitiliginous patches as well as non-vitiliginous skin. In control group, we took serum sample and one tissue biopsy. IL-15 was assessed by ELISA technique in all samples. Results There was no statistically significant difference between IL-15 levels in tissue and serum of control group. All levels of IL-15 in patients were significantly higher than in control. In patients, level of IL-15 in serum was significantly higher than in active and stable patches but lower than in recurrent patches. IL-15 level, in recurrent patches, was significantly the highest of all parameters. Conclusion IL-15 may have an important role in the pathogenesis, activity and mainly recurrence of vitiligo. It seems to be a potential therapeutic target to control the disease and prevent recurrence.

"Understanding and treating baras (vitiligo) in unani medicine: historical perspectives, pathophysiology, and therapeutic approaches".

Vitiligo, also known as baras in Unani medicine, causes patches of depigmented skin due to the loss of melanocytes. According to ancient Unani scholars, factors like excessive phlegm in the blood and weakened color-controlling power were believed to be the cause. This study dives into the historical insights of luminaries like Majūsī and Hakim Akbar Arzānī, alongside modern medical understanding. It explores the pathophysiology, epidemiology, and clinical features of vitiligo, while also addressing confusing definitions, dietary influences, and demographic patterns. We take a close look at the classification, prognosis, and investigative methods. The aim of this research is to bring together traditional and modern perspectives to fully understand vitiligo, covering its cultural, historical, and scientific aspects. By incorporating epidemiological data, dietary considerations, and insights into the underlying mechanisms, we enhance diagnostic and treatment approaches. In conclusion, this study establishes a cohesive connection between the historical wisdom of Unani medicine and the current scientific discourse on vitiligo. By merging these perspectives, we gain a comprehensive understanding of the condition, enabling a more holistic approach to diagnosis and management. As dermatological research continues to evolve, the integration of traditional and modern insights becomes crucial in effectively addressing complex skin disorders like vitiligo.

The Anti-Vitiligo Effects of Feshurin In Vitro from Ferula samarcandica and the Mechanism of Action.

Vitiligo is a complex disorder characterized by skin depigmentation; the canonical Wnt signaling pathway that involves β-catenin plays a crucial role in promoting the melanin production in melanocytes. Targeted inhibition of the Janus kinase JAK-STAT pathway can effectively diminish the secretion of the chemokine C-X-C motif ligand CXCL10, thereby safeguarding melanocytes. Ferula has been applied as a treatment regimen for a long period; however, its use for the treatment of vitiligo has not been previously documented. CCK-8 assay, Intracellular melanin content assay, Tyrosinase activity assay, Western blotting, qRT-PCR, and ELISA methods were employed. Using molecular docking verified the inhibitory effects of feshurin on the JAK1. The sesquiterpene coumarin feshurin was separated from Ferula samarcandica. Feshurin was shown to induce GSK-3β phosphorylation, resulting in the translocation of β-catenin into the nucleus. This translocation subsequently upregulated the transcription of microphthalmia-associated transcription factor (MITF), leading to increased tyrosinase activity and melanin production. In addition, feshurin inhibited the production of chemokine CXCL10 via the JAK-STAT signaling pathway, which was verified by molecular docking. Based on these findings, it can be concluded that feshurin exhibits significant potential for the development of novel anti-vitiligo therapeutics.

Clinical and dermoscopic patterns of idiopathic guttate hypomelanosis

Depigmented skin lesions are of great concern in society, especially in the Indian subcontinent. These comprise many infective and inflammatory conditions that cause apprehension and anxiety among patients due to the social stigma attached to these conditions. Idiopathic guttate hypomelanosis (IGH) appears similar to many depigmented lesions and differentiation of IGH from these conditions is difficult clinically as well as histopathologically. IGH is one of the common causes of acquired leukoderma. It is also called disseminated lenticular leukoderma. The etiology is yet not clearly delineated, probably multifactorial. Various etiological factors have been proposed including ultraviolet (UV) exposure, post-phototherapy (psoralen and UVA monotherapy, narrowband-UVB), aging, genetic factors, trauma, and autoimmunity. Clinically, it is characterized by multiple, discrete porcelain-white round to oval macules of 2–5 mm average size. It most commonly occurs in the elderly. The most common sites observed are chronically sun-exposed areas such as the arm, pretibial regions, and forearm extensors. It is not easy to differentiate IGH from other hypo and depigmented conditions such as vitiligo, pityriasis versicolor, extragenital lichen sclerosus et atrophicus, guttate morphea, and post-inflammatory hypopigmentation. It poses a diagnostic challenge to dermatologists. One has to differentiate depigmented lesions from vitiligo as it carries tremendous social implications as social stigma, especially in India. Research on dermoscopic evaluation is uncommon in the literature, despite the abundance of clinic-epidemiological and histological studies of IGH. Four dermoscopic patterns, namely, petaloid, amoeboid, feathery, and nebuloid have been described. These patterns are specific to IGH and help clinicians to differentiate many depigmented skin lesions from IGH in clinical practice. Patients often seek cosmetic treatment. There has been no standard therapy for this condition. Newer treatment modalities range from topical agents to procedure-based therapies and have enhanced the therapeutic armamentarium.

