308 nm Excimer Laser Combined With JAK Inhibitors for Adult Localized Non-Segmental Vitiligo: A Multicenter...

Area of Science:

• Dermatology
• Immunology
• Phototherapy

Background:

• Vitiligo is an autoimmune skin disorder causing depigmentation due to melanocyte destruction.
• Localized non-segmental vitiligo presents a significant therapeutic challenge.
• Current treatments for vitiligo often yield limited efficacy.

Purpose of the Study:

• To evaluate the efficacy of combination therapy with 308 nm excimer laser and Janus kinase (JAK) inhibitors for localized non-segmental vitiligo.
• To compare combination therapy against monotherapy and conventional treatments.
• To identify factors influencing treatment response and assess long-term outcomes.

Main Methods:

• A randomized trial involving 251 patients with localized refractory non-segmental vitiligo.
• Four groups: combination therapy (308 nm excimer laser + JAK inhibitors), JAK inhibitor monotherapy, 308 nm excimer laser monotherapy, and positive control.
• Treatment duration of 52 weeks, with assessments using Vitiligo Area Scoring Index (VASI) and dermoscopy, followed by a 1-year follow-up.

Main Results:

• Combination therapy demonstrated significantly higher repigmentation rates (14.20% higher than positive control, p<0.001), indicating synergistic effects.
• Early repigmentation was predicted by melanocyte island density (≥5/cm² at Week 4).
• Higher efficacy was observed in facial lesions, females, and patients with shorter disease duration; no recurrence was noted at 1-year follow-up.

Conclusions:

• Combination therapy with 308 nm excimer laser and JAK inhibitors is highly effective for repigmentation in adult localized non-segmental vitiligo.
• Early identification of pigment islands via dermoscopy aids in predicting treatment success.
• The combination therapy offers sustained pigmentation with no recurrence at one year.