{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T19:25:59Z","timestamp":1787772359996,"version":"build-2784847793"},"reference-count":64,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:sec>\n                    <jats:title\/>\n                    <jats:p>Melanocytes are highly specialized dendritic cells that synthesize and store melanin in subcellular organelles called melanosomes, before transfer to keratinocytes. Melanin is a complex pigment that provides colour and photoprotection to the skin, hair and eyes. The process of synthesis of melanin is called melanogenesis and is regulated by various mechanisms and factors such as genetic, environmental and endocrine factors. The knowledge of the pigmentation process is important to understand hypopigmentation disorders such as vitiligo and also to design adequate treatments. In the present work, we review the signalling pathways involved in vitiligo. Finally, current therapies and treatments including topical, oral and phototherapies are discussed and described, emphasizing future therapies based on different pigmentation mechanisms.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ijd.ijd_1067_21","type":"journal-article","created":{"date-parts":[[2024,5,29]],"date-time":"2024-05-29T12:14:59Z","timestamp":1716984899000},"page":"524-530","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":7,"title":["Melanogenesis and Hypopigmentation"],"prefix":"10.4103","volume":"67","author":[{"given":"M. Pilar","family":"Vinardell","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriana Solange","family":"Maddaleno","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Montserrat","family":"Mitjans","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-7-20240829","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1016\/S0140-6736(14)60763-7","article-title":"Vitiligo","volume":"386","author":"Ezzedine","year":"2015","journal-title":"Lancet"},{"key":"R2-7-20240829","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1016\/j.clindermatol.2019.07.018","article-title":"The color of skin: White diseases of the skin, nails, and mucosa","volume":"37","author":"Brown","year":"2019","journal-title":"Clin Dermatol"},{"key":"R3-7-20240829","doi-asserted-by":"crossref","first-page":"1157","DOI":"10.1111\/ijd.14055","article-title":"Comorbidities in vitiligo: Comprehensive review","volume":"57","author":"Dahir","year":"2018","journal-title":"Int J Dermatol"},{"key":"R4-7-20240829","doi-asserted-by":"crossref","first-page":"8820","DOI":"10.3390\/ijms22168820","article-title":"Metabolic comorbidities in vitiligo: A brief review and report of new data from a single-center experience?","volume":"22","author":"D'Arino","year":"2021","journal-title":"Int J Mol Sci"},{"key":"R5-7-20240829","doi-asserted-by":"crossref","first-page":"e13418","DOI":"10.1111\/dth.13418","article-title":"Psychodermatology of vitiligo: Psychological impact and consequences","volume":"33","author":"Simons","year":"2020","journal-title":"Dermatol Ther"},{"key":"R6-7-20240829","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1111\/1346-8138.15743","article-title":"Vitiligo: A focus on pathogenesis and its therapeutic implications","volume":"48","author":"Bergqvist","year":"2021","journal-title":"J Dermatol"},{"key":"R7-7-20240829","doi-asserted-by":"crossref","first-page":"1089","DOI":"10.1111\/jdv.14792","article-title":"Critical appraisal of the oxidative stress pathway in vitiligo: A systematic review and meta-analysis","volume":"32","author":"Speeckaert","year":"2018","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"R8-7-20240829","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s41702-019-0043-1","article-title":"Vitiligo susceptibility at workplace and in daily life: The contribution of oxidative stress gene polymorphisms","volume":"3","author":"Chiarella","year":"2019","journal-title":"Biomedical Dermatol"},{"key":"R9-7-20240829","doi-asserted-by":"crossref","first-page":"1017","DOI":"10.12659\/MSM.914898","article-title":"2019. Perspectives of new advances in the pathogenesis of vitiligo: From