"Speaking of Vitiligo..."

Many have heard that some forms of vitiligo can be treated with surgical approaches, like skin or cellular grafts. This can be a very effective treatment for some patients, and many times the standard vitiligo treatments are no longer needed. Each procedure has pros and cons, but it seems that the cellular grafts have the best results and can cover the largest areas; this is typically called the Melanocyte-Keratinocyte Transplant Procedure, or MKTP. The caveat is that it doesn’t work for every, or even most, patients. 

We recently published a report about a vitiligo patient who quickly improved after taking ruxolitinib (Jakafi), a drug that inhibits Janus Kinases (JAKs), which are important for signals that tell the immune cells where to go and what to do. This result is really exciting, because it is an oral drug that had a very rapid effect on vitiligo, improving the patient’s facial pigmentation from less than 1% to over 50% in just 4-5 months. We hypothesized that it might be effective for vitiligo because it blocks a pathway in the immune system that we have found to be critical for vitiligo.

I previously posted that we were organizing a meeting specifically for vitiligo patients in Orange, CA titled Advances in Vitiligo Research and Care, where experts from all over the world would speak about vitiligo, what causes it, how to treat it, and the progress that has been made through research. But, many couldn’t make it to the meeting, and I promised to write a summary. Here it is!

You may have already heard about the recent report by Dr. Brett King at Yale University, about one of his patients with vitiligo who responded to treatment with tofacitinib (brand name Xelganz), regaining much of the pigment in her face and hands within a few months. While only a single patient, this report is indeed very exciting, as it suggests that Jak inhibitors may provide a new effective treatment for vitiligo. We are also excited because Dr. King based his rationale for using tofacitinib in vitiligo on our research, which defined the IFN-γ signaling pathway as critical for vitiligo progression and maintenance. It supports our hypothesis that targeting this pathway would be an effective strategy for developing new treatments. 

Today, June 25th, 2015, is World Vitiligo Day, and I am going to tell you how I spent my day! I had the honor and pleasure to stand with our Boston vitiligo support group, VitFriends, on the steps of the State House in Boston talking to passersby about vitiligo to raise awareness of the disease. It was sunny and HOT, but there was a lot of foot traffic during lunch hour, and we educated some and also met new friends with the disease. Then we were invited into the State House to meet with State Representative Gloria L. Fox, who listened intently to our concerns about vitiligo. We are excited to consider her the newest member of our team to help develop a plan to change the way people with vitiligo are viewed and treated in Massachusetts, the United States, and around the world.

We are organizing a meeting specifically designed for vitiligo patients! Dermatologists and scientists who have particular expertise in vitiligo will be speaking about a multitude of topics, from explaining the importance of their research, to how to treat vitiligo and work with your health insurance company to get important treatments covered. 

Should someone with vitiligo get a tattoo? The answer is not straightforward, and requires some discussion about the purpose of the tattoo, the stability of vitiligo, and the expectations of the patient. Some people want to tattoo a vitiligo spot with their skin color, so that it covers the spot and their skin looks even. Others want to tattoo a picture or phrase over their spots to serve as a distraction, and others just want to get a tattoo on a part of the body that doesn’t have spots, but they heard that it might make their vitiligo worse. I will address all of these options here, as well as their pros and cons.