{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T02:46:59Z","timestamp":1791946019907,"version":"4.3.4"},"reference-count":119,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p>Vitiligo is a chronic autoimmune disorder characterized by selective melanocyte loss and progressive depigmentation. Narrowband ultraviolet B (NB-UVB) and excimer-based phototherapy are widely regarded as standard treatments in clinical practice and remain the most effective approaches for inducing repigmentation. However, excessive or uncontrolled ultraviolet radiation (UVR) exposure can impair skin barrier function, cause melanocyte dysfunction, and increase the risk of photoaging and carcinogenesis. This apparent paradox arises from the bidirectional biological effects of UVR: on the one hand, UVR activates melanocytes and promotes skin pigmentation through coordinated effects on melanocyte maturation, proliferation, and melanin synthesis, while on the other hand, UVR can induce oxidative stress, DNA damage, apoptosis, and genomic instability. Therefore, combination strategies incorporating JAK inhibitors, platelet-rich plasma, or cellular grafting techniques have been increasingly explored in clinical practice. In this review, we provide an integrated perspective on the dual effects of UVR on melanocyte biology, discuss emerging combination therapies for vitiligo, and highlight the mechanistic links between phototherapy, melanocyte homeostasis, and melanoma risk.<\/jats:p>","DOI":"10.3389\/fmed.2026.1823921","type":"journal-article","created":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T04:18:13Z","timestamp":1780287493000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Ultraviolet radiation as a double-edged regulator of melanocyte function in vitiligo therapy and melanoma carcinogenesis"],"prefix":"10.3389","volume":"13","author":[{"given":"Heng-Heng","family":"Fan","sequence":"first","affiliation":[{"name":"Department of Dermatology, Institute of Regenerative Medicine, Affiliated Hospital of Jiangsu University, Jiangsu University","place":["Zhenjiang, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan-Yan","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Institute of Regenerative Medicine, Affiliated Hospital of Jiangsu University, Jiangsu University","place":["Zhenjiang, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun","family":"Geng","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Institute of Regenerative Medicine, Affiliated Hospital of Jiangsu University, Jiangsu University","place":["Zhenjiang, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi-Fei","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Institute of Regenerative Medicine, Affiliated Hospital of Jiangsu University, Jiangsu University","place":["Zhenjiang, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Institute of Regenerative Medicine, Affiliated Hospital of Jiangsu University, Jiangsu University","place":["Zhenjiang, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-Yun","family":"Xiong","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Institute of Regenerative Medicine, Affiliated Hospital of Jiangsu University, Jiangsu University","place":["Zhenjiang, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun-Wen","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Institute of Regenerative Medicine, Affiliated Hospital of Jiangsu University, Jiangsu University","place":["Zhenjiang, Jiangsu, China"]},{"name":"Guangdong Provincial Key Laboratory of Large Animal Models for Biomedicine, South China Institute of Large Animal Models for Biomedicine, Wuyi University","place":["Jiangmen, Guangdong, China"]},{"name":"School of Pharmacy and Food Engineering, Wuyi University","place":["Jiangmen, Guangdong, China"]},{"name":"Department of Medical and Life Sciences, Faculty of Pharmaceutical Sciences, Tokyo University of Science","place":["Chiba, Japan"]},{"name":"Center for Stem Cell Biology and Regenerative Medicine, Institute of Medical Science, The University of Tokyo","place":["Tokyo, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-Mei","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Institute of Regenerative Medicine, Affiliated Hospital of Jiangsu University, Jiangsu University","place":["Zhenjiang, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,1]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"8230646","DOI":"10.1155\/2022\/8230646","article-title":"UVB-induced secretion of IL-1 \u03b2 promotes melanogenesis by upregulating TYR\/TRP-1 expression in vitro","volume":"2022","author":"Yang","year":"2022","journal-title":"Biomed Res Int"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"695","DOI":"10.1016\/s0955-0674(99)00038-1","article-title":"Induction and differentiation of the neural crest","volume":"11","author":"Garc\u00eda-Castro","year":"1999","journal-title":"Curr Opin Cell Biol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"440","DOI":"10.1118\/1.4903963","article-title":"Ultraviolet radiation therapy and UVR dose