dermatologic disorders
Vitiligo
Etiology of Vitiligo
Etiology of vitiligo is unclear, but melanocytes are lacking in affected areas. Proposed mechanisms include autoimmune destruction of melanocytes, reduced survival of melanocytes, and primary melanocyte defects. Vitiligo can be familial ( Autosomal Dominant with incomplete penetrance and variable expression) or acquired. Some patients have antibodies to melanin. Up to 30% have other autoimmune antibodies (to thyroglobulin, adrenal cells, and parietal cells) or clinical autoimmune endocrinopathies ( Occasionally, vitiligo occurs after a direct physical injury to the skin (eg, as a response to sunburn). Vitiligo can also result from exposure to vitiligo-inducing phenols ( General reference ). Patients may associate the onset of vitiligo with emotional stress. Immune Therapy for melanoma (eg, BRAF inhibitors, programmed death receptor 1 [PD-1] inhibitors) can trigger vitiligo as an immunologic side effect. 1.Arowojolu OA, Orlow SJ, Elbuluk N, et al: The nuclear factor (erythroid-derived 2)-like 2 (NRF2) antioxidant response promotes melanocyte viability and reduces toxicity of the vitiligo-inducingphenolmonobenzone.Exp Dermatol26(7):637-644. doi: 10.1111/exd.13350 