ABSTRACT
Vitiligo， a skin pigmentation disorder caused by the loss of melanocytes in the basal layer of the skin， is manifested as creamy white or ivory white pigmented islands on the head， face， hair， areola， genitals， mucous membranes and traumatic areas with distinct borders， seriously affecting the patient’s social， physical， and mental health. The disease has attracted wide attention in the medical circle as a difficult aesthetic dermatosis with an increasing prevalence year by year. There are still blind spots in the hypotheses that autoimmunity， melanocyte autophagy， oxidative stress， autocytotoxicity， neurohumors， and genetic and environmental factors are associated with the pathogenesis of this disease. The commonly used Western medical therapies， including glucocorticoids， small-molecule antagonists， calcium-regulated neurophosphatase inhibitors， biologics， vitamin D derivatives， phototherapy， and surgery are flawed with side effects and prone to recurrence. Traditional Chinese Medicine （TCM） can treat vitiligo via a wide range of pathways and targets， with definite effects and low adverse reactions. Studies have demonstrated that TCM can promote autophagy of melanocytes and protect them from oxidative stress. However， there are few systematic summaries of the signaling pathways in the TCM treatment of vitiligo. Therefore， this paper introduces the main signaling pathways involved in the TCM treatment of vitiligo by reviewing the relevant articles published at home and abroad in recent years. Specifically， the signaling pathways include the molecular hydrogen-activated nuclear factor erythroid-related factor 2 （Nrf2）， tyrosine kinase receptor （c-Kit）， nuclear transcription factor-κB （NF-κB）， Janus tyrosine protein kinase （JAK）， mitogen-activated protein kinase （MAPK）， phosphatidylinositol 3-kinase （PI3K）/protein kinase B （Akt）， and adenosine monophosphate-activated protein kinase （AMPK） signaling pathways.