models","volume":"42","author":"Grimes","year":"2015","journal-title":"Med Phys"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"359","DOI":"10.1016\/s0076-6879(00)19035-4","article-title":"Photocarcinogenesis: UVA vs UVB","volume":"319","author":"De Gruijl","year":"2000","journal-title":"Methods Enzymol"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"537","DOI":"10.1007\/s12551-025-01275-0","article-title":"Impact of ecological UV radiation on the photochemistry of nuclear DNA","volume":"17","author":"S\u00e1nchez","year":"2025","journal-title":"Biophys Rev"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"2704","DOI":"10.1007\/s10753-024-02221-0","article-title":"UVB induces sympathetic nervous system activation and norepinephrine secretion to regulate the skin color of mice through the \u03b22-AR\/AP-1 pathway in epidermal keratinocytes","volume":"48","author":"Deng","year":"2025","journal-title":"Inflammation"},{"key":"ref7","first-page":"111322","volume-title":"A New Model to Investigate UVB-Induced Cellular Senescence and Pigmentation in MelanocytesMech Ageing Dev.","author":"Martic","year":"2020"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1089\/ast.2015.1359","article-title":"Influence of the UV environment on the synthesis of prebiotic molecules","volume":"16","author":"Ranjan","year":"2016","journal-title":"Astrobiology"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"eaar3302","DOI":"10.1126\/sciadv.aar3302","article-title":"The origin of RNA precursors on exoplanets","volume":"4","author":"Rimmer","year":"2018","journal-title":"Sci Adv"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"113329","DOI":"10.1016\/j.jphotobiol.2025.113329","article-title":"UVB enhances SLC6A15-mediated phenylalanine transport to promote melanogenesis","volume":"274","author":"Zhou","year":"2026","journal-title":"J Photochem Photobiol B Biol"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"e3002776","DOI":"10.1371\/journal.pbio.3002776","article-title":"Distinct melanocyte subpopulations defined by stochastic expression of proliferation or maturation programs enable a rapid and sustainable pigmentation response","volume":"22","author":"Aggarwal","year":"2024","journal-title":"PLoS Biol"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"165","DOI":"10.1111\/exd.14693","article-title":"TRPA1 promotes UVB-induced skin pigmentation by regulating melanosome luminal pH","volume":"32","author":"Wu","year":"2023","journal-title":"Exp Dermatol"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"920","DOI":"10.1046\/j.0022-202x.2001.01370.x","article-title":"Kit+ melanocytes seem to contribute to melanocyte proliferation after UV exposure as precursor cells","volume":"116","author":"Kawaguchi","year":"2001","journal-title":"J Invest Dermatol"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"429","DOI":"10.2147\/CCID.S396272","article-title":"New mechanistic insights of melasma","volume":"16","author":"Liu","year":"2023","journal-title":"Clin Cosmet Investig Dermatol"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"3095","DOI":"10.3390\/ijms25063095","article-title":"Comprehensive analysis of Exosomal MicroRNAs derived from UVB-irradiated keratinocytes as potential melanogenesis regulators","volume":"25","author":"Yoon","year":"2024","journal-title":"Int J Mol Sci"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"355","DOI":"10.1007\/s00403-025-03841-8","article-title":"Exosomal miR-365b-5p derived from keratinocyte promotes melanogenesis by directly targeting GLI2","volume":"317","author":"Zhao","year":"2024","journal-title":"Arch Dermatol Res"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"9440","DOI":"10.1038\/s41598-024-60165-9","article-title":"Ribosomal S6 kinase 2-forkhead box protein O4 signaling pathway plays an essential role in melanogenesis","volume":"14","author":"Jeung","year":"2024","journal-title":"Sci Rep"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"5506","DOI":"10.3390\/ijms24065506","article-title":"Radiofrequency irradiation attenuated UVB-induced skin pigmentation by modulating ATP release and CD39 expression","volume":"24","author":"Byun","year":"2023","journal-title":"Int J Mol Sci"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"112702","DOI":"10.1016\/j.jphotobiol.2023.112702","article-title":"Melanopsin (OPN4) is a novel player in skin homeostasis and attenuates UVA-induced effects","volume":"242","author":"Sua-Cespedes","year":"2023","journal-title":"J Photochem Photobiol B Biol"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"2003","DOI":"10.1007\/s00403-023-02585-7","article-title":"Altered levels of lymphocyte enhancer-binding factor-1 modulates the pigmentation in acral and non-acral lesions of non-segmental vitiligo patients: a follow-up-9999999based study in North India","volume":"315","author":"Nayak","year":"2023","journal-title":"Arch Dermatol Res"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"1835","DOI":"10.1016\/j.freeradbiomed.2012.02.040","article-title":"Microphthalmia-associated transcription