From the Guidelines
Vitiligo is primarily caused by an autoimmune response where the body's immune system mistakenly attacks and destroys its own melanocytes, as evidenced by the involvement of autoimmune mechanisms in many cases 1. The exact cause of vitiligo remains unclear, but it is believed to involve a combination of genetic, environmental, and autoimmune factors.
- Genetic factors play a significant role, with approximately 30% of vitiligo patients having a family history of the condition 1.
- Environmental triggers such as severe sunburn, chemical exposure, or emotional stress can initiate or worsen vitiligo in genetically susceptible individuals.
- Oxidative stress within skin cells may also contribute to melanocyte damage.
- Certain autoimmune conditions like thyroid disorders, pernicious anemia, and Addison's disease are associated with higher vitiligo risk, with 32% of patients having a history of autoimmune disease in a family member 1. The condition typically manifests as well-defined white patches on the skin that may gradually enlarge over time, often appearing symmetrically on both sides of the body, with common sites of affection including the fingers and wrists, axillae and groins, and body orifices such as the mouth, eyes, and genitalia 1.
From the Research
Causes of Vitiligo
The causes of vitiligo are complex and multifaceted, involving various factors such as:
- Autoimmune responses, as evidenced by circulating melanocyte-specific antibodies and association with other autoimmune diseases 2, 3
- Genetic predisposition, which sensitizes melanocytes to environmental agents 2, 4
- Oxidative stress, which contributes to aberrant stress response, neo-antigenicity, and susceptibility of melanocytes to immune attack and apoptosis 2, 3
- Environmental triggers, such as sunburn, mechanical trauma, and chemical exposures, which can cause stress to melanocytes and lead to an autoimmune response 3, 4
- Intrinsic defects in melanocytes and their microenvironment, which contribute to dysregulation of immune responses and melanocyte loss 2, 5
- Immunometabolic abnormalities, including mitochondrial dysfunction, enhanced oxidative stress, and specific defects in metabolic pathways, which promote dysregulation of innate and adaptive immune responses in vitiligo 5
Key Factors Contributing to Vitiligo
Some key factors that contribute to the development and progression of vitiligo include:
- Melanocyte loss due to autoimmune responses and oxidative stress 2, 3
- Genetic susceptibility and environmental triggers 2, 4
- Dysregulation of immune responses and immunometabolic pathways 3, 5
- Abnormalities in melanocyte function and survival 2, 5
Pathogenesis of Vitiligo
The pathogenesis of vitiligo involves a complex interplay between various factors, including:
- Autoimmune responses and oxidative stress, which lead to melanocyte loss and depigmentation 2, 3
- Genetic and environmental factors, which contribute to the development and progression of the disease 2, 4
- Immunometabolic abnormalities, which promote dysregulation of immune responses and melanocyte loss 5