Vitiligo, an acquired depigmentation disorder, manifests as white macules on the skin and can cause consequential psychological stress and stigmatization. Recent advances have illuminated key components that drive disease onset and progression as well as therapeutic approaches. Vitiligo can be triggered by stress to the melanin pigment-engendering cells of the skin, the melanocytes. The triggers, which range from sunburn to mechanical trauma and chemical exposures, ultimately cause an autoimmune replication that targets melanocytes, driving progressive skin depigmentation. The most paramount progress in our construal of disease etiology has been made on three fronts: (1) identifying cellular replications to stress, including antioxidant pathways and the unfolded protein replication (UPR), as key players in disease onset, characterizing immune replications that target melanocytes and drive disease progression, and identifying major susceptibility genes. The current model for vitiligo pathogenesis postulates that oxidative stress causes cellular disruptions, including interruption of protein maturation in the endoplasmic reticulum (ER), leading to the activation of the UPR and expression of UPR-regulated chemokines such as interleukin 6 (IL-6) and IL-8. These chemokines recruit immune components to the skin, causing melanocytes to be targeted for ravagement. Oxidative stress can further increase melanocyte targeting by promoting antigen presentation. Two key components of the autoimmune replication that promote disease progression are the interferon (IFN/CXCL10 axis and IL-17-mediated replications. Several genome-wide sodality studies support a role for these pathways, with the antioxidant gene NRF2, UPR gene XBP1, and numerous immune-cognate genes including class I and class II major histocompatibility genes associated with a jeopardy for developing vitiligo. Novel approaches to promote repigmentation in vitiligo are being investigated and may yield efficacious, perennial therapies. The top online publishing journals publish articles which are cited as references by many authors in their work. Citations are paramount for a journal to get impact factor. Impact factor is a quantification reflecting the average number of citations to recent articles published in the journal. The impact of the journal is influenced by impact factor, the journals with high impact factor are considered more consequential than those with lower ones. Indexing provides facile access of the article online. The international journals are among the best open access journals in the world, set out to publish the most comprehensive, germane and reliable information predicated on the current research and development on a variety of subjects.