factor modulates expression of NADPH oxidase type 4: a negative regulator of melanogenesis","volume":"52","author":"Liu","year":"2012","journal-title":"Free Radic Biol Med"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"760","DOI":"10.1111\/j.1600-0625.2009.00892.x","article-title":"Neuroendocrine activity of the melanocyte","volume":"18","author":"Slominski","year":"2009","journal-title":"Exp Dermatol"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"1155","DOI":"10.1152\/physrev.00044.2003","article-title":"Melanin pigmentation in mammalian skin and its hormonal regulation","volume":"84","author":"Slominski","year":"2004","journal-title":"Physiol Rev"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"188","DOI":"10.1111\/php.12335","article-title":"MC 1R, eumelanin and pheomelanin: their role in determining the susceptibility to skin Cancer","volume":"91","author":"Nasti","year":"2015","journal-title":"Photochem Photobiol"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"293","DOI":"10.1016\/j.jid.2021.06.018","article-title":"MC1R functions, expression, and implications for targeted therapy","volume":"142","author":"Guida","year":"2022","journal-title":"J Invest Dermatol"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1016\/j.jphotobiol.2020.112024","article-title":"The regulation of skin pigmentation in response to environmental light by pineal type II opsins and skin melanophore melatonin receptors","volume":"212","author":"Bertolesi","year":"2020","journal-title":"J Photochem Photobiol B Biol"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"118789","DOI":"10.1016\/j.bbamcr.2020.118789","article-title":"Melanopsin mediates UVA-dependent modulation of proliferation, pigmentation, apoptosis, and molecular clock in normal and malignant melanocytes","volume":"1867","author":"De Assis","year":"2020","journal-title":"Biochim Biophys Acta (BBA) - Mol Cell Res"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"185","DOI":"10.3389\/fonc.2018.00185","article-title":"Expression of the circadian clock gene BMAL1 positively correlates with antitumor immunity and patient survival in metastatic melanoma","volume":"8","author":"De Assis","year":"2018","journal-title":"Front Oncol"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"632","DOI":"10.1007\/s00403-024-03363-9","article-title":"The influence of phototherapy on circadian melatonin and sleep regulation and potential benefits of these pathways in the management of vitiligo: a narrative review: vitiligo, phototherapy, sleep and melatonin","volume":"316","author":"Xerfan","year":"2024","journal-title":"Arch Dermatol Res"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1210\/endrev\/bnae034","article-title":"Endocrine controls of skin aging","volume":"46","author":"B\u00f6hm","year":"2025","journal-title":"Endocr Rev"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1126\/science.adj9687","article-title":"Direct photoreception by pituitary endocrine cells regulates hormone release and pigmentation","volume":"387","author":"Fukuda","year":"2025","journal-title":"Science"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"146","DOI":"10.3389\/fgene.2016.00146","article-title":"Significance of the melanocortin 1 and endothelin B receptors in melanocyte homeostasis and prevention of Sun-induced genotoxicity","volume":"7","author":"Swope","year":"2016","journal-title":"Front Genet"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"2221","DOI":"10.1038\/jid.2014.152","article-title":"67 Clinical Strategies and Research Advances in Phototherapy for Vitiligo","volume":"134","author":"Jian","year":"2014","journal-title":"J Invest Dermatol"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"1992","DOI":"10.1210\/en.2017-03230","article-title":"How UV light touches the brain and endocrine system through skin, and why","volume":"159","author":"Slominski","year":"2018","journal-title":"Endocrinology"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"933","DOI":"10.1038\/s41598-023-51058-4","article-title":"Biomarkers of UVB radiation-related senescent fibroblasts","volume":"14","author":"Qiang","year":"2024","journal-title":"Sci Rep"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"1195272","DOI":"10.3389\/fphys.2023.1195272","article-title":"Skin aging from mechanisms to interventions: focusing on dermal aging","volume":"14","author":"Shin","year":"2023","journal-title":"Front Physiol"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1016\/S1011-1344(01)00201-9","article-title":"Solar UV irradiation and dermal photoaging","volume":"63","author":"Wlaschek","year":"2001","journal-title":"J Photochem Photobiol B Biol"},{"key":"ref38","first-page":"5952","article-title":"N-acetylcysteine protects melanocytes against oxidative stress\/damage and delays onset of UV-induced melanoma in mice","author":"Cotter","year":"2008"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1080\/713803463","article-title":"The broad spectrum of responses to oxidants in proliferating cells: a new paradigm for oxidative