Clinical and pathological characterization of tebentafusp-associated skin toxicity: A cohort study with 33 patients

BackgroundTebentafusp is a novel treatment for patients with metastatic uveal melanoma and often causes cutaneous side effects. ObjectivesThe aim of this study was to better characterize these heterogenous cutaneous side effects. MethodsThis prospective cohort study evaluated all patients from a tertiary hospital center who were treated with tebentafusp between January 2019 and June 2023 clinically and assessed skin biopsies histologically. ResultsIn total, 33 patients were analysed. Skin toxicity was observed in 78.8% of patients and was classified in five clinical categories: 1) symmetrical erythematous patches (83.8%), 2) hemorrhagic macules (11.8%), 3) urticarial lesions (7.4%), 4) bullous lesions (1.5%) and 5) skin (8.5%) and hair depigmentation (11.4%). Histopathologic features were focal lymphocytic interface dermatitis with epidermal infiltration of CD8-positive lymphocytes. Patients with skin reactions had a significantly longer median overall survival compared to patients without any cutaneous events (34 versus 4 months, p<0.001). LimitationMonocentric study with a limited number of patients. ConclusionTebentafusp frequently induced cutaneous reactions. Pathogenesis is likely due to binding of tebentafusp to stimulated melanocytes in the skin followed by infiltration and activation of lymphocytes. Development of treatment induced skin reactions may be associated with survival benefit.

Causal Explanations and Risk-Taking Associated with Voluntary Skin Depigmentation in Cameroon

For individuals, conforming to beauty standards sometimes requires body transformations such as voluntary skin depigmentation. Skin depigmentation is a growing phenomenon in society. The reasons given in the literature vary from country to country. The health, economic and social consequences have been reported in the literature. Although the harmfulness of this practice is well known, people continue to use it, even though they are sometimes well informed and aware of it, despite the fact that it is a behaviour that is considered risky for their health. To understand this risky behaviour, individuals put forward reasons that may explain it, thus providing a means of analysis. This study uses the semi-directive interview method. It is made up of men and women aged between 18 and 50 from the town of Foumbot, recruited using purposive sampling. The study shows that the reasons given for this practice are either internal or external to the individual. The results show that most of the respondents have a good knowledge of voluntary skin depigmentation and the meaning they give to it. This study shows that depigmentation is not only practised by women, even men use lightening products. Individuals would therefore do well to accept themselves as they are (self-acceptance), as this practice has health, economic and social consequences.

A meta-analysis of therapeutic trials of topical ruxolitinib cream for the treatment of vitiligo: therapeutic efficacy, safety, and implications for therapeutic practice.

Vitiligo, an autoimmune condition characterized by depigmented skin patches due to the loss of functional melanocytes, has been linked to dysregulation in the JAK-STAT signaling pathway, particularly in IFN-g signaling. The use of JAK inhibitors, such as ruxolitinib cream, a JAK1 and JAK2 inhibitor, presents a promising approach for vitiligo treatment. This study aims to systematically assess the effectiveness and safety of ruxolitinib cream in patients with vitiligo. We conducted a systematic review and meta-analysis following PRISMA guidelines to evaluate the efficacy and safety of ruxolitinib cream for the treatment of vitiligo. A comprehensive search of PubMed, Google Scholar, and Cochrane Library databases for randomized controlled trials (RCTs). Data selection, screening, extraction, and risk of bias assessment were meticulously performed. Statistical analysis was conducted using Review Manager Software, version 5.4, with significant heterogeneity addressed through appropriate methods. Our meta-analysis included 3 studies with 830 vitiligo patients. Significant improvements were observed in F-VASI, T-VASI, F-BSA, and T-BSA scores, with greater efficacy at 24weeks compared to 12weeks [MD -24.17, 95% CI (-31.78 to -16.56), P < 0.00001], [MD -14.12, 95% CI (-20.54 to -7.70); P < 0.0000], [MD -16.25, 95% CI (-22.20 to -10.31), P < 0.00001], [MD -9.19, 95% CI (-13.47 to -4.92); P < 0.00001]. Ruxolitinib showed increased risk ratios for F-VASI75, F-VASI90, and F-VASI50, indicating better outcomes with longer treatment durations [MD 2.9, 95% CI 1.88-4.49; P < 0.00001], [MD 4.66, 95% CI 2.09-10.39; P = 0.0002], [MD 2.53, 95% CI 1.84-3.46; P < 0.00001]. No significant differences were found in mild and moderate adverse events, while severe cases favored ruxolitinib. Placebo had a significant advantage in any adverse events, with no significant difference in drug-related adverse events. Serious adverse events did not significantly differ between groups. The findings strongly support the efficacy of ruxolitinib therapy in improving various parameters over time for treating vitiligo. However, thorough consideration of its safety profile, particularly concerning adverse events and potential side effects, is warranted. Further studies with larger sample sizes are needed to confirm these conclusions.

