Breakthrough in treating leucoderma

Leucoderma
The patient’s hands showed significant repigmentation (bottom) after five months of treatment. – Photo: Dr. Brett King

In a first, a medication for treating rheumatoid arthritis has restored skin colour in a patient suffering from vitiligo. The results of the study were published on June 24 in the journal JAMA Dermatology .

Leucoderma is a condition that causes skin to lose its pigmentation or colour. As a result, people with vitiligo have white patches on the skin. In an advanced stage, most of the body skin can lose its pigmentation.

Current treatments, such as steroid creams and light therapy, fall short as they are “not reliably effective in reversing the disease.” Researchers from Yale University used an existing FDA-approved medication for rheumatoid arthritis called tofacitinib citrate to successfully treat a patient suffering from vitiligo.

Dr. Brett A. King, assistant professor of dermatology at Yale University School of Medicine and Brittany Craiglow, the two authors of the paper, administered tofacitinib citrate to a 53-year-old patient with prominent white spots covering her face, hands, and body.

Quick result

According to a Yale School of Medicine press release, within two months of treatment, the patient experienced partial repigmentation on her face, arms, and hands. And after five months of treatment, the white spots on her face and hands had completely disappeared. The drug caused no adverse side effects in the patient.

“It’s a first, and it could revolutionize treatment of an awful disease,” Dr. King was quoted as saying.. “This may be a huge step forward in the treatment of patients with this condition.” He intends to carry out clinical trials to test the drug’s efficacy in treating people with vitiligo.

The inspiration

What inspired the researchers to use the drug was its magical power in treating hair loss in a patient suffering from alopecia universalis condition. People with this condition tend to rapidly lose all hair on the body, including eyebrows and eyelashes.

The 25-year-old patient who had psoriasis was referred to Dr. King for psoriasis treatment. Since tofacitinib citrate had been used successfully for treating psoriasis in humans and had also reversed alopecia areata in mice, Dr. King used the drug on the patient.

After two months of treatment, some improvement was seen in his psoriasis condition and hair growth was seen on his scalp and face. His scalp hair had completely regrown and “clearly visible eyebrows, eyelashes, and facial hair, as well as armpit hair were seen” at the end of the fifth month. By end of the eighth month the patient had “full regrowth” of hair. The results of the work were published in June 2014 in the Journal of Investigative Dermatology .

“Tofacitinib appears to spur hair regrowth in a patient with alopecia universalis by turning off the immune system attack on hair follicles that is prompted by the disease,” Dr. King had said in a release last year. “The drug helps in some, but not all, cases of psoriasis, and was mildly effective in this patient’s case.”

Published in The Hindu on June 25, 2015

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