Vitiligo: Evidenced Based Medicine applied to Cases

Dr. Julian Seneschal from the University of Bordeaux presented on the pathogenesis of vitiligo, emphasizing the autoimmune aspect of the disease. He highlighted that genes associated with vitiligo primarily relate to immune responses and melanocyte function. Dr. Seneschal discussed the immune infiltration of T cells in the perilesional skin of vitiligo patients, illustrating how these T cells actively contribute to melanocyte loss through inflammatory processes. He elaborated on the role of innate lymphoid cells and memory T cells in the immune response, indicating that their presence can lead to disease flare-ups post-treatment cessation. The research pointed out the production of type 1 and type 2 cytokines in affected skin, with findings suggesting that melanocytes in vitiligo are not entirely functional and are more susceptible to damage from reactive oxygen species and inflammatory cytokines. Furthermore, Dr. Seneschal noted that non-lesional skin in patients is not normal either, showing similarities in T cell populations and their functionality to lesional skin, implicating it in potential future lesions. He concluded by acknowledging ongoing research and the implications of understanding the immune dynamics in vitiligo for better treatment strategies.