节段型白癜风的发病机制及治疗进展

doi:10.35541/cjd.20250500

Abstract

Abstract: 【Abstract】 The key pathological mechanisms underlying the unilateral involvement in segmental vitiligo remain poorly elucidated, and its fundamental distinctions from non-segmental vitiligo have not been clearly defined, resulting in a lack of targeted therapeutic strategies for segmental vitiligo. This review systematically summarizes the clinical features, pathogenesis, and diagnostic and therapeutic advances in segmental vitiligo, and discusses promising directions for future research.

Key words: Vitiligo, Melanocytes, Mosaicism, Segmental vitiligo, Neuroimmunity

Fang Qinyi, Shen Naiting, Xu Zhongyi, Xiang Leihong, Zhang Chengfeng. Pathogenesis and treatment of segmental vitiligo[J]. Chinese Journal of Dermatology,2026,e20250500. doi:10.35541/cjd.20250500

References ［44］

［1］	Brunner PM, David E, Del Duca E, et al. Transcriptomic profiling of vitiligo patients shows polar immune dysregulation in involved and uninvolved skin［J］. J Allergy Clin Immunol, 2025,156（4）:993⁃1007. DOI: 10.1016/j.jaci.2025.06.002.
［2］	中国中西医结合学会皮肤性病专业委员会色素病学组, 中华医学会皮肤性病学分会白癜风研究中心, 中国医师协会皮肤科医师分会色素病专委会. 白癜风诊疗共识（2024版）［J］. 中华皮肤科杂志, 2024,57（12）:1065⁃1070. DOI: 10.35541/cjd. 20240260.
［3］	van Geel N, Speeckaert R. Segmental vitiligo［J］. Dermatol Clin, 2017,35（2）:145⁃150. DOI: 10.1016/j.det.2016.11.005.
［4］	Katz EL, Harris JE. Translational research in vitiligo［J］. Front Immunol, 2021,12:624517. DOI: 10.3389/fimmu.2021.624517.
［5］	Lin X, Meng X, Lin J. Segmental vitiligo: autoimmune pathogenesis, neuronal mechanisms, and somatic mosaicism［J］. Int J Dermatol, 2025,64（3）:490⁃498. DOI: 10.1111/ijd.17627.
［6］	Xu X, Jiang M, Zhang C, et al. New insights into segmental vitiligo: a clinical and immunological comparison with nonsegmental vitiligo［J］. Pigment Cell Melanoma Res, 2022,35（2）:220⁃228. DOI: 10.1111/pcmr.13022.
［7］	Souroujon AA, Guttman I, Levin N, et al. Autologous cell transplant as a treatment for stable segmental vitiligo: a systematic review［J］. Int J Dermatol, 2023,62（11）:1324⁃1331. DOI: 10.1111/ijd.16844.
［8］	李阳, 祝逸平, 许爱娥. 387例节段型白癜风患者的临床分析［J］. 中华皮肤科杂志, 2013,46（10）:749⁃750. DOI: 10.3760/cma.j.issn.0412⁃4030.2013.10.019.
［9］	Farajzadeh S, Khalili M, Mirmohammadkhani M, et al. Global clinicoepidemiological pattern of childhood vitiligo: a systematic review and meta⁃analysis［J］. BMJ Paediatr Open, 2023,7（1）:e001839. DOI: 10.1136/bmjpo⁃2022⁃001839.
［10］	Delbaere L, van Causenbroeck J, Duponselle J, et al. Hot spots for clinical signs of disease activity in vitiligo［J］. Exp Dermatol, 2024,33（1）: e14975. DOI: 10.1111/exd.14975.
［11］	Taneja N, Sreenivas V, Sahni K, et al. Disease stability in segmental and non⁃segmental vitiligo［J］. Indian Dermatol Online J, 2022,13（1）:60⁃63. DOI: 10.4103/idoj.IDOJ_154_21.
［12］	Willemsen M, Post NF, van Uden NOP, et al. Immunophenotypic analysis reveals differences in circulating immune cells in the peripheral blood of patients with segmental and nonsegmental vitiligo［J］. J Invest Dermatol, 2022,142（3 Pt B）:876⁃883. DOI: 10.1016/j.jid.2021.05.022.
［13］	Aulakh S, Goel S, Kaur L, et al. Differential expression of serum CXCL9 and CXCL10 levels in vitiligo patients and their correlation with disease severity and stability: a cross⁃sectional study［J］. Indian J Dermatol Venereol Leprol, 2025,91（1）:9⁃15. DOI: 10.25259/ijdvl_793_2023.