oxidative stress to autoimmunity","volume":"25","author":"Wang","year":"2019","journal-title":"Med Sci Monitor"},{"key":"R10-7-20240829","doi-asserted-by":"crossref","first-page":"13663","DOI":"10.1038\/s41598-017-13961-5","article-title":"Energetic mitochondrial failing in vitiligo and possible rescue by cardiolipin","volume":"7","author":"Dell'Anna","year":"2017","journal-title":"Sci Rep"},{"key":"R11-7-20240829","doi-asserted-by":"crossref","first-page":"1965","DOI":"10.1016\/j.jid.2017.04.025","article-title":"MicroRNA-211 regulates oxidative phosphorylation and energy metabolism in human vitiligo","volume":"137","author":"Sahoo","year":"2017","journal-title":"J Invest Dermatol"},{"key":"R12-7-20240829","doi-asserted-by":"crossref","first-page":"2230","DOI":"10.1016\/j.jid.2019.03.1165","article-title":"Molecular hydrogen protects human melanocytes from oxidative stress by activating Nrf2 signaling","volume":"140","author":"Fang","year":"2020","journal-title":"J Invest Dermatol"},{"key":"R13-7-20240829","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1016\/j.coi.2013.10.010","article-title":"Innate immune mechanisms in vitiligo: Danger from within","volume":"25","author":"Richmond","year":"2013","journal-title":"Curr Opini Immunol"},{"key":"R14-7-20240829","doi-asserted-by":"crossref","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":"R15-7-20240829","doi-asserted-by":"crossref","first-page":"1794","DOI":"10.1016\/j.jid.2019.12.035","article-title":"ATP-P2X7-induced inflammasome activation contributes to melanocyte death and CD8+ T-cell trafficking to the skin in vitiligo","volume":"140","author":"Ahn","year":"2020","journal-title":"J Invest Dermatol"},{"key":"R16-7-20240829","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1111\/phpp.12653","article-title":"Oxidative stress and the cholinergic system in non-segmental vitiligo: Effect of narrow band ultraviolet b","volume":"37","author":"Said","year":"2021","journal-title":"Photodermatol Photoimmunol Photomed"},{"key":"R17-7-20240829","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1038\/jid.2013.268","article-title":"Oxidative stress-induced calreticulin expression and translocation: New insights into the destruction of melanocytes","volume":"134","author":"Zhang","year":"2014","journal-title":"J Invest Dermatol"},{"key":"R18-7-20240829","doi-asserted-by":"crossref","first-page":"237","DOI":"10.3892\/mmr.2012.1117","article-title":"CD8+ T cells from vitiligo perilesional margins induce autologous melanocyte apoptosis","volume":"7","author":"Wu","year":"2013","journal-title":"Mol Med Rep"},{"key":"R19-7-20240829","doi-asserted-by":"crossref","first-page":"11","DOI":"10.4049\/jimmunol.1900027","article-title":"The role of memory CD8(+) T cells in vitiligo","volume":"203","author":"Riding","year":"2019","journal-title":"J. Immunol"},{"key":"R20-7-20240829","doi-asserted-by":"crossref","first-page":"1318","DOI":"10.1111\/bjd.14416","article-title":"Increased expression of CXCR3 and its ligands in patients with vitiligo and CXCL10 as a potential clinical marker for vitiligo","volume":"174","author":"Wang","year":"2016","journal-title":"Br J Dermatol"},{"key":"R21-7-20240829","doi-asserted-by":"crossref","first-page":"33","DOI":"10.4103\/ijd.IJD_344_18","article-title":"Antimelanocyte antibodies: A possible role in patients with vitiligo","volume":"65","author":"El-Gayyar","year":"2020","journal-title":"Indian J Dermatol"},{"key":"R22-7-20240829","first-page":"845","article-title":"Vitiligo and autoantibodies: A systematic review and meta-analysis","volume":"16","author":"Liu","year":"2018","journal-title":"J Dtsch Dermatol Ges"},{"key":"R23-7-20240829","doi-asserted-by":"crossref","first-page":"473","DOI":"10.5114\/ada.2020.93272","article-title":"Comparison of tyrosinase antibody, tyrosinase-related protein-1 and -2 antibodies, melanin-concentrating hormone receptor antibody levels with autologous serum skin test and autologous plasma skin test results in patients with vitiligo","volume":"38","author":"Unal","year":"2021","journal-title":"Postepy Dermatol