stress","volume":"48","author":"Davies","year":"1999","journal-title":"IUBMB Life"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"6655","DOI":"10.3390\/ijms23126655","article-title":"Molecular mechanisms of changes in homeostasis of the dermal extracellular matrix: both involutional and mediated by ultraviolet radiation","volume":"23","author":"Zorina","year":"2022","journal-title":"Int J Mol Sci"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"13149","DOI":"10.2147\/IJN.S470225","article-title":"Regenerative potential nanomedicine of adipocyte stem cell-derived exosomes in senescent skin tissue","volume":"19","author":"Li","year":"2024","journal-title":"Int J Nanomedicine"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"317","DOI":"10.1111\/j.1751-1097.2007.00257.x","article-title":"Topical treatment with OGG1 enzyme affects UVB-induced skin carcinogenesis\u2020","volume":"84","author":"Wulff","year":"2008","journal-title":"Photochem Photobiol"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"1659","DOI":"10.1093\/carcin\/16.7.1659","article-title":"DNA damage in UVB-irradiated keratinocytes","volume":"16","author":"Maccubbin","year":"1995","journal-title":"Carcinogenesis"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2012\/329635","article-title":"Mitochondria-Ros crosstalk in the control of cell death and aging","volume":"2012","author":"Marchi","year":"2012","journal-title":"J Signal Transduct"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"861","DOI":"10.3390\/metabo13070861","article-title":"Ultraviolet radiation-induced mitochondrial disturbances are attenuated by metabolites of melatonin in human epidermal keratinocytes","volume":"13","author":"Holtkamp","year":"2023","journal-title":"Meta"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"e12993","DOI":"10.1111\/phpp.12993","article-title":"KGF -2 ameliorates UVB -triggered skin photodamage in mice by attenuating DNA damage and inflammatory response and mitochondrial dysfunction","volume":"40","author":"Li","year":"2024","journal-title":"Photodermatol Photoimmunol Photomed"},{"key":"ref47","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1080\/15287394.2024.2387041","article-title":"Penilumamide, a novel SIRT1 activator, protects UVB-induced photodamages in HaCaT cells","volume":"88","author":"Park","year":"2025","journal-title":"J Toxic Environ Health A"},{"key":"ref48","doi-asserted-by":"publisher","first-page":"1119","DOI":"10.1016\/j.jid.2020.09.031","article-title":"Cellular senescence and the senescence-associated secretory phenotype as drivers of skin photoaging","volume":"141","author":"Fitsiou","year":"2021","journal-title":"J Invest Dermatol"},{"key":"ref49","doi-asserted-by":"publisher","first-page":"2221","DOI":"10.1038\/jid.2014.152","article-title":"Impaired activation of the Nrf2-ARE signaling pathway undermines H2O2-induced oxidative stress response: a possible mechanism for melanocyte degeneration in vitiligo","volume":"134","author":"Jian","year":"2014","journal-title":"J Invest Dermatol"},{"key":"ref50","doi-asserted-by":"publisher","first-page":"1","DOI":"10.5114\/wo.2021.112447","article-title":"Oxidative stress in melanogenesis and melanoma development","volume":"26","author":"Kami\u0144ski","year":"2022","journal-title":"Wsp\u00f3\u0142czesna Onkologia"},{"key":"ref51","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1016\/j.jdermsci.2015.09.003","article-title":"Vitiligo: how do oxidative stress-induced autoantigens trigger autoimmunity?","volume":"81","author":"Xie","year":"2016","journal-title":"J Dermatol Sci"},{"key":"ref52","doi-asserted-by":"publisher","first-page":"1121","DOI":"10.3390\/antiox11061121","article-title":"Focus on the contribution of oxidative stress in skin aging","volume":"11","author":"Papaccio","year":"2022","journal-title":"Antioxidants Basel"},{"key":"ref53","doi-asserted-by":"publisher","first-page":"936","DOI":"10.3390\/cells12060936","article-title":"The role of oxidative stress in vitiligo: an update on its pathogenesis and therapeutic implications","volume":"12","author":"Chang","year":"2023","journal-title":"Cells"},{"key":"ref54","doi-asserted-by":"publisher","first-page":"1138","DOI":"10.1002\/med.21754","article-title":"Mechanisms of melanocyte death in vitiligo","volume":"41","author":"Chen","year":"2021","journal-title":"Med Res Rev"},{"key":"ref55","doi-asserted-by":"publisher","first-page":"621","DOI":"10.1146\/annurev-immunol-100919-023531","article-title":"Vitiligo: mechanisms of pathogenesis and treatment","volume":"38","author":"Frisoli","year":"2020","journal-title":"Annu Rev Immunol"},{"key":"ref56","doi-asserted-by":"publisher","first-page":"4952","DOI":"10.5826\/dpc.1502a4952","article-title":"Melanoma on chronically Sun-damaged skin: deciphering gene expression signatures","volume":"15","author":"Avila","year":"2025","journal-title":"Dermatol Pract Concept"},{"key":"ref57","doi-asserted-by":"publisher","first-page":"104","DOI":"10.1186\/s12885-025-13481-w","article-title":"Dual role of cathepsin S in