Worldwide expert recommendations for the diagnosis and management of vitiligo: Position statement from the international Vitiligo Task Force—Part 2: Specific treatment recommendations

Author:

Seneschal Julien1ORCID,Speeckaert Reinhart2,Taïeb Alain3ORCID,Wolkerstorfer Albert4,Passeron Thierry5ORCID,Pandya Amit G.6ORCID,Lim Henry W.7,Ezzedine Khaled8ORCID,Zhou Youwen9,Xiang Flora10ORCID,Thng Steven11,Tanemura Atsushi12ORCID,Suzuki Tamio13,Rosmarin David14,Rodrigues Michelle1516ORCID,Raboobee Noufal17,Pliszewski Georg18,Parsad Davinder19ORCID,Oiso Naoki20ORCID,Monteiro Paul21,Meurant Jean Marie22,Maquignon Nicolle23,Lui Harvey9,Le Poole Caroline24,Leone Giovanni25,Lee Ai‐Young26,Lan Eric27ORCID,Katayama Ichiro28,Huggins Richard7,Oh Sang Ho29ORCID,Harris John E.30,Hamzavi Iltefat H.7,Gupta Somesh31ORCID,Grimes Pearl32,Goh Boon Kee33,Ghia Deepti34,Esmat Samia35,Eleftheriadou Viktoria36,Böhm Markus37ORCID,Benzekri Laila38ORCID,Bekkenk Marcel39,Bae Jung Min40ORCID,Alomar Augustin41,Abdallah Marwa42ORCID,Picardo Mauro43,van Geel Nanja2ORCID

Affiliation:

1. Department of Dermatology and Pediatric Dermatology, National Reference Center for Rare Skin Disorders, Hospital Saint‐André ImmunoConcept, CNRS UMR 5164, Bordeaux University Bordeaux France

2. Department of Dermatology Ghent University Hospital Ghent Belgium

3. Department of Dermatology and Pediatric Dermatology, National Reference Center for Rare Skin Disorders, Hospital Saint‐André, BRIC, UMR 1312, Inserm University Bordeaux Bordeaux France

4. Department of Dermatology, Netherlands Institute for Pigment Disorders Amsterdam University Medical Centers, Amsterdam Institute for Infection and Immunity, University of Amsterdam Amsterdam The Netherlands

5. Department of Dermatology University Hospital of Nice Nice France

6. Department of Dermatology The University of Texas Southwestern Medical Center Dallas Texas USA

7. Department of Dermatology Henry Ford Health Detroit Michigan USA

8. Department of Dermatology, University Hospital Henri Mondor, EpiDermE EA 7379 Université Paris‐Est Créteil Val de Marne Créteil France

9. Department of Dermatology and Skin Science University of British Columbia Vancouver British Columbia Canada

10. Department of Dermatology, Huashan Hospital Fudan University Shanghai China

11. Skin Research Institute of Singapore, ASTAR Singapore Singapore

12. Department of Dermatology Integrated Medicine Osaka University Graduate School of Medicine Osaka Japan

13. Department of Dermatology Yamagata University Faculty of Medicine Yamagata Japan

14. Department of Dermatology Tufts University School of Medicine Boston Massachusetts USA

15. Chroma Dermatology Pigment and Skin of Colour Centre Wheelers Hill Victoria Australia

16. Department of Dermatology The Royal Children's Hospital Parkville Victoria Australia

17. Department of Dermatology Westville Hospital Durban South Africa

18. Deutscher Vitiligo‐Bund e.V. Adelsdorf Germany

19. Department of Dermatology, Venereology & Leprology Postgraduate Institute of Medical Education and Research Chandigarh India

20. Department of Dermatology Kindai University Nara Hospital Ikoma Japan

21. Vitiligo.nl The Hague The Netherlands

22. Vitiligo International Patient Organisations Paris France

23. Association Française du Vitiligo Paris France

24. Department of Dermatology, Microbiology and Immunology, Robert H. Lurie Comprehensive Cancer Center Northwestern University Chicago Illinois USA

25. Photodermatology and Vitiligo Treatment Unit, Israelite Hospital, Roma

26. Department of Dermatology College of Medicine, Dongguk University Ilsan Hospital Goyang Korea

27. Department of Dermatology Kaohsiung Medical University Hospital Kaohsiung Taiwan

28. Pigmentation Research and Therapeutics Osaka Metropolitan University Osaka Japan

29. Department of Dermatology, Severance Hospital, Cutaneous Biology Research Institute Yonsei University College of Medicine Seoul South Korea

30. Department of Dermatology University of Massachusetts Chan Medical School Worcester Massachusetts USA

31. Department of Dermatology and Venereology All India Institute of Medical Sciences New Delhi India

32. Vitiligo & Pigmentation Institute of Southern California Los Angeles California USA

33. Skin Physicians Pte Ltd Singapore Singapore

34. Department of Dermatology Jaslok Hospital and Research Hospital and South Mumbai Dermatology Clinic Mumbai India

35. Department of Dermatology Faculty of Medicine Cairo University Cairo Egypt

36. New Cross Hospital The Royal Wolverhampton NHS Trust Wolverhampton UK

37. Department of Dermatology University Hospital Münster Münster Germany

38. Department of Dermatology Mohammed V University, Ibn Sina University Hospital Rabat Morocco

39. Department of Dermatology, Netherlands Institute for Pigment Disorders Amsterdam University Medical Centers, Amsterdam Institute for Infection and Immunity, VU University Amsterdam The Netherlands

40. Department of Dermatology, St. Vincent's Hospital, College of Medicine The Catholic University of Korea Seoul South Korea

41. Department of Dermatology Clinica Dermatologica Moragas Barcelona Spain

42. Dermatology, Andrology, and Venereology Department Ain Shams University Cairo Egypt

43. Unicamillus International University Rome Italy

Abstract

AbstractBackgroundThe treatment of vitiligo can be challenging. Up‐to‐date agreed consensus recommendations on the use of topical and systemic therapies to facilitate the clinical management of vitiligo are currently lacking.ObjectivesTo develop internationally agreed‐upon expert‐based recommendations for the treatment of vitiligo.MethodsIn this consensus statement, a consortium of 42 international vitiligo experts and four patient representatives participated in different online and live meetings to develop a consensus management strategy for vitiligo. At least two vitiligo experts summarized the evidence for different topics included in the algorithms. A survey was then given to a core group of eight experts to resolve the remaining issues. Subsequently, the recommendations were finalized and validated based on further input from the entire group during two live meetings.ResultsThe recommendations provided summarize the latest evidence regarding the use of topical therapies (steroids, calcineurin inhibitors and Jak‐inhibitors) and systemic therapies, including steroids and other systemic immunomodulating or antioxidant agents. The different modalities of phototherapies (NB‐UVB, photochemotherapy, excimer devices and home phototherapy), which are often combined with other therapies, are also summarized. Interventional approaches as well as depigmentation strategies are presented for specific indications. Finally, the status of innovative and targeted therapies under development is discussed.ConclusionsThis international consensus statement culminated in expert‐based clinical practice recommendations for the treatment of vitiligo. The development of new therapies is ongoing in vitiligo, and this will likely improve the future management of vitiligo, a disease that still has many unmet needs.

Publisher

Wiley

Subject

Infectious Diseases,Dermatology

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