Enhancing Therapeutic Outcomes in Vitiligo: The Role of 5-Fluorouracil as a Pharmacological Adjuvant

Abstract

Vitiligo is a complex dermatological condition characterized by the autoimmune destruction of melanocytes. This disorder leads to the development of distinct depigmented patches on the skin. As such, it poses not only aesthetic challenges, but also profound psychological burdens for those affected. In this issue of Current Reviews in Clinical and Experimental Pharmacology, Kohaf et al. offer a comprehensive systematic review and meta-analysis that evaluates the efficacy and safety of 5- fluorouracil (5FU) as an adjuvant therapy in the management of vitiligo [1]. Their findings highlight a promising path forward in the quest for effective treatments. Given the complex nature of vitiligo, a deeper understanding of its underlying mechanisms is essential. The dominant theory links its onset to an autoimmune response, where T-cell lymphocytes target and destroy melanocytes. However, alternative explanations, such as the neurogenic hypothesis, propose that neuropeptides released from skin nerve endings may also contribute to melanocyte toxicity. This complexity highlights the need for novel therapeutic strategies that address the condition's root causes while promoting repigmentation.