［14］	Passeron T, Malmqvst VEA, Bzioueche H, et al. Increased activation of innate immunity and pro⁃apoptotic CXCR3B in normal⁃appearing skin on the lesional site of patients with segmental vitiligo［J］. J Invest Dermatol, 2022,142（2）:480⁃483. DOI: 10.1016/j.jid.2021.07.157.
［15］	宋璞, 刘宇, 郭森李, 等. 肥大细胞来源的趋化因子配体5影响氧化应激状态下白癜风CD8⁺T细胞的迁移［J］. 中华皮肤科杂志, 2025,58（9）:839⁃843. DOI: 10.35541/cjd.20230513.
［16］	Tulic MK, Cavazza E, Cheli Y, et al. Innate lymphocyte⁃induced CXCR3B⁃mediated melanocyte apoptosis is a potential initiator of T⁃cell autoreactivity in vitiligo［J］. Nat Commun, 2019,10（1）:2178. DOI: 10.1038/s41467⁃019⁃09963⁃8.
［17］	Kahle J, Rohr B, Shah SD. The co⁃occurrence of segmental vitiligo and linear morphea in a pediatric patient and a review of the literature［J］. Pediatr Dermatol, 2023,40（3）:507⁃510. DOI: 10.1111/pde.15180.
［18］	Balik ZB, Simsek G, Dogan ND, et al. Unusual presentation: concomitant segmental vitiligo, segmental morphea, and lichen striatus［J］. Ir J Med Sci, 2025,194（6）:2179⁃2182. DOI: 10. 1007/s11845⁃025⁃04033⁃z.
［19］	Vibhu M, Damini V, Ridhima L. Linear morphea with lipoatrophy associated with segmental vitiligo in a 13⁃year⁃old girl ⁃ a continuum of spectrum of autoimmunity［J］. Indian Dermatol Online J, 2023,14（6）:879⁃881. DOI: 10.4103/idoj.Idoj_644_22.
［20］	Seneschal J, Speeckaert R, Taïeb A, et al. Worldwide expert recommendations for the diagnosis and management of vitiligo: position statement from the international vitiligo task force⁃part 2: specific treatment recommendations［J］. J Eur Acad Dermatol Venereol, 2023,37（11）:2185⁃2195. DOI: 10.1111/jdv.19450.
［21］	van Geel N, De Lille S, Vandenhaute S, et al. Different phenotypes of segmental vitiligo based on a clinical observational study［J］. J Eur Acad Dermatol Venereol, 2011,25（6）:673⁃678. DOI: 10.1111/j.1468⁃3083.2010.03847.x.
［22］	Dellatorre G, Fava VM, Mira MT, et al. Experimental approaches to assess melanocytes mosaicism in segmental vitiligo［J］. An Bras Dermatol, 2023,98（2）:216⁃220. DOI: 10.1016/j.abd.2022. 05.001.
［23］	Zhou J, Zhong Z, Li J, et al. Motor nerve conduction velocity is affected in segmental vitiligo lesional limbs［J］. Int J Dermatol, 2016,55（6）:700⁃705. DOI: 10.1111/ijd.13171.
［24］	Wu CS, Yu HS, Chang HR, et al. Cutaneous blood flow and adrenoceptor response increase in segmental⁃type vitiligo lesions［J］. J Dermatol Sci, 2000,23（1）:53⁃62. DOI: 10.1016/s0923⁃1811（99）00090⁃0.
［25］	Hu Z, Chen T, Chen D. Local sympathetic nerve depletion does not alter vitiligo progression in a mouse model［J］. Front Med （Lausanne）, 2025,12:1466996. DOI: 10.3389/fmed.2025.1466996.
［26］	Zhang B, Ma S, Rachmin I, et al. Hyperactivation of sympathetic nerves drives depletion of melanocyte stem cells［J］. Nature, 2020,577（7792）:676⁃681. DOI: 10.1038/s41586⁃020⁃1935⁃3.
［27］	Wu Y, Dai Y, Peng J, et al. Increased expression of β2⁃adrenoceptors is involved in vitiligo⁃associated grey hair［J］. J Eur Acad Dermatol Venereol, 2022,36（11）:e949⁃e951. DOI: 10. 1111/jdv.18380.
［28］	Yang X, Ding W, Lou F, et al. Nociceptor⁃derived CGRP enhances dermal typeⅠ conventional dendritic cell function to drive autoreactive CD8+ T cell responses in vitiligo［J］. Immunity, 2025,58（8）:2086⁃2103. DOI: 10.1016/j.immuni. 2025.05.018.
［29］	Hanč P, Gonzalez RJ, Mazo IB, et al. Multimodal control of dendritic cell functions by nociceptors［J］. Science, 2023,379（6639）:eabm5658. DOI: 10.1126/science.abm5658.
［30］	Benzekri L, Cario⁃André M, Laamrani FZ, et al. Segmental vitiligo distribution follows the underlying arterial blood supply territory: a hypothesis based on anatomo⁃clinical, pathological and physio⁃pathological studies［J］. Front Med （Lausanne）, 2024,11:1424887. DOI: 10.3389/fmed.2024.1424887.
