Micro - Focused Phototherapy Associated To Janus Kinase Inhibitor: A Promising Valid Therapeutic Option for Patients with Localized Vitiligo

Serena Gianfaldoni; Georgi Tchernev; Uwe Wollina; Maria Grazia Roccia; Massimo Fioranelli; Jacopo Lotti; Miriam Rovesti; Francesca Satolli; Yan Valle; Andy Goren; Michael Tirant; Mirna Situm; Maja Kovacevic; Katlein FranÃ§a; Torello Lotti

doi:10.3889/oamjms.2018.042

Authors

Serena Gianfaldoni University G. Marconi of Rome - Dermatology and Venereology, University G. Marconi of Rome, Rome
Georgi Tchernev Medical Institute of Ministry of Interior (MVR), Department of Dermatology, Venereology and Dermatologic Surgery, Sofia
Uwe Wollina StÃ¤dtisches Klinikum Dresden, Department of Dermatology and Venereology, Dresden, Sachsen
Maria Grazia Roccia University B.I.S. Group of Institutions, Punjab Technical University, Punjab
Massimo Fioranelli G. Marconi University - Department of Nuclear Physics, Subnuclear and Radiation, Rome
Jacopo Lotti G. Marconi University - Department of Nuclear Physics, Subnuclear and Radiation, Rome
Miriam Rovesti Department of Dermatology, University of Parma, Parma
Francesca Satolli Department of Dermatology, University of Parma, Parma
Yan Valle Vitiligo Research Foundation, New York
Andy Goren Department of Dermatology, University G. Marconi of Rome, Rome
Michael Tirant Psoriasis & Skin Clinic, 374 Nepean Highway Frankston Victoria, Melbourne 3199
Mirna Situm Department of Dermato-Venereology, Zagreb University Hospital Center Sisters of Charity, University of Zagreb, Zagreb
Maja Kovacevic Department of Dermato-Venereology, Zagreb University Hospital Center Sisters of Charity, University of Zagreb, Zagreb
Katlein FranÃ§a University of Miami School of Medicine Ringgold standard institution, Miami, Florida
Torello Lotti University G. Marconi of Rome, Dermatology and Venereology, Rome

DOI:

https://doi.org/10.3889/oamjms.2018.042

Keywords:

Vitiligo, Micro â€“ phototherapy, BIOSKIN EVOLUTIONÂ®, Janus kinase inhibitor, Tofacitinib, Repigmentation

Abstract

BACKGROUND: Vitiligo is an acquired pigmentary cutaneous disease, characterised by the progressive loss of melanocytes, resulting in hypopigmented skin areas which progressively become amelanotic. Classically, vitiligo treatments are unsatisfactory and challenging. Despite the continuous introduction of new therapies, phototherapy is still the mainstay for vitiligo repigmentation.

AIM: The aim of this multicenter observational retrospective study was to evaluate the efficacy and safety of the nb - UVB micro - phototherapy (BIOSKIN EVOLUTIONÂ®), used alone or in associations with an oral Janus kinase inhibitor (Tofacitinib citrate), in the treatment of stable or active forms of localised vitiligo.

MATERIAL AND METHODS: Fifty eight patients had been treated with n-UVB micro-photootherapy (Group A); 9 patients had been treated with phototherapy plus Tofacitinb citrate (Group B).

RESULTS: Among Group A, 42 patients (72%) obtained a re-pigmentation rate higher than 75%, with a medium value of 77%. 11 patients (19%) achieved a marked improvement of the clinical findings with a repigmentation rate between 50-75%; 4 patients (8%) showed a moderate response with a lesional repigmentation of 25-50%. Only one patient (1%) had a poor response to the phototherapeutic treatment

CONCLUSION: Nb - UVB micro-focused phototherapy is one of the most effective therapeutic options for vitiligo treatment. The association of micro-focused phototherapy to Tofacitinib citrate seems to provide better clinical results in term of repigmentation rate.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

Plum Analytics Artifact Widget Block

References

Lotti T, Hautmann G, HercogovÃ J. Vitiligo: disease or symptom? From the confusion of the past to current doubts. In: Lotti T, HercogovÃ J, eds. Vitiligo. Problems and solutions. New York, NY, Basel: Marcel Dekker, Inc, 2004:1-14. PMid:15063608

Shah AA, Sinha AA. Oxidative stress and autoimmune skin disease. Eur J Dermatol. 2013; 23(1):5-13. PMid:23420016

