Year: 2026
Type: article
Abstract: Vitiligo is increasingly recognized as a systemic autoimmune disorder rather than a purely cutaneous disease.Beyond melanocyte destruction and skin depigmentation, accumulating evidence highlights significant genetic, immunologic, and epidemiologic links between vitiligo and systemic autoimmune rheumatic diseases.Shared susceptibility loci, along with convergence on the interferon-gamma (IFN-γ)/Janus kinase-signal transducer and activator of transcription (JAK-STAT) pathway, help explain the increased coexistence of vitiligo with conditions such as rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), Sjögren's syndrome, and systemic sclerosis.Large epidemiologic studies and Mendelian randomization analyses suggest that RA is among the most frequent rheumatic comorbidities in patients with vitiligo.These pathogenic overlaps have direct therapeutic implications.Janus kinase inhibitors, initially developed for inflammatory and hematologic disorders, have demonstrated efficacy in vitiligo and may offer therapeutic benefits in selected patients with concomitant rheumatic disease.However, the strength of evidence varies across agents and indications, ranging from randomized controlled trials to case reports and mechanistic extrapolation.Conversely, paradoxical vitiligo occurring during treatment with biologic disease-modifying antirheumatic drugs (bDMARDs)-particularly tumor necrosis factor-alpha (TNF-α) and interleukin-17 (IL-17) inhibitors-has been increasingly reported, although current evidence remains largely limited to case reports and small observational studies.This focused narrative review explores the immunopathogenic relationship between vitiligo and rheumatic diseases, synthesizes current epidemiologic data, and discusses practical diagnostic and therapeutic considerations relevant to both dermatologists and rheumatologists.It also underscores the importance of multidisciplinary collaboration and individualized therapeutic strategies for patients at the interface between dermatology and rheumatology.
Author: Kamel REMITA
Language: English
Subfield: Cell Biology
Domain: Life Sciences
Open Access status: diamond
OpenAlex ID: W7162648366