Vitiligo is the most common hypopigmentation disease affecting both the skin and mucous membranes. The pathogenesis of this disorder is complex and involves the influence of genetic and environmental factors, oxidative stress, and autoimmune responses. Recent studies have indicated that skin lesions observed in vitiligo tend to recur in the same places where they were found before treatment. This phenomenon is explained by the presence of recently discovered tissue-resident memory T cells (T_RM), whose primary function is to provide antiviral and antibacterial protection in non-lymphoid tissues. T_RM cells show the presence of CD49a, CD69, and CD103 markers on their surface, although not all of them express these particles. Due to their ability to produce and secrete perforin, IFN-γ, and granzyme B, T_RM cells demonstrate a cytotoxic effect on melanocytes, thus inducing depigmented lesions in the course of the vitiligo. It has been proved that the occurrence of T_RM cells largely depends on IL-15, which promotes the T_RM function ex vivo. The findings above, as well as their reference to the pathogenesis of autoimmune skin diseases will have a considerable influence on the development of new therapeutic strategies in the near future. This article presents an up-to-date review of information regarding the role of T_RM cells in the development and progression of vitiligo.

Vitiligo is described as a dermatological condition characterized by pigmentation disorders in both the skin and mucous membranes. Clinically, this disease is characterized by the presence of well-defined white areas of various shapes and sizes, which are a manifestation of a reduced number of melanocytes. Due to the fact that vitiligo can be a significant cosmetic problem for patients, a number of methods are currently available to help fight for a better skin appearance. If all the available non-invasive procedures turn out to be ineffective, surgery can help, which is a very good alternative in the case of difficult-to-treat but stable changes. Both the development of new techniques and modifications to the already available treatment of cell and tissue transplantation give hope to numerous patients around the world. The effectiveness of a particular method is determined by its appropriate selection depending on the lesions undergoing therapy. Each form of surgical intervention has its advantages and disadvantages, which, along with the location or size of the treated hypopigmentation area, should be analyzed by a doctor and discussed with their patient. This article is an overview of the currently available methods of surgical treatment of vitiligo and a comparison of their pros and cons.

Background/Objectives: Calcinosis cutis (CC) is a condition that may develop in the course of several autoimmune connective tissue diseases (ACTDs). Among these, the conditions most frequently associated with CC are systemic sclerosis (SSc) and dermatomyositis (DM). Despite both the prevalence and diversity of available treatment options, therapeutic recommendations remain not fully established due to a limited number of studies and lack of unambiguous evidence regarding their effectiveness. Case Presentation: We report two cases of patients with DM and concomitant massive cutaneous calcifications who were treated: in the case of a 71-year-old man with DM and past medical history of primary cutaneous T-cell lymphoma (CTCL) who received intralesional (IL) 25% sodium thiosulfate (STS) with platelet-rich plasma (PRP) injections, and, in the case of a second patient, 24-year-old woman with nephrolithiasis, who received intravenous immunoglobulin (IVIG) infusions at a dose of 2 g/kg in combination with prednisone at a dose of 5 mg/day. Conclusions: The applied treatment led to reduction in pain, size, and number of calcified lesions. Additionally, healing of fingertip ulcers after PRP injections was observed. While this report highlights only two isolated cases, the use of IVIG and STS with PRP injections appears to be an effective treatment method. Nevertheless, both standardization and additional research are required.

Stable non-segmental vitiligo is sustained by persistent autoimmune responses involving tissue-resident memory T (TRM) cells, impaired regulatory T-cell (Treg) function, and chronic cytokine-mediated inflammation. Although fractional carbon dioxide (CO₂) laser and narrowband ultraviolet B (NB-UVB) phototherapy are widely used to induce repigmentation, their immunomodulatory mechanisms remain incompletely understood. In this prospective, non-randomized exploratory study, 19 patients with stable non-segmental vitiligo received either monthly fractional CO₂ laser monotherapy or fractional CO₂ laser combined with NB-UVB phototherapy for 6 months. Serum IL-15 and IL-17A concentrations were quantified by ELISA at baseline, 3 months, and 6 months. Double immunofluorescence was performed to evaluate cutaneous TRM- and Treg-associated markers (CD4, CD8, CD25, CD49a, CD69, CD103, FOXP3) together with melanocyte-associated markers (MITF and c-KIT). Longitudinal differences between treatment groups were assessed using linear mixed-effects models with treatment-by-time interactions. Serum IL-15 and IL-17A concentrations decreased significantly over time in both treatment groups. At 6 months, IL-15 concentrations did not differ significantly from those in healthy controls in either group, whereas IL-17A concentrations did not differ significantly from healthy-control values in the fractional CO₂ laser monotherapy group but remained significantly higher in the combination-treatment group. Cutaneous analyses demonstrated longitudinal changes in selected TRM- and Treg-associated markers and melanocyte-associated markers, with MITF showing the most pronounced increase. Several cutaneous immune markers remained significantly different from healthy-control values after 6 months. No statistically significant treatment-by-time interactions were detected for IL-15, IL-17A, or the evaluated dermal and epidermal markers. Fractional CO₂ laser monotherapy and fractional CO₂ laser combined with NB-UVB were both associated with longitudinal changes in circulating inflammatory cytokines and selected cutaneous immune- and melanocyte-associated markers in patients with stable non-segmental vitiligo. Persistent abnormalities in several cutaneous immune markers suggest that treatment did not fully restore the cutaneous immune-marker profile within the 6-month observation period. Given the small sample size and non-randomized exploratory design, the absence of statistically significant treatment-by-time interactions should not be interpreted as evidence of therapeutic equivalence, non-inferiority, or absence of an additional effect of NB-UVB.