Oral communication, CS24 / C116

Official XXIst International Pigment Cell Conference website - 21-24 Sept 2011, Bordeaux - France | updated: September 04 2011

Active vitiligo lesions are more responsive to combination therapy with narrowband ultraviolet light B and topical tacrolimus

BACKGROUND AND OBJECTIVES: At present, narrow band UVB is the most commonly used treatment worldwide for regaining pigment in patients suffering from vitiligo. Recent results support improved efficacy by addition of topical tacrolimus. The objective for the current study is to evaluate if the clinical factors such as lesional activity and lesional molecular markers are correlated with therapeutic outcomes. METHODS: Fifty nine patients with non-segmental vitiligo were recruited for this study. A target lesion is selected for each vitiligo patient. The lesional activity is deemed “active” if one of the following two conditions is met: (1) its onset is within 6 month, or (2) for lesions lasting longer than 6 month, they show signs of expansion the past 6 months. The target lesion was then biopsied, together with non-lesional skin that matches the target lesional skin in anatomic characteristics. As controls, torso skin from healthy volunteers was also obtained. The vitiligo patients then underwent repigmentation therapy that combines narrowband UVB phototherapy (2 x / week) and topical tacrolimus (twice per day on non-phototherapy days). The therapeutic response is defined as significant if there is greater than 30% repigmentation at 6 months. In addition, the gene expression profiles of the skin biopsies were analyzed using DNA microarrays containing 41K human gene probes. The results were verified using RT-PCR. RESULTS: The “active” vitiligo lesions are much more likely to respond to combined NBUVB plus topical tacrolimus therapy than older or stable lesions. Further, compared with lesions that show no or little repigmentation response, the responsive lesions showed much higher residual markers of melanogenesis, such as TYR and TRP1. CONCLUSION: Recent onset vitiligo lesions are much more responsive to the repigmentation therapy, possibility due to higher numbers of residual melanocytes. Therefore, early initiation of therapy is an important therapeutic strategy for regaining lost pigmentation.

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