Key points Heredity: 20% of vitiligo patients have a first-degree relative with vitiligo Human leukocyte antigen (HLA) haplotypes may contribute to vitiligo susceptibility Many pathological states are associated with vitiligo: its thought to be a possible trigger for disease development Vitiligo onset is mostly associated with stressful life events Physical trauma to the skin can cause vitiligo (homozygous reaction) Solution It is well known that heredity is a It is well known that genetics is a predisposing factor for vitiligo. About 20% of vitiligo patients report that one of their first-degree relatives has vitiligo. Children of patients with vitiligo have a 1.7-fold increased risk of developing vitiligo compared to children of other families. Human leukocyte antigen haplotypes may increase susceptibility to pancreatic vitiligo, such as HLAs-A2, -DR4, -DR7and -DQB1 0303. The NALP-1 gene (NACHT leucine-rich repeat protein 1), epidemiologically, is the main susceptibility gene associated with pancreatic vitiligo and other autoimmune diseases such as thyroid disease, pernicious anemia and lupus erythematosus. Patients with the following diseases are more likely to develop vitiligo (and vice versa): pemphigus, pernicious anemia, IgA selective deficiency Autoimmune thyroid disease Addison’s disease. Congenital neviMELAS syndrome of melanocytes (mitochondrial encephalomyopathy, lactic acidosis, stroke attack syndrome) Stressful life events may interfere with the psycho-neuro-endocrine-immune system; also physical skin injuries, including sunburn, can easily induce vitiligo in susceptible individuals.