Palermo B, Campanelli R, Garbelli S et al. Specific cytotoxic T lymphocyte responses against Melan-A/MART1, tyrosinase and gp100 in vitiligo by the use of major histocompatibility complex/peptide tetramers: the role of cellular immunity in the etiopathogenesis of vitiligo. J Invest Dermatol. 2001; 117:326-32. https://doi.org/10.1046/j.1523-1747.2001.01408.x PMid:11511311

Lee BW, Schwartz RA, HercogovÃ¡ J, Valle Y, Lotti TM. Vitiligo road map. Dermatol Ther. 2012; 25(Suppl 1):S44-56. https://doi.org/10.1111/dth.12006 PMid:23237038

Cui J, Harning R, Henn M, Bystryn JC. Identification of pigment cell antigens defined by vitiligo antibodies. J Invest Dermatol. 1992; 98:162-5. https://doi.org/10.1111/1523-1747.ep12555773 PMid:1370675

Lotti T, Hautmann G, HercogovÃ J. Vitiligo: disease or symptom? From the confusion of the past to current doubts. In: Lotti T, HercogovÃ J, eds. Vitiligo. Problems and solutions. New York, NY: Basel: Marcel Dekker Inc., 2004: 1-14. PMid:15063608

Lotti TM, HercogovÃ¡ J, Schwartz RA et al. Treatments of vitiligo: what's new at the horizon. Dermatol Ther. 2012; 25(Suppl 1):S32-S40. https://doi.org/10.1111/dth.12011 PMid:23237036

Lotti T, Hanna D, Buggiani G, Urple M. The color of the skin: psycho-anthropologic implications. J Cosmet Dermatol 2005; 4(3):219-20. https://doi.org/10.1111/j.1473-2165.2005.00316.x PMid:17129270

Gianfaldoni S, Hercogova J, Lotti T. The last frontier of Vitiligo repigmentation. The Asthetic J. 2014;34-37.

Lotti TM, Menchini G, Andreassi L. UV-B radiation microphotherapy: An elective treatment for segmental vitiligo. J Eur Acad Dermatol Venereol. 1999; 13:102-8. https://doi.org/10.1111/j.1468-3083.1999.tb00861.x PMid:10568488

Buggiani G, Tsampau D, HercogovÃ J, Rossi R, Brazzini B, Lotti T. Clinical efficacy of a novel topical formulation fro vitiligo: compared evaluation of different treatment modalities in 149 patients. Derm Ther. 2012; 25:472-76. https://doi.org/10.1111/j.1529-8019.2012.01484.x PMid:23046028

Di Lernia V, Bardazzi F. Profile of tofacitinib citrate and its potential in the treatment of moderatetosevere chronic plaque psoriasis. Drug Des Devel Ther. 2016; 10:533-9. https://doi.org/10.2147/DDDT.S82599 PMid:26889081 PMCid:PMC4743637

Bergrath E, Gerber RA, Gruben D et Al. Tofacitinib versus Biologic Treatments in Moderate-to Severe Rheumatoid Arthritis Patients Who Have Had an Inadequate Response to Nonbiologic DMARDs: Systematic Literature Review and Network Meta-Analysis. Int J Rheumatol. 2017; 2017:8417249. https://doi.org/10.1155/2017/8417249 PMid:28377787 PMCid:PMC5362710

Smolen JS, Aletaha D, Gruben D et Al. Brief Report: Remission Rates With Tofacitinib Treatment in Rheumatoid Arthritis: A Comparison of Various Remission Criteria. Arthritis Rheumatol. 2017; 69(4):728-734. https://doi.org/10.1002/art.39996 PMid:27907269 PMCid:PMC5396306

Patterson H, Nibbs R, McInnes I et al. Protein kinase inhibitors in the treatment of inflammatory and autoimmune diseases. Clin Exp Immunol. 2014; 176:1 â€“10. https://doi.org/10.1111/cei.12248 PMid:24313320 PMCid:PMC3958149

Lotti T, Hercogova J, Wollina U, Chokoeva AA, Zarrab Z, Gianfaldoni S, Roccia MG, Fioranelli M, Tchernev G. Vitiligo: successful combination treatment based on oral low dose cytokines and different topical treatments. J Biol Regul Homeost Agents. 2015; 29(1 Suppl):53-8. PMid:26016984