Alergol"},{"key":"R24-7-20240829","doi-asserted-by":"crossref","first-page":"35390","DOI":"10.1074\/jbc.M102391200","article-title":"The transcription factors SOX9 and SOX10 are vitiligo autoantigens in autoimmune polyendocrine syndrome type I","volume":"76","author":"Hedstrand","year":"2001","journal-title":"J Biol Chem"},{"key":"R25-7-20240829","doi-asserted-by":"crossref","first-page":"102664","DOI":"10.1016\/j.autrev.2020.102664","article-title":"New insight into the role of exosomes in vitiligo","volume":"19","author":"Wong","year":"2020","journal-title":"Autoimmun Rev"},{"key":"R26-7-20240829","doi-asserted-by":"crossref","first-page":"986","DOI":"10.1080\/10715762.2017.1402303","article-title":"Levels of oxidative damage and proinflammatory cytokines are enhanced in patients with active vitiligo","volume":"51","author":"Mitra","year":"2017","journal-title":"Free Radic Res"},{"key":"R27-7-20240829","doi-asserted-by":"crossref","first-page":"2097","DOI":"10.1111\/jdv.15016","article-title":"The role of interleukins in vitiligo: A systematic review","volume":"32","author":"Gomes","year":"2018","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"R28-7-20240829","doi-asserted-by":"crossref","first-page":"4899","DOI":"10.1096\/fj.201701242RR","article-title":"IL-17 induces cellular stress microenvironment of melanocytes to promote autophagic cell apoptosis in vitiligo","volume":"32","author":"Zhou","year":"2018","journal-title":"FASEB J"},{"key":"R29-7-20240829","first-page":"514","article-title":"Microbiome and skin diseases","volume":"13","author":"Zeeuwen","year":"2013","journal-title":"CurrOpin Allergy Clin Immunol"},{"key":"R30-7-20240829","doi-asserted-by":"crossref","first-page":"1287","DOI":"10.1111\/bjd.17931","article-title":"Gut microbiota dysbiosis in a cohort of patients with psoriasis","volume":"181","author":"Hidalgo-Cantabrana","year":"2019","journal-title":"Br J Dermatol"},{"key":"R31-7-20240829","doi-asserted-by":"crossref","first-page":"18761","DOI":"10.1038\/srep18761","article-title":"Microbial community profiling shows dysbiosis in the lesional skin of Vitiligo subjects","volume":"6","author":"Ganju","year":"2016","journal-title":"Sci Rep"},{"key":"R32-7-20240829","doi-asserted-by":"crossref","first-page":"2280","DOI":"10.1016\/j.jid.2021.01.036","article-title":"Analysis of matched skin and gut microbiome of patients with vitiligo reveals deep skin dysbiosis: Link with mitochondrial and immune changes","volume":"141","author":"Bzioueche","year":"2021","journal-title":"J Invest Dermatol"},{"key":"R33-7-20240829","doi-asserted-by":"crossref","first-page":"592248","DOI":"10.3389\/fmicb.2020.592248","article-title":"Gut microbial dysbiosis and plasma metabolic profile in individuals with vitiligo","volume":"11","author":"Ni","year":"2020","journal-title":"Front Microbiol"},{"key":"R34-7-20240829","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1111\/1346-8138.12147","article-title":"Modern vitiligo genetics sheds new light on an ancient disease","volume":"40","author":"Spritz","year":"2013","journal-title":"J Dermatol"},{"key":"R35-7-20240829","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s41702-018-0030-y","article-title":"Exploring vitiligo susceptibility and management: A brief review","volume":"2","author":"Rahman","year":"2018","journal-title":"Biomedical Dermatol"},{"key":"R36-7-20240829","doi-asserted-by":"crossref","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":"R37-7-20240829","doi-asserted-by":"crossref","first-page":"1110","DOI":"10.1016\/j.freeradbiomed.2013.08.189","article-title":"Involvement of superoxide dismutase isoenzymes and their genetic variants in progression of and higher susceptibility to vitiligo","volume":"65","author":"Laddha","year":"2013","journal-title":"Free Radic Biol Med"},{"key":"R38-7-20240829","doi-asserted-by":"crossref","first-page":"S91","DOI":"10.1016\/j.cegh.2015.10.002","article-title":"Effect of chemical exposure in induction and evolution of vitiligo: Correlation between duration of exposure and disease, site of exposure and onset, and impact upon