Advances in Janus kinase inhibitors for vitiligo

Vitiligo is a chronic autoimmune disease that can manifest at any age and affect any anatomical site. Clinically characterized by hypopigmented or depigmented macules and patches on the skin and mucous membranes, and occasionally accompanied by leukotrichia, the condition imposes a profound psychosocial burden and significantly impairs patients' quality of life. Although conventional therapeutic modalities-including corticosteroids, topical calcineurin inhibitors, phototherapy, and surgical interventions-can achieve varying degrees of disease control, their long-term efficacy is frequently constrained by the chronic, relapsing, and unpredictable nature of the disease.Recently, a deeper understanding of the pathogenesis of vitiligo has highlighted the substantial therapeutic potential of small-molecule targeted agents, particularly Janus kinase (JAK) inhibitors. Emerging evidence from clinical trials and case reports corroborates the efficacy of specific JAK inhibitors in promoting the repigmentation of lesional skin. This review synthesizes current research concerning the mechanisms of action, clinical applications, and safety profiles of representative JAK inhibitors-namely ruxolitinib, upadacitinib, and abrocitinib-in the management of vitiligo, aiming to provide novel insights for future therapeutic strategies.