Vitiligo is a very common disease that significantly affects our patients’ quality of life. In fact, the mental anguish of patients with vitiligo is comparable to those with psoriasis and other skin diseases. However, compared with psoriasis, our understanding of disease pathogenesis is probably more advanced, while our progress in treatment is far behind. This is likely because psoriasis patients benefit from new biologics and other targeted therapies developed for a wide range of other diseases, yet these treatments are largely ineffective for vitiligo. However, recent advances in our understanding of vitiligo pathogenesis promise to deliver new targeted treatments in the near future.
We have found that many vitiligo patients who attend our clinics have previously seen other dermatologists who told them that vitiligo “wasn’t a big deal” or that there was “nothing that could be done for it.” In addition, concerns about patients’ risk of developing skin cancer, especially from UV-B therapy, have needlessly hampered their treatment. Current topical immunosuppressants, phototherapy, and combined approaches reportedly result in over 75% repigmentation in the majority of patients, with minimal risk. New surgical approaches result in excellent outcomes for most patients with the segmental variant of vitiligo and other stable forms of disease. However, the management strategy must be optimized to achieve the best results.
Our goal in this issue of Dermatologic Clinics was to summarize current “best practices” in the management of vitiligo, and also to make recent advances in research accessible to clinicians who are confronted daily with distraught vitiligo patients. Indeed, there is much we can do for these patients, and there is even more on the horizon that should soon make treating this population easier and, yes, even fun! To achieve this goal, clinicians and researchers who are at the forefront of advancements in vitiligo were invited to offer their expertise, advice, and thoughts on future developments in vitiligo. This team effort has resulted in an exciting resource for anyone with an interest in helping the large number of vitiligo patients that seek their advice and entrust themselves to their care.