Mechanism of action of various therapies for vitiligo. Pharmacologist’s and dermatovenerologist’s perspective

Vitiligo is considered as an acquired hypomelanosis with a genetic predisposition to autoimmune responses. The disease manifests with depigmentation foci. Vitiligo is often mistakenly identified as a cosmetic defect and treatment is avoided. The disease has a significant impact on patients’ life quality. Conventional therapy methods for vitiligo remain pathogenetically substantiated and effective but they do not prevent disease recurrences as well as cannot be used as prevention of exacerbations. There has been a progress in understanding the etiopathogenesis and new targeted treatment methods for vitiligo have been introduced over the past 5 years. The article considers in detail the action mechanisms of some drugs that currently show estimated effectiveness in vitiligo treatment and can be potentially introduced into clinical practice after a final confirmation of their effectiveness and safety, action mechanisms of various treatment methods, including topical and systemic therapy for stabilizing progressive disease course, are being analyzed. In addition, mechanisms of light therapy for vitiligo, both classical methods of light therapy and excimer and fractional lasers, have been described. The importance of early therapy initiation in order to minimize memory cells’ accumulation and reduce the probability of disease recurrences is emphasized. The presented data have a substantial significance for optimization of therapeutic approaches to the vitiligo treatment.