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Early Initiation of Vitiligo Treatment Promotes Better Treatment Response

A recent study published in the Frontiers in Immunology Journal suggests that early initiation of immune suppressive vitiligo therapies is associated with favourable treatment outcomes. The study identified significant biomarkers and clinical parameters that could be used to predict favourable outcomes of vitiligo therapy.

The study involved a total of 36 vitiligo patients, out of which 30 patients had non-segmental vitiligo and 6 patients had segmental vitiligo. Out of these patients, 11 of them did not receive treatment and were not included for treatment analysis. The remaining 25, received treatment. The required clinical information was obtained from each of these individuals. This information included general medical history and vitiligo specific history. After obtaining consent from the participants, full-thickness punch biopsies of the target lesions and non lesional skin were taken. Transcriptional sequencing of these biopsies was carried out to identify RNA sequences and genes which contribute to favourable responses to treatment.

The vitiligo patients then received a combination therapy which included Narrow-Band Ultraviolet-B therapy (NBUVB) and topical Tacrolimus 0.1% ointment application. The protocol involved NBUVB phototherapy thrice a week andTacrolimus 0.1% ointment application twice daily. The participants were divided into two groups, the good response group and the bad response group based on whether they achieved >10% repigmentation or not.

The repigmentation levels were assessed every three months, with 11 participants showing greater than 10% repigmentation after 6 months and 14 participants showing less than 10% repigmentation after 6 months. The results showed no changes related to age, gender, race, location of lesion or vitiligo severity between the two groups. However, significant changes related to duration of lesions were observed between the groups. The good response group showed an average duration of 2.5 years and the bad response group showed an average duration of 8.5 years, implying that lesion with new onset responded better to therapies than old lesions. The results also showed higher gene regulation of cellular and adaptive immunity in shorter duration vitiligo lesions.

Thus, the findings of the study suggest that early therapeutic interventions including immune suppressive therapies such as NBUVB phototherapy and topical Tacrolimus are more favourable for successful outcomes in treating vitiligo.

Source: Yang Q, Zhang G, Su M et al. Vitiligo Skin Biomarkers Associated With Favorable Therapeutic Response. Front Immunol. 2021;12.

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