Serum Biomarkers of Vitiligo

The pathogenesis of vitiligo is complex, although the driving factors seem to become gradually clarified. This may help to identify possible targets for both detection of activity as well as discovering new therapeutic agents. In the coming years, new clinical trials are expected based on this scientific progress. Logically, a biomarker that allows an early and accurate determination of treatment response will also be of a considerable value. In contrast to other inflammatory skin disorders such as psoriasis or atopic dermatitis, vitiligo lacks obvious inflammatory signs, which can be easily evaluated by clinical examination. Several clinical activity signs have been described in vitiligo (such as hypochromic areas, blurred borders and confetti-like depigmentation, and Koebners' phenomenon), although these signs are only present in a subset of active vitiligo patients. Moreover, it is unclear whether these signs can be used to evaluate disease activity over time. The hallmark of vitiligo is its unpredictable clinical course, including periods of disease stability and disease flares. This complicates the daily management of vitiligo. Biomarker analysis could be useful to follow patients over time and even predict the chance of future disease progression, allowing to tailor the treatment to the individual biomarker profile.