Skin Depigmentation Research Articles

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.

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.

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.

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

Vitiligo, also known as a 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.

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.

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.

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.

Phenylalanine Butyramide: A Butyrate Derivative as a Novel Inhibitor of Tyrosinase.

Metabolites resulting from the bacterial fermentation of dietary fibers, such as short-chain fatty acids, especially butyrate, play important roles in maintaining gut health and regulating various biological effects in the skin. However, butyrate is underutilized due to its unpleasant odor. To circumvent this organoleptic unfavorable property, phenylalanine butyramide (PBA), a butyrate precursor, has been synthesized and is currently available on the market. We evaluated the inhibition of mushroom tyrosinase by butyrate and PBA through in vitro assays, finding IC50 values of 34.7 mM and 120.3 mM, respectively. Docking calculations using a homology model of human tyrosinase identified a putative binding mode of PBA into the catalytic site. The anti-aging and anti-spot efficacy of topical PBA was evaluated in a randomized, double-blind, parallel-arm, placebo-controlled clinical trial involving 43 women affected by photo-damage. The results of this study showed that PBA significantly improved skin conditions compared to the placebo and was well tolerated. Specifically, PBA demonstrated strong skin depigmenting activity on both UV and brown spots (UV: -12.7% and -9.9%, Bs: -20.8% and -17.7% after 15 and 30 days, respectively, p < 0.001). Moreover, PBA brightened and lightened the skin (ITA°: +12% and 13% after 15 and 30 days, respectively, p < 0.001). Finally, PBA significantly improved skin elasticity (Ua/Uf: +12.4% and +32.3% after 15 and 30 days, respectively, p < 0.001) and firmness (Uf: -3.2% and -14.9% after 15 and 30 days, respectively, p < 0.01).

Do users of skin-lightening products recognize their consequences? A socio-anthropological study on awareness of skin depigmentation consequences among female users in Burkina Faso

Skin depigmentation’s sociocultural and health impacts are widely studied. This socio-anthropological study in Bobo-Dioulasso, Burkina Faso, involving 46 women, explores their awareness of both positive and negative effects of skin-lightening products. Ethical standards guided the research, which included a literature review and in-depth interviews. Users recognize benefits like improved self-esteem and social status, alongside health risks like skin diseases and sun sensitivity. The decision to use these products reflects a thoughtful balance of personal, social, and economic benefits against potential health risks, indicating a nuanced understanding of skin depigmentation’s impacts.

Non-coding RNA NEAT-1 and interleukin-6 as diagnostic indicators for vitiligo

Vitiligo belongs to chronic autoimmune diseases and results in a loss of functioning melanocytes and skin depigmentation. Nuclear enriched abundant transcript 1 (NEAT-1) is a long non-coding RNA that has a vital role in the diagnostics and treatment of certain autoimmune and inflammatory diseases. It is suggested that NEAT-1 can increase the pro-inflammatory cytokine level via regulatory network. The aim of the work was to measure the serum level of NEAT-1 and IL-6 in vitiligo patients compared with healthy controls and to estimate its relation to disease activity. In the study, 60 individuals were enrolled subdivided into 40 vitiligo patients and 20 healthy controls of similar age and gender. NEAT-1 expression was detected by Quantitative real-time PCR, and IL-6 level was measured by ELISA. To assess the severity of the disease Vitiligo area scoring index (VASI) was calculated. Results showed that there was a significant increase in both NEAT-1 and IL-6 levels in vitiligo patients compared with the control group. A positive correlation between NEAT-1 and IL-6 levels­ and a negative correlation between NEAT-1 level and VASI score was revealed. The elevated serum levels­ of NEAT-1 and IL-6 suggest that these circulating biomarkers have promise as diagnostic indicators for vitiligo and possible targets for therapeutic interventions. Keywords: IL-6, NEAT-1, non-coding RNA, serum, vitiligo

Wall-following - Phylogenetic context of an enhanced behaviour in stygomorphic Sinocyclocheilus (Cypriniformes: Cyprinidae) cavefishes.

With 75 known species, the freshwater fish genus Sinocyclocheilus is the largest cavefish radiation in the world and shows multiple adaptations for cave-dwelling (stygomorphic adaptations), which include a range of traits such as eye degeneration (normal-eyed, micro-eyed and eyeless), depigmentation of skin, and in some species, the presence of "horns". Their behavioural adaptations to subterranean environments, however, are poorly understood. Wall-following (WF) behaviour, where an organism remains in close contact with the boundary demarcating its habitat when in the dark, is a peculiar behaviour observed in a wide range of animals and is enhanced in cave dwellers. Hence, we hypothesise that wall-following is also present in Sinocyclocheilus, possibly enhanced in eyeless species compared to eye bearing (normal-/micro-eyed species). Using 13 species representative of Sinocyclocheilus radiation and eye morphs, we designed a series of assays, based on pre-existing methods for Astyanax mexicanus behavioural experiments, to examine wall-following behaviour under three conditions. Our results indicate that eyeless species exhibit significantly enhanced intensities of WF compared to normal-eyed species, with micro-eyed forms demonstrating intermediate intensities in the WF distance. Using a mtDNA based dated phylogeny (chronogram with four clades A-D), we traced the degree of WF of these forms to outline common patterns. We show that the intensity of WF behaviour is higher in the subterranean clades compared to clades dominated by normal-eyed free-living species. We also found that eyeless species are highly sensitive to vibrations, whereas normal-eyed species are the least sensitive. Since WF behaviour is presented to some degree in all Sinocyclocheilus species, and given that these fishes evolved in the late Miocene, we identify this behaviour as being ancestral with WF enhancement related to cave occupation. Results from this diversification-scale study of cavefish behaviour suggest that enhanced wall-following behaviour may be a convergent trait across all stygomorphic lineages.