A Scoping Review of Pathogenesis, Current Treatments, and Novel Approaches for Vitiligo.

BACKGROUND: Vitiligo is a chronic skin disorder characterized by loss of melanocytes, causing depigmentation and psychological distress. Its pathogenesis is complex and multifactorial, involving genetic predisposition, autoimmune, oxidative stress, and neurogenic mechanisms. AIMS: This scoping review summarizes current understanding of vitiligo pathogenesis and provides an overview of available and emerging treatment modalities. METHODS: A systematic search was conducted in Web of Science, Scopus, and EBSCO Medline for English-language publications from January 2019 onwards. Eligible studies included those investigating the pathogenesis, therapeutic approaches, or novel strategies for idiopathic vitiligo across all age groups and clinical types. Exclusion criteria included secondary vitiligo due to drugs, comorbidities, or systemic diseases, as well as studies involving pregnant or lactating women and those reporting negative findings. RESULTS: The search identified 5298 relevant articles. Established therapies include topical and oral agents, phototherapy, surgical interventions, and combination regimens. Recent advances highlight novel therapeutic targets and experimental interventions, many of which are not yet approved but show promising preliminary outcomes. These include immune-modulating agents, antioxidants, and regenerative strategies aimed at restoring melanocyte function and repigmentation. CONCLUSIONS: Vitiligo remains a challenging dermatological disorder with significant clinical and psychosocial implications. Although existing therapies provide variable outcomes, emerging treatments offer encouraging prospects. This review provides a comprehensive resource for clinicians and researchers, guiding future directions in vitiligo management and therapeutic innovation.