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

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 EVOLUTION®), 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.

[1]  R. Gerber,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 , 2017, International journal of rheumatology.

[2]  J. Smolen,et al.  Brief Report: Remission Rates With Tofacitinib Treatment in Rheumatoid Arthritis: A Comparison of Various Remission Criteria , 2017, Arthritis & rheumatology.

[3]  C. Lin,et al.  Low-Dose Therapy for the Treatment of Low-Grade Chronic Inflammation , 2017 .

[4]  C. Lin,et al.  Integrated Approach to Hypertension , 2017 .

[5]  C. Guarneri,et al.  5-hydroxytryptamine and Lyme disease. Opportunity for a novel therapy to reduce the cerebellar tremor? , 2016, Journal of biological regulators and homeostatic agents.

[6]  U. Wollina,et al.  Coexistent trichilemmoma and trichoblastoma without associated nevus sebaceus. , 2016, Journal of biological regulators and homeostatic agents.

[7]  U. Wollina,et al.  Biofibre hair implant – impact on the quality of life. , 2016, Journal of biological regulators and homeostatic agents.

[8]  C. Guarneri,et al.  Pilomatrixoma of the breast in a patient with type 1 myotonic dystrophy: successful surgical approach. , 2016, Journal of biological regulators and homeostatic agents.

[9]  T. Lotti,et al.  Use of Boswellia‐based cream for prevention of adjuvant radiotherapy skin damage in mammary carcinoma , 2016, Dermatologic therapy.

[10]  M. Roccia,et al.  Effects of Arnica comp.-Heel® on reducing cardiovascular events in patients with stable coronary disease. , 2016, Minerva cardioangiologica.

[11]  F. Bardazzi,et al.  Profile of tofacitinib citrate and its potential in the treatment of moderate-to-severe chronic plaque psoriasis , 2016, Drug design, development and therapy.

[12]  U. Wollina,et al.  Isolated CMV infection causing perianal and sacral ulceration in a patient with aids. , 2016, Journal of biological regulators and homeostatic agents.

[13]  U. Wollina,et al.  Vitiligo: successful combination treatment based on oral low dose cytokines and different topical treatments. , 2015, Journal of biological regulators and homeostatic agents.

[14]  Fioranelli M and Roccia Mg The History of Low Dose Medicine Research Review of Preclinical and Clinical Studies with Low Dose SKA Cytokines Since 2009 , 2014 .

[15]  H. Patterson,et al.  Protein kinase inhibitors in the treatment of inflammatory and autoimmune diseases , 2014, Clinical and experimental immunology.

[16]  T. Lotti,et al.  The Last Frontier Of Vitiligo Repigmentation , 2014 .

[17]  Animesh A Sinha,et al.  Oxidative stress and autoimmune skin disease. , 2013, European journal of dermatology : EJD.

[18]  R. Schwartz,et al.  Treatments of vitiligo: what's new at the horizon , 2012, Dermatologic therapy.

[19]  R. Schwartz,et al.  Vitiligo road map , 2012, Dermatologic therapy.

[20]  T. Lotti,et al.  Clinical efficacy of a novel topical formulation for vitiligo: compared evaluation of different treatment modalities in 149 patients , 2012, Dermatologic therapy.

[21]  D. Dowe,et al.  CT Evaluation of Coronary Artery Disease , 2008 .

[22]  Massimo Fioranelli Caratteristiche anatomo-patologiche della placca coronarica , 2008 .

[23]  T. Lotti,et al.  The color of the skin: psycho‐anthropologic implications , 2005, Journal of cosmetic dermatology.

[24]  L. Tavazzi,et al.  Treatment of chronic heart failure with β adrenergic blockade beyond controlled clinical trials: the BRING-UP experience , 2003, Heart.

[25]  A. Necker,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. , 2001, The Journal of investigative dermatology.

[26]  L. Andreassi,et al.  UV‐B radiation microphototherapy. An elective treatment for segmental vitiligo , 1999, Journal of the European Academy of Dermatology and Venereology : JEADV.

[27]  J. Bystryn,et al.  Identification of pigment cell antigens defined by vitiligo antibodies. , 1992, The Journal of investigative dermatology.