Implication of colloidal therapeutics in the treatment of vitiligo: Portray of signaling cascade, current drug-targets and preclinical and clinical evidences

Vitiligo is an autoimmune disease that spreads depigmented patches on the skin and has a negative impact on a patient's mental health, physical health, and quality of life. It is a multifaceted disorder that involves both genetic predisposition and environmental triggers. Non-segmental vitiligo, segmental vitiligo, and unclassified vitiligo are the three major subtypes of vitiligo. The pathophysiology of vitiligo is complex and involves multiple combinatorial factors. Research development has identified oxidative stress, autoimmune illness, and auto-inflammation as major contributors to vitiligo. The complexity of vitiligo's pathogenesis makes its treatment challenging. Vitiligo treatment has three primary goals prevention of the spread of depigmentation, promotion of repigmentation, and reduction of psychological distress. Current therapeutic strategies include non-targeted and broad immunosuppressants that only partially relieve symptoms without changing the natural course of the disease. Vitiligo management aims to reduce disease progression, stimulate repigmentation, and prevent relapses. Statins inhibit IFN-γ and ROS production. JAK-STAT inhibitors block IFN-γ signaling and support the repigmentation of vitiligo and Topical prostaglandin analogs stimulate the growth of melanocytes. Topical colloidal therapeutics exploited the properties of the stratum corneum to improve transdermal drug delivery and their therapeutic effects. This review aims at the pathophysiology, cellular signaling mechanism, emerging drug targets and topical drug delivery strategies in treating vitiligo. This research achieved substantial progress by enhancing drug penetration or drug loading efficiency.