Assessing Participants' Experiences with Vitiligo from Patient Interviews.

Vitiligo is an autoimmune disease, causing skin depigmentation. Individuals with vitiligo incur substantial psychosocial burden and have expressed frustration with their treatments. Here, we describe the burden of vitiligo and opinions on what constitutes meaningful change among participants of two qualitative interview studies. Qualitative interviews were conducted with a subgroup of adolescent and adult participants with vitiligo from two pivotal phase 3 clinical trials of ruxolitinib cream (Study 1) and a real-world panel (Study 2). Participants were asked about their disease burden, treatment goals, importance of facial/body improvement (treatment satisfaction: scale range 0-10), and meaningfulness of change (yes/no). A total of 36 participants from Study 1 and 23 from Study 2 were interviewed. In Study 1, the highest degree of impact was on reduced self-esteem (facial lesions, 62.5%; body lesions, 55.6%), social inhibition (facial lesions, 65.6%; body lesions, 61.1%), and sun sensitivity (facial lesions, 31.3%; body lesions, 55.6%). Most participants (83.3%) reported that facial improvement was equally (36.1%) or more important (47.2%) than body improvement, with mean treatment satisfaction of 8.1 and 6.9, respectively. Meaningful change was reported by 83.3% and 92.9% of participants with 50-74% and ≥ 75% improvement per the facial Vitiligo Area Scoring Index, respectively, and by 82.6% of participants with ≥ 25% improvement per the total Vitiligo Area Scoring Index per Study 1 outcomes at Week 24. In Study 2, most (82.6%) participants felt that the noticeability of their vitiligo affected their behavior. Nearly all (87.0%) said that an ideal treatment would repigment or return natural color to their facial skin; 56.5% considered ≥ 50% facial repigmentation to be the smallest meaningful improvement. Participants from both qualitative interviews expressed substantial psychosocial burden. Repigmentation in both facial and body vitiligo were important, with meaningful change determined to be ≥ 50% facial repigmentation and ≥ 25% body repigmentation.

Identification of piRNA Expression Profiles in Vitiligo

Objective: Vitiligo is a systemic dermatological disorder characterized by skin depigmentation due to melanocyte damage and dysfunction. The treatment of vitiligo remains a challenging aspect in dermatological practice. PIWI-interacting RNAs (piRNAs), approximately 24–32 nucleotides in length, are crucial in the epigenetic regulation of developmental processes. However, research on piRNA expression profiling in vitiligo is limited. This study aimed to identify and characterize piRNAs in skin tissues from vitiligo patients and healthy controls. Methods: We compared and analyzed piRNA expression profiles of human vitiligo skin by RNA sequencing. Results and Discussion: Our findings revealed a pronounced preference for uridine (U) at the 5′ end of piRNAs, predominantly originating from repeat and other genomic regions. Notably, we detected 73 differentially expressed piRNAs between the patient and control groups, with 40 piRNAs upregulated and 33 downregulated in vitiligo patients. Bioinformatics analysis indicated that the genes responsible for piRNA production were more prevalent in metabolic processes and implicated in regulating the PI3K-Akt and AMPK signaling pathways. Conclusions: The elucidation of piRNA expression profiles enhances our understanding of their functional roles in the pathogenesis of vitiligo.

The experience of living with vitiligo in Nigeria: A participatory Interpretative Phenomenological Analysis.

Vitiligo is a visible depigmenting skin condition, particularly noticeable on Black skin. There is widespread misunderstanding of the condition. Using a participatory form of Interpretative Phenomenological Analysis (IPA), we conducted eight semi-structured interviews with Nigerians living with vitiligo. Participants described their initial attempts to understand the condition, which typically drew on both traditional illness beliefs, religious influences, and the biomedical disease model. All participants reported experiencing marked stigmatization and discrimination. Participants experienced distress associated with thoughts about the personal meaning of the disease including its impact on their appearance and from concerns about anticipated and direct discrimination. Despite the wide-ranging impact, the participants' narratives also contained references to the development of strategies that maintained wellbeing. This study provides valuable insights into the role of faith and traditional beliefs in both the experience and management of vitiligo in Nigeria. These insights can be used to develop individual and community interventions.

Review of modern methods of treating vitiligo

Vitiligo is an autoimmune disease that causes skin depigmentation. The article is a review of the literature with a detailed description of the pathogenesis and the main combinations of therapeutic approaches. The issue of the use of oral and topical janus kinase inhibitors for the treatment of vitiligo was raised.