The development of effective treatment for vitiligo depends on understanding the mechanisms of depigmentation and repigmentation. The basic pathogenesis of vitiligo in general, or for any of the putative subsets of vitiligo, is not fully known although substantial strides have been made in pathogenesis and the treatment of vitiligo. Since the etiopathogenesis of depigmentation in vitiligo is still obscure, the source of pigmentation in the repigmentating lesion and its stability is also not fully known.
An approach combining clinical investigations and focused research on the cellular and molecular mechanisms of vitiligo repigmentation will lead to finding better treatments for this disease. The mechanistic aspects of melanocyte repopulation in vitiligo and of other factors that trigger and influence melanocyte growth, maturation and survival have been little explored. A better understanding of vitiligo repigmentation will provide new therapeutic perspectives leading to development of an ideal weapon against vitiligo.
Understanding basic mechanism of repigmentation in vitiligo and its co-relation with various treatment modalities seems to be the key to successful treatment. Recently we successfully demonstrated presence of dermal stem cell in depigmented vitiligo lesion. Next question to be answered is how to stimulate these dermal stem cells which will be an ideal treatment of vitiligo.