Building on prior research that examined the use of an arthritis medication to treat vitiligo, a team of Yale dermatologists has successfully applied a novel combination therapy -- the medication and light -- to restore skin color in patients.
The study, led by associate professor of dermatology Brett King, M.D., was published in JAMA Dermatology on January 31, 2018.
King and his colleagues reported two cases of patients with significant loss of skin color from vitiligo, a chronic autoimmune disease that destroys skin pigment, leaving white splotches where there had been color. For King's patients, standard treatments, such as steroid creams and light treatment, had failed to restore pigmentation. To address these difficult cases, the research team combined the medication, tofacitinib, with narrow band ultraviolet B light therapy. In recent experiments, King and Dr. John Harris, a dermatologist at University of Massachusetts-Worcester, had shown that tofacitinib keeps the immune system from attacking the skin cells that manufacture melanin pigment (color), and light stimulates pigment-making cells to restore color to the skin.
After a few months of the combination therapy, there was remarkable improvement, report the researchers: One patient saw near-total restoration of skin color on her face, neck, chest, forearms, and shins. The other patient experienced similar success.
While more research is needed, the study highlights another advance by the Yale team in treating this and other stigmatizing skin conditions. "These findings will define treatment of vitiligo in the future," King said.
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Other Yale authors are Sa Rang Kim, Henry Heaton, and Lucy Y. Liu. King has served on advisory boards or is a consultant for Celgene, Eli Lilly and Company, Concert Pharmaceuticals Inc., and Pfizer Inc.
JAMA Dermatology