Vitiligo as a skin memory disease: The need for early intervention with immunomodulating agents and a maintenance therapy to target resident memory T cells

The understanding of the immune mechanisms of vitiligo has profoundly improved over the past years. The recent discovery of a new population of antigen-experienced memory T cells called resident memory T cells (T-RM) has changed the concept of immune surveillance in peripheral tissue as skin, and the presence of melanocyte-specific T-RM is clearly demonstrated in vitiligo, a disease that could be now seen such as a memory skin disease. This review summarizes the recent knowledge on skin T-RM and their role in vitiligo. Future management or therapies for this disease will have the goal to block their migration/differentiation, to dampen their activation and/or their accumulation in the vitiligo skin to prevent flare-up or to promote repigmentation.