cutaneous melanoma: insights from mendelian randomization and bioinformatics analysis","volume":"25","author":"Zhou","year":"2025","journal-title":"BMC Cancer"},{"key":"ref58","doi-asserted-by":"publisher","first-page":"1089","DOI":"10.1016\/j.jid.2025.09.011","article-title":"Melanin-driven delayed CPD formation is independent of melanin biosynthesis pathway","volume":"146","author":"Yadav","year":"2026","journal-title":"J Invest Dermatol"},{"key":"ref59","doi-asserted-by":"publisher","first-page":"842","DOI":"10.1126\/science.1256022","article-title":"Chemiexcitation of melanin derivatives induces DNA photoproducts long after UV exposure","volume":"347","author":"Premi","year":"2015","journal-title":"Science"},{"key":"ref60","doi-asserted-by":"publisher","first-page":"1132","DOI":"10.1111\/bjd.19666","article-title":"The long noncoding RNA MALAT1 suppresses miR-211 to confer protection from ultraviolet-mediated DNA damage in vitiligo epidermis by upregulating sirtuin 1","volume":"184","author":"Brahmbhatt","year":"2021","journal-title":"Br J Dermatol"},{"key":"ref61","doi-asserted-by":"publisher","first-page":"5775","DOI":"10.3390\/ijms25115775","article-title":"Ex vivo analysis of cell differentiation, oxidative stress, inflammation, and DNA damage on cutaneous field cancerization","volume":"25","author":"Camillo","year":"2024","journal-title":"Int J Mol Sci"},{"key":"ref62","doi-asserted-by":"publisher","first-page":"522","DOI":"10.1074\/jbc.M115.685883","article-title":"Mutations in replicative stress response pathways are associated with S phase-specific defects in nucleotide excision repair","volume":"291","author":"B\u00e9langer","year":"2016","journal-title":"J Biol Chem"},{"key":"ref63","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1111\/pcmr.12443","article-title":"FK 506 regulates pigmentation by maturing the melanosome and facilitating their transfer to keratinocytes","volume":"29","author":"Jung","year":"2016","journal-title":"Pigment Cell Melanoma Res"},{"key":"ref64","doi-asserted-by":"publisher","first-page":"173","DOI":"10.1111\/j.1365-2230.2009.03311.x","article-title":"Topical tacrolimus has a limited direct effect on ultraviolet B-irradiated keratinocytes: implications for its photocarcinogenic potential","volume":"35","author":"Lan","year":"2010","journal-title":"Clin Exp Dermatol"},{"key":"ref65","doi-asserted-by":"publisher","first-page":"1306","DOI":"10.3390\/ph17101306","article-title":"Protective effects of sesame glycoproteins on ultraviolet-induced skin aging: in vitro and in vivo studies","volume":"17","author":"Baik","year":"2024","journal-title":"Pharmaceuticals"},{"key":"ref66","doi-asserted-by":"publisher","first-page":"318","DOI":"10.1111\/bjd.20662","article-title":"Autophagy induction regulates aquaporin 3-mediated skin fibroblast ageing*","volume":"186","author":"Xie","year":"2022","journal-title":"Br J Dermatol"},{"key":"ref67","doi-asserted-by":"publisher","first-page":"864331","DOI":"10.3389\/fphar.2022.864331","article-title":"Autophagy plays an essential role in ultraviolet radiation-driven skin photoaging","volume":"13","author":"Ma","year":"2022","journal-title":"Front Pharmacol"},{"key":"ref68","doi-asserted-by":"publisher","first-page":"1661","DOI":"10.3390\/cells13191661","article-title":"Protective effects of keratinocyte-derived GCSF and CCL20 on UVB-induced melanocyte damage","volume":"13","author":"Jeayeng","year":"2024","journal-title":"Cells"},{"key":"ref69","doi-asserted-by":"publisher","first-page":"111268","DOI":"10.1016\/j.cbi.2024.111268","article-title":"The assessment of the phototoxic potential of drugs forming complexes with melanin - screening in vitro studies using normal skin cells with varying pigmentation irradiated by a sunlight simulator","volume":"404","author":"Rok","year":"2024","journal-title":"Chem Biol Interact"},{"key":"ref70","doi-asserted-by":"publisher","first-page":"107784","DOI":"10.1016\/j.pharmthera.2020.107784","article-title":"A deep dive into UV-based phototherapy: mechanisms of action and emerging molecular targets in inflammation and cancer","volume":"222","author":"Vieyra-Garcia","year":"2021","journal-title":"Pharmacol Ther"},{"key":"ref71","doi-asserted-by":"publisher","first-page":"111615","DOI":"10.1016\/j.yexcr.2019.111615","article-title":"miR-9 regulates melanocytes adhesion and migration during vitiligo repigmentation induced by UVB treatment","volume":"384","author":"Su","year":"2019","journal-title":"Exp Cell Res"},{"key":"ref72","doi-asserted-by":"publisher","first-page":"e2016963118","DOI":"10.1073\/pnas.2016963118","article-title":"Chronic UV radiation\u2013induced ROR\u03b3t+ IL-22\u2013producing lymphoid cells are associated with mutant KC clonal expansion","volume":"118","author":"Lewis","year":"2021","journal-title":"Proc Natl Acad Sci"},{"key":"ref73","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1016\/j.jaci.2023.12.021","article-title":"Solar urticaria involves rapid mast cell STAT3 activation and neutrophil recruitment, with Fc\u03b5R1 as an upstream