［31］	Gauthier Y, Lepreux S, Cario⁃Andre M, et al. Varicella⁃zoster virus in actively spreading segmental vitiligo skin: pathological, immunochemical, and ultrastructural findings （a first and preliminary study）［J］. Pigment Cell Melanoma Res, 2023,36（1）:78⁃85. DOI: 10.1111/pcmr.13064.
［32］	Wang Z, Sun Y. Segmental vitiligo following nine⁃valent human papillomavirus vaccination: a case report［J］. Hum Vaccin Immunother, 2025,21（1）:2541498. DOI: 10.1080/21645515. 2025.2541498.
［33］	Li D, Zhou T, She Q, et al. Circulating exosomal miR⁃493⁃3p affects melanocyte survival and function by regulating epidermal dopamine concentration in segmental vitiligo［J］. J Invest Dermatol, 2022,142（12）:3262⁃3273. DOI: 10.1016/j.jid. 2022. 05.1086.
［34］	van Geel N, Speeckaert R, Taïeb A, et al. Worldwide expert recommendations for the diagnosis and management of vitiligo: position statement from the International Vitiligo Task Force Part 1: towards a new management algorithm［J］. J Eur Acad Dermatol Venereol, 2023,37（11）:2173⁃2184. DOI: 10.1111/jdv. 19451.
［35］	Majid I, Masood Q, Hassan I, et al. Childhood vitiligo: response to methylprednisolone oral minipulse therapy and topical fluticasone combination［J］. Indian J Dermatol, 2009,54（2）:124⁃127. DOI: 10.4103/0019⁃5154.53185.
［36］	Kathuria S, Khaitan BK, Ramam M, et al. Segmental vitiligo: a randomized controlled trial to evaluate efficacy and safety of 0.1% tacrolimus ointment vs 0.05% fluticasone propionate cream［J］. Indian J Dermatol Venereol Leprol, 2012,78（1）:68⁃73. DOI: 10.4103/0378⁃6323.90949.
［37］	中国研究型医院学会皮肤科学专业委员会, 中国医师协会皮肤科医师分会. 白癜风光疗指南（2025版）［J］. 中华皮肤科杂志, 2025,58（3）:197⁃208. DOI: 10.35541/cjd.20240547.
［38］	Silpa⁃Archa N, Weerasubpong P, Junsuwan N, et al. Treatment outcome and persistence of repigmentation from narrow⁃band ultraviolet B phototherapy in vitiligo［J］. J Dermatolog Treat, 2019,30（7）:691⁃696. DOI: 10.1080/09546634.2018.1544409.
［39］	Khalili M, Amiri R, Mohammadi S, et al. Efficacy and safety of traditional and surgical treatment modalities in segmental vitiligo: a review article［J］. J Cosmet Dermatol, 2022,21（6）:2360⁃2373. DOI: 10.1111/jocd.14899.
［40］	Bhingradia YM, Maniya SG. Follicular unit extraction as a treatment modality for stable segmental inguinoscrotal vitiligo: a case report［J］. J Cutan Aesthet Surg, 2023,16（4）:340⁃342. DOI: 10.4103/jcas.Jcas_2_21.
［41］	Jisha P, Nilesh G. Repigmentation of segmental vitiligo with scalp and pubic follicular unit extraction graft transplantation［J］. Int J Trichol, 2023,15（2）:70⁃73. DOI: 10.4103/ijt.Ijt_41_22.
［42］	Li J, Zeng X, Chen S, et al. The treatment of refractory vitiligo with autologous cultured epithelium grafting: a real⁃world retrospective cohort study［J］. Stem Cells Transl Med, 2024,13（5）:415⁃424. DOI: 10.1093/stcltm/szae009.
［43］	Mu Y, Pan T, Chen L. Treatment of refractory segmental vitiligo and alopecia areata in a child with upadacitinib and NB⁃UVB: a case report［J］. Clin Cosmet Investig Dermatol, 2024,17:1789⁃1792. DOI: 10.2147/ccid.S467026.
［44］	Meister HM, Lebwohl M, Silverberg N. Case series of topical 1.5% ruxolitinib cream for pediatric vitiligo［J］. JAAD Case Rep, 2024,54:27⁃30. DOI: 10.1016/j.jdcr.2024.02.034.

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Pathogenesis and treatment of segmental vitiligo

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