avoidance","volume":"3","author":"Alam","year":"2015","journal-title":"Clin Epidemiol Glob Health"},{"key":"R39-7-20240829","doi-asserted-by":"crossref","first-page":"540","DOI":"10.1111\/pcmr.12774","article-title":"Mechanism of action of 4-substituted phenols to induce vitiligo and antimelanoma immunity","volume":"32","author":"Kammeyer","year":"2019","journal-title":"Pigment Cell Melanoma Res"},{"key":"R40-7-20240829","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1016\/j.jdermsci.2020.06.004","article-title":"Chemical induced pathognomonic features observed in human vitiligo are mediated through miR-2909 R Nomics pathway","volume":"100","author":"Kaushik","year":"2020","journal-title":"J Dermatol Sci"},{"key":"R41-7-20240829","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1016\/j.det.2016.11.006","article-title":"Chemical-induced vitiligo","volume":"35","author":"Harris","year":"2017","journal-title":"Dermatol Clin"},{"key":"R42-7-20240829","doi-asserted-by":"crossref","first-page":"2601","DOI":"10.1038\/jid.2012.181","article-title":"Vitiligo-inducing phenols activate the unfolded protein response in melanocytes resulting in upregulation of IL6 and IL8","volume":"132","author":"Toosi","year":"2012","journal-title":"J Invest Dermatol"},{"key":"R43-7-20240829","doi-asserted-by":"crossref","first-page":"701","DOI":"10.4103\/idoj.IDOJ_40_21","article-title":"Efficacy of NB-UVB in progressive versus non-progressive non-segmental vitiligo: A prospective comparative study","volume":"12","author":"Bhatia","year":"2021","journal-title":"Indian Dermatol Online J"},{"key":"R44-7-20240829","doi-asserted-by":"crossref","first-page":"e14649","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":"R45-7-20240829","doi-asserted-by":"crossref","first-page":"43","DOI":"10.3889\/oamjms.2018.047","article-title":"Successful treatment with UVA 1 laser of non-responder vitiligo patients","volume":"6","author":"Lotti","year":"2018","journal-title":"Open Access Maced J Med Sci"},{"key":"R46-7-20240829","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1089\/pho.2015.4004","article-title":"UVA1 laser in the treatment of vitiligo","volume":"34","author":"Babino","year":"2016","journal-title":"Photomed Laser Surg"},{"key":"R47-7-20240829","doi-asserted-by":"crossref","first-page":"117","DOI":"10.4103\/2229-5178.131071","article-title":"Role of the ACTH test and estimation of a safe dose for high potency steroids in vitiligo: A prospective randomized study","volume":"5","author":"de la Fuente-Garcia","year":"2014","journal-title":"Indian Dermatol Online J"},{"key":"R48-7-20240829","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1016\/j.abd.2020.05.007","article-title":"Consensus on the treatment of vitiligo-Brazilian Society of Dermatology","volume":"95","author":"Dellatorre","year":"2020","journal-title":"An Bras Dermatol"},{"key":"R49-7-20240829","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3310\/hta24640","article-title":"Home-based narrowband UVB, topical corticosteroid or combination for children and adults with vitiligo: HI-Light Vitiligo three-arm RCT?","volume":"24","author":"Batchelor","year":"2020","journal-title":"Health Technol Assess"},{"key":"R50-7-20240829","doi-asserted-by":"crossref","first-page":"828","DOI":"10.1111\/bjd.19592","article-title":"Randomized controlled trial of topical corticosteroid and home-based narrowband ultraviolet B for active and limited vitiligo: Results of the hi-light vitiligo Trial","volume":"184","author":"Thomas","year":"2021","journal-title":"Br J Dermatol"},{"key":"R51-7-20240829","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1590\/abd1806-4841.20164012","article-title":"Effectiveness and safety of topical tacrolimus monotherapy for repigmentation in vitiligo: A comprehensive literature review","volume":"91","author":"Sisti","year":"2016","journal-title":"An Bras Dermatol"},{"key":"R52-7-20240829","doi-asserted-by":"crossref","first-page":"29","DOI":"10.4103\/2231-4040.197388","article-title":"Effectiveness and safety of topical tacrolimus in treatment of