I am a physician-scientist who focuses my clinical and research efforts on vitiligo, and therefore I think about this disease a lot – all the time, in fact. Therefore I thought it would be helpful to share my thoughts with others who are interested in vitiligo as well, particularly the patients who suffer from it and their loved ones. I want to make clear that while I am affiliated with many vitiligo organizations, my comments in this blog are my own, and do not reflect the opinions of those organizations. In addition, my research is largely focused on finding new treatments, and ultimately a cure, for vitiligo. This work is supported by a number of sources, including pharmaceutical companies, which by definition creates potential conflicts of interest. In full disclosure, here is a list of our vitiligo research supporters. Please know that, to the best of my ability, all of my comments are unbiased reflections of my understanding of vitiligo as both a physician and scientist. I do not permit advertisements on my website, and do not endorse companies or products that may advertise on other sites that may be referenced here.
I am excited to announce outstanding results of the first large, randomized clinical trial to test a treatment for vitiligo! For some background, we and a few others reported that the JAK inhibitors tofacitinib and ruxolitinib were effective treatments in a small number of patients with vitiligo. The rationale for using these treatments was based on the cytokine signaling pathways responsible for driving vitiligo. Read more...
This has been a tremendous year for us in the Vitiligo Clinic and Research Center at UMass Medical School. It’s fun to reflect at this time and to think about the hard work done for vitiligo and its potential global impact! I am currently on a much-needed vacation with my wife’s family near Chicago, and I’m using some of my downtime to think and write this summary about the year. There were some ups and downs, but mostly ups, and next year promises to bring even more excitement. Read more...
This blog post in response to multiple exciting and generous requests to help support our research effort to find a cure for vitiligo. I have been touched by the unsolicited outreach by readers all over the world who are just as passionate as we are about improving the lives of tens of millions with vitiligo. In response, we have set up a user-friendly and safe method to donate to support our work. At the end of the blog post there is a link to do just that. I’ll also outline what we have done so far with donor support, and tell you where we’d like to go in the future if we have sufficient resources to do it. You can help!
We recently published our research study in the journal Science Translational Medicine in which we found a new immune pathway that could be targeted as a treatment for the disease. You can read the actual article hereif you’re interested, although it’s pretty dense reading. For those who would like a lighter summary of what we found, you can read the rest of this blog post.
Happy New Year! A lot has happened in our lives in 2017, and the vitiligo community is no exception. While I have become more and more busy since I started this blog, I do recognize its importance to those who read it, and heard the requests for updates on vitiligo research and clinical care. So here is one, looking back at 2017 and forward to 2018!
Watch webinar discusses common, uncommon, and rare presentations of vitiligo; available treatment options for vitiligo and their limitations; and new research discoveries to predict future targeted treatments for vitiligo.
I am sitting in a coffee shop in the Detroit Metro Airport on World Vitiligo Day, June 25th, 2017, drinking a caramel latte while I wait for my flight back to Boston, which will be followed by about an hour drive home. I’m exhausted, but it’s a “good kind of exhausted”, a phrase I’ve heard from others who attended the World Vitiligo Day meeting in Detroit, MI. Another phrase I heard there was “I’m on an incredible high that will last for the next few weeks, at least”. I understand exactly what they mean, and I’m writing this post now so that I can accurately record the incredible events that unfolded this weekend.
Jak inhibitors are all the rage in dermatology, and I recently moderated a symposium at the Society for Investigative Dermatology meeting in Portland that highlighted all the skin diseases for which Jak inhibitors have been used as treatments, including vitiligo, alopecia areata, eczema, and others. I’ve written a number of blogs about using them as a treatment for vitiligo, and many of you have asked for updates. So here is one that is particularly exciting, because it includes information about a clinical trial that should be starting soon.
The Vitiligo Clinic at the University of Massachusetts Medical School (UMMS) is growing, with more and more patients calling to schedule appointments with us from all over the country, and all over the world. With only my single vitiligo clinic on Tuesday afternoons, the wait to get an appointment in our Clinic is 6 months or more. In addition, we are now officially offering the Melanocyte Keratinocyte Transplant Procedure (MKTP) for patients with stable vitiligo, and represent one of only 3 or 4 centers in the country that offers this treatment. We also added excimer laser treatment for our patients, so we knew we needed to expand the clinic to accommodate all of the vitiligo patients who wanted our help. And so I am excited to formally announce the addition of three new doctors to the Vitiligo Clinic and Research Center!
Ever since the report from Yale published about a vitiligo patient who improved after using Xeljanz (tofacitinib)and then our report about Jakafi (ruxolitinib) in another patient, there has been a lot of buzz around the use of JAK inhibitors in vitiligo. Many have asked me for updates on these new drugs for vitiligo by commenting below the blog posts, or tweeting, or emailing me, or stopping me in the hall, pulling me aside at conferences, etc. There have been no published reports since these first two, and I have to be careful speaking publicly about ongoing studies, discussions with companies, etc. But I will do my best to update you on the potential for these drugs in vitiligo.
Many of you have commented on this blog and sent emails asking about the results of a trial we conducted a number of years ago to test simvastatin (brand name Zocor) as a treatment for vitiligo. Before we became aware of the newer types of immune therapies, we were hopeful that existing, safe, and cheaper ones might be able to turn off autoimmunity and treat vitiligo. We first became interested in testing simvastatin after some observations we initially made in mice that get vitiligo. It actually worked in the mice, so we initiated a trial to test it in human vitiligo patients. . .
Recent Interview with DermTube.com "Ask an Expert", hosted by Adam Friedman, MD about the need to understand vitiligo as a skin disease, not simply a cosmetic concern, and stresses the importance of recognizing the impact of the disease on quality of life and the patient's psyche.
Well, here it is, the vitiligo awareness video that we began working on last September, 2015! “Vitiligo: Truth, Hope and Change”, and features a variety of vitiligo patients, their family members, and physician experts. It is touching, informative, and inspirational – take a look!
Did Michael Jackson have vitiligo? First, we know that he stated that he had vitiligo, although this was not until many years after rumors were flying about his “turning white” and his many surgeries. He said that his skin started to change sometime after Thriller, which was released in 1982, so he was about 24 years old when it started. After his death in 2009, his autopsy report provided evidence that he had vitiligo. Michael Jackson was undoubtedly an incredibly talented performer, maybe one of the best in history. The self-proclaimed perfectionist who was never happy with his music or his appearance must have been very self-conscious about the white spots appearing on his skin, visible evidence of a disease called vitiligo that refuses to be ignored. Overall the discussion is complicated, as was his life, but I think there are a few things that I can clear up in this post.
One of the most frequent questions asked by my patients and their families is about the role of diet and supplements in the treatment of their vitiligo. A quick search on the internet will return many claims about how special diets, vitamins, and other supplements treat or even cure vitiligo, and others to avoid, as they supposedly make vitiligo worse. Patients often feel that this is one thing they can control in their treatment strategy, and they want to try whatever they can.
I previously blogged about a trial conducted in the US to test the ability of afamelanotide (Scenesse) to improve the response of vitiligo patients to narrow band UVB (nbUVB). More recently, Clinuvel conducted a smaller clinical trial at the National Skin Center in Singapore, and the results are promising.
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.