regulator","volume":"153","author":"Rutter","year":"2024","journal-title":"J Allergy Clin Immunol"},{"key":"ref74","doi-asserted-by":"publisher","first-page":"2858","DOI":"10.1002\/eji.1830251022","article-title":"Low-dose UVB radiation perturbs the functional expression of B7.1 and B7.2 co-stimulatory molecules on human Langerhans cells","volume":"25","author":"Weiss","year":"1995","journal-title":"Eur J Immunol"},{"key":"ref75","doi-asserted-by":"publisher","first-page":"e13209","DOI":"10.1111\/pcmr.13209","article-title":"Low-dose baricitinib plus narrow-band ultraviolet B for the treatment of progressive non-segmental vitiligo: a prospective, controlled, open-label study","volume":"38","author":"Hu","year":"2025","journal-title":"Pigment Cell Melanoma Res"},{"key":"ref76","doi-asserted-by":"publisher","first-page":"356","DOI":"10.1080\/16878507.2020.1742443","article-title":"Narrow band ultraviolet B therapy deactivates Th1\/Th17 pathway and activates Th2 cytokines secretion in Egyptian psoriatic arthritis patients","volume":"13","author":"Farid","year":"2020","journal-title":"J Radiat Res Appl Sci"},{"key":"ref77","doi-asserted-by":"publisher","first-page":"1532","DOI":"10.1016\/j.jaci.2011.01.068","article-title":"Vitamin D3 targets epidermal and dermal dendritic cells for induction of distinct regulatory T cells","volume":"127","author":"Van Der Aar","year":"2011","journal-title":"J Allergy Clin Immunol"},{"key":"ref78","doi-asserted-by":"publisher","first-page":"310","DOI":"10.1093\/toxsci\/kfx215","article-title":"TCDD, FICZ, and other high affinity AhR ligands dose-dependently determine the fate of CD4+ T cell differentiation","volume":"161","author":"Ehrlich","year":"2018","journal-title":"Toxicol Sci"},{"key":"ref79","doi-asserted-by":"publisher","first-page":"171","DOI":"10.1084\/jem.20011450","article-title":"Platelet-activating factor, a molecular sensor for cellular damage, activates systemic immune suppression","volume":"195","author":"Walterscheid","year":"2002","journal-title":"J Exp Med"},{"key":"ref80","doi-asserted-by":"publisher","first-page":"333","DOI":"10.5021\/ad.23.065","article-title":"Understanding of Pathomechanisms and clinical practice for vitiligo","volume":"35","author":"Tanemura","year":"2023","journal-title":"Ann Dermatol"},{"key":"ref81","doi-asserted-by":"publisher","first-page":"e3002940","DOI":"10.1371\/journal.pbio.3002940","article-title":"Melanocortin 1 receptor mediates melanin production by interacting with the BBSome in primary cilia","volume":"22","author":"Tian","year":"2024","journal-title":"PLoS Biol"},{"key":"ref82","doi-asserted-by":"publisher","first-page":"303","DOI":"10.1016\/j.jdermsci.2018.02.016","article-title":"Exposure of human melanocytes to UVB twice and subsequent incubation leads to cellular senescence and senescence-associated pigmentation through the prolonged p53 expression","volume":"90","author":"Choi","year":"2018","journal-title":"J Dermatol Sci"},{"key":"ref83","doi-asserted-by":"publisher","first-page":"754","DOI":"10.1111\/exd.13555","article-title":"4-(4-hydroxyphenyl)-2-butanol (rhododendrol)-induced melanocyte cytotoxicity is enhanced by UVB exposure through generation of oxidative stress","volume":"27","author":"Goto","year":"2018","journal-title":"Exp Dermatol"},{"key":"ref84","doi-asserted-by":"publisher","first-page":"1110","DOI":"10.1002\/ijc.35463","article-title":"Global burden of cutaneous melanoma incidence attributable to ultraviolet radiation in 2022","volume":"157","author":"Langselius","year":"2025","journal-title":"Int J Cancer"},{"key":"ref85","doi-asserted-by":"publisher","first-page":"1728","DOI":"10.1016\/j.jid.2024.08.042","article-title":"Analysis of variants induced by combined ex vivo irradiation and in vivo tumorigenesis suggests a role for the ZNF831 p.R1393Q mutation in cutaneous melanoma development","volume":"145","author":"Usoltsev","year":"2024","journal-title":"J Invest Dermatol"},{"key":"ref86","doi-asserted-by":"publisher","first-page":"4111","DOI":"10.1073\/pnas.0511248103","article-title":"UV causation of melanoma in xiphophorus is dominated by melanin photosensitized oxidant production","volume":"103","author":"Wood","year":"2006","journal-title":"Proc Natl Acad Sci"},{"key":"ref87","first-page":"6724","article-title":"Ink4a\/arf deficiency promotes ultraviolet radiation-induced melanomagenesis","volume":"62","author":"Recio","year":"2002","journal-title":"Cancer Res"},{"key":"ref88","doi-asserted-by":"publisher","first-page":"172","DOI":"10.1016\/j.biocel.2010.09.004","article-title":"The International journal of biochemistry and cell biology. Preface","volume":"43","author":"Yeoh","year":"2011","journal-title":"Int J Biochem Cell Biol"},{"key":"ref89","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1111\/j.1600-0781.2011.00631.x","article-title":"Effect of PUVA therapy on melanocytes and keratinocytes in non-segmental vitiligo: histopathological, immuno-histochemical and ultrastructural study: PUVA effect on melanocytes and keratinocytes","volume":"28","author":"Anbar","year":"2012","journal-title":"Photodermatol