vitiligo","volume":"8","author":"Rokni","year":"2017","journal-title":"J Adv Pharm Technol Res"},{"key":"R53-7-20240829","doi-asserted-by":"crossref","first-page":"S34","DOI":"10.1016\/j.jisp.2017.01.001","article-title":"Vitiligo surgery: Shuffling melanocytes","volume":"18","author":"Nahhas","year":"2017","journal-title":"J Investig Dermatol Symp Proc"},{"key":"R54-7-20240829","doi-asserted-by":"crossref","first-page":"159","DOI":"10.4103\/0378-6323.93632","article-title":"Ultrathin split-thickness skin grafting followed by narrowband UVB therapy for stable vitiligo: An effective and cosmetically satisfying treatment option","volume":"78","author":"Majid","year":"2012","journal-title":"Indian J Dermatol Venereol Leprol"},{"key":"R55-7-20240829","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1001\/jamadermatol.2018.4919","article-title":"Efficacy of transplantation of combination of noncultured dermal and epidermal cell suspension vs epidermal cell suspension alone in vitiligo: A randomized clinical trial","volume":"155","author":"Thakur","year":"2019","journal-title":"JAMA Dermatol"},{"key":"R56-7-20240829","doi-asserted-by":"crossref","first-page":"526","DOI":"10.1111\/ics.12575","article-title":"Innovations in skin camouflaging techniques: Where are we scientifically?","volume":"41","author":"Derbyshire","year":"2019","journal-title":"Int J Cosmet Sci"},{"key":"R57-7-20240829","first-page":"173","article-title":"Emotional benefit of cosmetic camouflage in the treatment of facial skin conditions: Personal experience and review","volume":"5","author":"Levy","year":"2012","journal-title":"Clin CosmetInvestig Dermatol"},{"key":"R58-7-20240829","doi-asserted-by":"crossref","first-page":"402","DOI":"10.1111\/j.1365-4632.2008.03356.x","article-title":"Dihydroxyacetone: A safe camouflaging option in vitiligo","volume":"47","author":"Rajatanavin","year":"2008","journal-title":"Int J Dermatol"},{"key":"R60-7-20240829","first-page":"343","article-title":"Interfering with the IFN-\u03b3\/CXCL10 pathway to develop new targeted treatments for vitiligo","volume":"3","author":"Rashighi","year":"2015","journal-title":"Ann Transl Med"},{"key":"R61-7-20240829","doi-asserted-by":"crossref","first-page":"630","DOI":"10.1111\/exd.13069","article-title":"Targeting CTLA-4, PD-L1 and IDO to modulate immune responses in vitiligo","volume":"26","author":"Speeckaert","year":"2017","journal-title":"Exp Dermatol"},{"key":"R62-7-20240829","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1001\/2013.jamadermatol.386","article-title":"The efficacy of afamelanotide and narrowband UV-B phototherapy for repigmentation of vitiligo","volume":"149","author":"Grimes","year":"2013","journal-title":"JAMA Dermatol"},{"key":"R63-7-20240829","doi-asserted-by":"crossref","first-page":"2921","DOI":"10.1038\/jid.2015.372","article-title":"Melanocyte regeneration in vitiligo requires WNT beneath their wings","volume":"135","author":"Harris","year":"2015","journal-title":"J Invest Dermatol"},{"key":"R64-7-20240829","first-page":"911","article-title":"Vitiligo-new treatment approach","volume":"12","author":"Konstantinova","year":"2019","journal-title":"Clin CosmetInvestig Dermatol"},{"key":"R65-7-20240829","doi-asserted-by":"crossref","first-page":"634553","DOI":"10.3389\/fgene.2021.634553","article-title":"Integrative analysis of omics data reveals regulatory network of CDK10 in vitiligo risk","volume":"12","author":"Cai","year":"2021","journal-title":"Front Genet"}],"container-title":["Indian Journal of Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/ijd.ijd_1067_21","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T18:40:59Z","timestamp":1787769659000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/ijd.ijd_1067_21"}},"subtitle":["The Case of Vitiligo"],"short-title":[],"issued":{"date-parts":[[2022,9]]},"references-count":64,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2022]]}},"URL":"https:\/\/doi.org\/10.4103\/ijd.ijd_1067_21","relation":{},"ISSN":["0019-5154"],"issn-type":[{"value":"0019-5154","type":"print"}],"subject":[],"published":{"date-parts":[[2022,9]]}}}