Background: Vitiligo is a common acquired immune disorder of the skin characterized by the presence of 
milky white depigmented macules in various distributions. It is an autoimmune disorder caused by the 
destruction of melanocytes in the skin. Its immunopathogenesis is not fully understood, but there are 
inflammatory alterations in the skin microenvironment. Aim of the work: This study aims to estimate 
the level of IL-33 and TNF–alpha in lesional tissues of patients with vitiligo in comparison with 
healthy controls. Subjects and methods: this is a case control study that was conducted on outpatients attending Beni-Suef University Hospital, 30 patients with vitiligo and 30 healthy 
controls, Tissue samples was be collected by punch biopsy (4mm) in diameter from Lesion 
(vitiliginous areas) of the patients and normal skin from the healthy controls. Results: TNF-α 
and IL-33 tissue levels were significantly increaesd in patients with vitiligo compared with healthy 
controls. No correlation between Level of Interlukien-33 and level of Tumor Necrosis Factor-α in 
Vitiligo Lesions among Studied Cases; (p-values> 0.05). Conclusion: Tissue IL-33 levels in 
patients with vitiligo were significantly increased compared with healthy controls. IL-33 could be 
considered a reliable marker for the disease. These results also might partly explain the mechanism 
for TNF-α inhibitor efficacy in patients with vitiligo. Tumour necrosis factor (TNF)‐α, a 
proinflammatory cytokine central to many autoimmune diseases, has been implicated in the 
depigmentation process in vitiligo, as it is also increased in patients with vitiligo compared with 
healthy controls.