Photoimmunol Photomed"},{"key":"ref90","doi-asserted-by":"publisher","first-page":"e19182","DOI":"10.7759\/cureus.19182","article-title":"An update on narrowband ultraviolet B therapy for the treatment of skin diseases","volume":"13","author":"Myers","year":"2021","journal-title":"Cureus"},{"key":"ref91","doi-asserted-by":"publisher","first-page":"468","DOI":"10.1111\/j.1365-2133.2012.11008.x","article-title":"A review of monochromatic excimer light in vitiligo: a review of monochromatic excimer light in vitiligo","volume":"167","author":"Park","year":"2012","journal-title":"Br J Dermatol"},{"key":"ref92","doi-asserted-by":"publisher","first-page":"e12944","DOI":"10.1111\/phpp.12944","article-title":"A triple combination of latanoprost, fractional CO2 laser, and platelet-rich plasma in localized vitiligo: a clinical and histopathologic study","volume":"40","author":"Omar","year":"2024","journal-title":"Photodermatol Photoimmunol Photomed"},{"key":"ref93","doi-asserted-by":"publisher","first-page":"1479","DOI":"10.1007\/s10103-020-03195-9","article-title":"Fractional CO2 laser, platelet rich plasma and narrow band ultraviolet B in the treatment of vitiligo (a randomized clinical trial)","volume":"36","author":"Afify","year":"2021","journal-title":"Lasers Med Sci"},{"key":"ref94","doi-asserted-by":"publisher","first-page":"e16715","DOI":"10.1111\/jocd.16715","article-title":"Assessment of efficacy on the treatment of localized vitiligo with a combination of 308 nm excimer light and 2940 erbium laser: a retrospective study","volume":"24","author":"Xie","year":"2025","journal-title":"J Cosmet Dermatol"},{"key":"ref95","doi-asserted-by":"publisher","first-page":"1120","DOI":"10.1097\/DSS.0000000000004320","article-title":"Impact of combined phototherapy and melanocyte transplantation on indicators of vitiligo activity","volume":"50","author":"Wang","year":"2024","journal-title":"Dermatologic Surg"},{"key":"ref96","doi-asserted-by":"publisher","first-page":"2606558","DOI":"10.1080\/07853890.2025.2606558","article-title":"Efficacy of janus kinase inhibitor combined with phototherapy in non-segmental vitiligo: systematic review and meta-analysis","volume":"58","author":"Shuaib","year":"2026","journal-title":"Ann Med"},{"key":"ref97","doi-asserted-by":"publisher","first-page":"567","DOI":"10.1080\/09546634.2025.2479567","article-title":"The efficacy of narrowband ultraviolet B phototherapy combination with tofacitinib in the treatment of vitiligo: a randomized controlled trial","volume":"36","author":"Guo","year":"2025","journal-title":"J Dermatolog Treat"},{"key":"ref98","doi-asserted-by":"publisher","first-page":"375","DOI":"10.1001\/jamadermatol.2024.5737","article-title":"Combination of baricitinib and phototherapy in adults with active vitiligo: a randomized clinical trial","volume":"161","author":"Seneschal","year":"2025","journal-title":"JAMA Dermatol"},{"key":"ref99","doi-asserted-by":"publisher","first-page":"2753","DOI":"10.1038\/jid.2013.235","article-title":"Wnt\/\u03b2-catenin and kit Signaling sequentially regulate melanocyte stem cell differentiation in UVB-induced epidermal pigmentation","volume":"133","author":"Yamada","year":"2013","journal-title":"J Invest Dermatol"},{"key":"ref100","doi-asserted-by":"publisher","first-page":"11651","DOI":"10.3390\/ijms252111651","article-title":"Current insights into the role of UV radiation-induced oxidative stress in melanoma pathogenesis","volume":"25","author":"Gieniusz","year":"2024","journal-title":"Int J Mol Sci"},{"key":"ref101","doi-asserted-by":"publisher","first-page":"103352","DOI":"10.1016\/j.annder.2025.103352","article-title":"Value of tacrolimus 0.1% in the treatment of vitiligo in the era of targeted therapy","volume":"152","author":"Duplaine","year":"2025","journal-title":"Ann Dermatol Venereol"},{"key":"ref102","doi-asserted-by":"publisher","first-page":"e70245","DOI":"10.1111\/jocd.70245","article-title":"Efficacy and safety of combined platelet-rich plasma with fractional laser for adult patients with vitiligo: a systematic review and Meta-analysis of randomized controlled trials","volume":"24","author":"Feng","year":"2025","journal-title":"J Cosmet Dermatol"},{"key":"ref103","doi-asserted-by":"publisher","first-page":"321","DOI":"10.25259\/IJDVL_71_2024","article-title":"Clinical efficacy and safety profile of handheld narrow band ultraviolet B device therapy in vitiligo \u2013 systematic review and meta-analysis","volume":"91","author":"Khandpur","year":"2025","journal-title":"Indian J Dermatol Venereol Leprol"},{"key":"ref104","doi-asserted-by":"publisher","first-page":"637","DOI":"10.1177\/12034754251320637","article-title":"Vitiligo: a review of pathogenesis and treatments, including new therapies on the horizon","volume":"29","author":"Retamal","year":"2025","journal-title":"J Cutan Med Surg"},{"key":"ref105","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1093\/bjd\/ljaf074","article-title":"Incidence, stage and outcome of malignant melanoma, keratinocyte and