Background: Vitiligo is a common acquired localized or generalized depigmentation of the skin. It is caused by the disappearance of melanocyte function in the skin, but the mechanism is unclear. It can occur in various parts of the body, and is common in the back of the fingers, wrist, forearm, face, neck and around the genitals. At present, the incidence is mostly in young people, children and women.
Existing treatments include: medication, surgery, depigmentation, and physical therapy, etc. These treatments are often difficult to achieve satisfactory results for all conditions. It has been previously reported that tyrosine kinase inhibitors (JAK inhibitors) are equally effective in the treatment of vitiligo.
Existing treatments
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The efficacy of JAK1/3 inhibitor-Tofacitinib in the treatment of vitiligo.
This was a retrospective study. The researchers reviewed 10 cases of vitiligo treated with tofacitinib. Depigmented body surface area was used to assess disease severity.
Results
Ten patients received tofacitinib. Five patients developed repigmentation at skin sites treated with light or low-dose narrow-band UV-B phototherapy. Negative-pressure blister sampling showed that immune responses were suppressed during treatment, with or without response, suggesting that the condition required for melanocyte regeneration was not immunosuppression, but illumination.
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The study population was small and the retrospective study lacked a control group.
Conclusions
Treatment of vitiligo with JAK inhibitors appears to require exposure. In contrast to light therapy, pigment regeneration during treatment with JAK inhibitors may only require a low-light environment. JAK inhibitor monotherapy may also achieve pigment regeneration. These results support a model in which JAK inhibitors inhibit vitiligo T-cytokines while light is necessary to stimulate melanocyte regeneration.
Original attribution :
Liu LY, Strassner JP, et al. Repigmentation in vitiligo using the Janus kinase inhibitor tofacitinib may require concomitant light exposure. J Am Acad Dermatol. 2017 Aug 17. pii: S0190-9622(17)31799-1. doi: 10.1016/j.jaad.2017.05.043. [Epub ahead of print]
Note: This article is only to provide relevant research progress in the field of vitiligo, to help patients understand the relevant trends, and does not provide any basis for medication or treatment. For specific medication guidelines and treatment plans, please consult the attending physician.