Abstract Number: 238

Case report: repigmentation of vitiligo with oral baricitinib

B.P. Mumford, A.H. Chong

Meeting: 2021 Dermcoll

Session Information

Date: -

Session Title: Poster Presentations

Session Time: -

Baricitinib, a JAK 1/2 inhibitor, was recently approved in
Australia for the treatment of rheumatoid arthritis.

We present the case of a 67-year-old male with vitiligo affecting the hands and forearms with the significant comorbidity of rheumatoid arthritis. Previous treatment for his rheumatoid arthritis included tofacitinib with little improvement in his vitiligo. No other treatment for the viti- ligo had been trialled.

Baricitinib 4 mg daily was commenced for treatment of his rheumatoid arthritis as a daily dosing alternative to tofaci- tinib, and significant repigmentation was observed after
10 months of therapy.

The precise pathogenesis of vitiligo remains to be eluci- dated, however, interferon-gamma (IFN-c) dependent che- mokine CXCL10 is an important mediator of depigmentation. First generation JAK inhibitors tofacitinib and ruxolitinib suppress IFN- c and consequently CXCL10, and can result in significant repigmentation in vitiligo.

This case adds to the evidence that JAK inhibitors repre- sent a pathogenesis-directed treatment for vitiligo.