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Genetic predisposition and increased vulnerability of melanocytes towards stressors lead to a melanocyte\u2010specific CD8<jats:sup>+<\/jats:sup> T cell\u2010driven immune response with a \u03b3\u2010interferon signature. Vitiligo may lead to significant impairment of life quality. Importantly, vitiligo can be associated with somatic and psychological disorders. Early recognition, correct classification, precise assessment of disease extent and activity, burden of disease and presence of comorbidities is crucial for a holistic therapeutic management. Shared decision making with the patient should define treatment goals including halting disease progression, induction of repigmentation, prevention of relapses, and in rare cases depigmentatation of residual normal skin. Topical treatments in addition to corticosteroids and calcineurin inhibitors now include the Janus kinase inhibitor ruxolitinib cream, as a first\u2010line therapy officially approved for children from 12\u00a0years on and adults with NSV and facial involvement. Targeted phototherapies, in combination with topical corticosteroids or calcineurin inhibitors, are used for limited NSV or SV. For extensive NSV, whole\u2010body UVB\u2010NB phototherapy remains a cornerstone treatment and may be combined with oral corticosteroid mini\u2010pulses in rapidly progressive cases. Among emerging therapeutic options for NSV, oral Janus kinase inhibitors are the most advanced in clinical development.<\/jats:p>","DOI":"10.1111\/ddg.15706","type":"journal-article","created":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T15:22:31Z","timestamp":1754925751000},"page":"968-987","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Vitiligo"],"prefix":"10.1111","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7338-7734","authenticated-orcid":false,"given":"Markus","family":"B\u00f6hm","sequence":"first","affiliation":[{"name":"Department of Dermatology University Hospital M\u00fcnster  M\u00fcnster Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian","family":"Tanew","sequence":"additional","affiliation":[{"name":"Private Office  Vienna 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