other cancers in individuals with vitiligo or alopecia: intraindividual or familial risks?","volume":"193","author":"Delcoigne","year":"2025","journal-title":"Br J Dermatol"},{"key":"ref106","doi-asserted-by":"publisher","first-page":"jcs261978","DOI":"10.1242\/jcs.261978","article-title":"UVB radiation suppresses dicer expression through \u03b2-catenin","volume":"137","author":"Aktary","year":"2024","journal-title":"J Cell Sci"},{"key":"ref107","doi-asserted-by":"publisher","first-page":"1660","DOI":"10.1016\/j.jid.2023.12.015","article-title":"TNF Signaling deficiency promotes UVB-induced melanocyte stem cell activation and migration","volume":"144","author":"An","year":"2024","journal-title":"J Invest Dermatol"},{"key":"ref108","doi-asserted-by":"publisher","first-page":"2492879","DOI":"10.1080\/09546634.2025.2492879","article-title":"Clinical observation of 10 cases of stable non-segmental vitiligo in adults treated with upadacitinib","volume":"36","author":"Yuan","year":"2025","journal-title":"J Dermatol Treat"},{"key":"ref109","doi-asserted-by":"publisher","first-page":"e12968","DOI":"10.1111\/phpp.12968","article-title":"Phototherapy for vitiligo: a narrative review on the clinical and molecular aspects, and recent literature","volume":"40","author":"Bishnoi","year":"2024","journal-title":"Photodermatol Photoimmunol Photomed"},{"key":"ref110","doi-asserted-by":"publisher","first-page":"2281","DOI":"10.3390\/antiox11112281","article-title":"Post-translational modifications evoked by reactive carbonyl species in ultraviolet-A-exposed skin: implication in fibroblast senescence and skin photoaging","volume":"11","author":"Negre-Salvayre","year":"2022","journal-title":"Antioxidants"},{"key":"ref111","doi-asserted-by":"publisher","first-page":"1529","DOI":"10.2174\/0115665240263196230920161019","article-title":"Tanshinone alleviates UVA-induced melanogenesis in melanocytes via the Nrf2-regulated antioxidant Defense Signaling pathway","volume":"24","author":"Chen","year":"2024","journal-title":"Curr Mol Med"},{"key":"ref112","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1159\/000538832","article-title":"Preventive and therapeutic benefits of natural ingredients in photo-induced epidermal dysfunction","volume":"37","author":"Lei","year":"2024","journal-title":"Skin Pharmacol Physiol"},{"key":"ref113","doi-asserted-by":"publisher","first-page":"257","DOI":"10.1111\/phpp.12536","article-title":"The effects of UVB irradiance on vitiligo phototherapy and UVB-induced photocarcinogenesis","volume":"36","author":"Yang","year":"2020","journal-title":"Photodermatol Photoimmunol Photomed"},{"key":"ref114","doi-asserted-by":"publisher","DOI":"10.1111\/dth.14649","article-title":"Evaluation of the effect of narrow band-ultraviolet B on the expression of tyrosinase, TYRP -1, and TYRP -2 mRNA in vitiligo skin and their correlations with clinical improvement: a retrospective study","volume":"34","author":"Awad","year":"2021","journal-title":"Dermatol Ther"},{"key":"ref115","doi-asserted-by":"publisher","first-page":"317","DOI":"10.1111\/j.1365-4632.2009.04332.x","article-title":"Clinical study of repigmentation patterns with either narrow-band ultraviolet B (NBUVB) or 308 nm excimer laser treatment in Korean vitiligo patients","volume":"49","author":"Yang","year":"2010","journal-title":"Int J Dermatol"},{"key":"ref116","doi-asserted-by":"publisher","first-page":"755","DOI":"10.1111\/j.0906-6705.2004.00221.x","article-title":"Narrow-band ultraviolet-B stimulates proliferation and migration of cultured melanocytes","volume":"13","author":"Wu","year":"2004","journal-title":"Exp Dermatol"},{"key":"ref117","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1111\/j.1365-4632.2004.02329.x","article-title":"Narrow-band UVB for the treatment of vitiligo: an emerging effective and well-tolerated therapy","volume":"44","author":"Kanwar","year":"2005","journal-title":"Int J Dermatol"},{"key":"ref118","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1016\/s1011-1344(02)00280-4","article-title":"Xenon chloride ultraviolet B laser is more effective in treating psoriasis and in inducing T cell apoptosis than narrow-band ultraviolet B","volume":"67","author":"Nov\u00e1k","year":"2002","journal-title":"J Photochem Photobiol B Biol"},{"key":"ref119","doi-asserted-by":"publisher","first-page":"407","DOI":"10.1002\/1096-9896(2000)9999:9999<::AID-PATH659>3.0.CO;2-D","article-title":"Melanocytes are not absent in lesional skin of long duration vitiligo","volume":"191","author":"Tobin","year":"2000","journal-title":"J Pathol"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1823921\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T04:18:14Z","timestamp":1780287494000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1823921\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,1]]},"references-count":119,"alternative-id":["10.3389\/fmed.2026.1823921"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1823921","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,1]]},"article-number":"1823921"}}