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.
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.
What are the best treatments for vitiligo? The answer is pretty simple. Get out your pen, and I’ll tell you exactly what I do when patients come to my clinic. It’s not a secret! Many times patients go to their doctor and they’re told, “There’s no cure for vitiligo”. Well that's true, but that doesn’t mean there aren’t good treatments! Also, we talk a lot on here about our excitement for new treatments for vitiligo, and sometimes that sounds like “current treatments don’t work”. Well, that’s NOT true. We have good treatments, but we’re trying to make better ones.
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.
Valarie Molyneaux has accomplished a tremendous amount in raising vitiligo awareness and bringing people together in a very short time. Valarie started the Vitfriends vitiligo support group in 2004, and now has a large membership with regular meetings in Boston and yearly conferences that have been really well attended (the picture is from the meeting in 2015, she’s on the far left of the picture, next to me). The group has since expanded to multiple locations across the country, including NY, CT, NC/SC, IN, DE, MN, and DC. Probably her most impressive accomplishment was in leading the first World Vitiligo Day meeting in the US, which took place in Washington D.C. this past summer of 2016. It was an incredibly successful and inspiring meeting, and has launched an annual event that will take place in Detroit this summer, 2017.
Do we truly know what causes vitiligo? Is it really an autoimmune disease? Isn’t the cause “unknown”, and aren’t there many alternative theories that are equally likely? These questions drive me nuts, but people keep asking them, so I thought I should probably take the time to answer. In fact, we know more about what causes vitiligo than any other autoimmune disease, including diabetes, thyroiditis, lupus, and others. It’s true that there have been many different ideas in the past about what causes vitiligo, from autoimmunity to cellular stress, chemicals, nerves, and genetics. And many scientists have spent a long time arguing about which one was correct. It turns out that most of them are correct, and work together to cause the clinical disease we call vitiligo.
Dr. Richard Spritz, a pediatrician and geneticist at the University of Colorado, is an interesting guy who not only does important research in genetics, but also does vintage car racing as a hobby. He recently published his third genomewide association study (GWAS) to identify genes involved in the development of vitiligo. It was a beautiful study, which added another 23 risk alleles (genes that increase the risk of getting disease), increasing the total known vitiligo susceptibility genes to about 50. This effort represents many years of work, and collaboration with physicians from all over the world who helped to recruit patients to donate their DNA, enabling the studies to identify these genes. I spend a lot of time discussing Dr. Spritz’s results with him at meetings, and thought it might be best to let him tell you about these latest results in his own words. So I sat down with him and asked him a few questions.
The Vitiligo Clinic at the UMass Chan Medical School (UMass Chan) 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!
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.