WEDNESDAY, March 13, 2024 -- In a consensus statement published online March 13 in JAMA Dermatology, evidence-based recommendations are presented for the diagnosis and treatment of vitiligo in young patients.

Yael Renert-Yuval, M.D., from the Icahn School of Medicine at Mount Sinai in New York City, and colleagues developed evidence- and consensus-based expert recommendations on the diagnosis and treatment of vitiligo in young patients. A total of 50 articles on topical corticosteroids and/or topical calcineurin inhibitors, five on topical Janus kinase inhibitors, two on pseudocatalase, and two on microdermabrasion met the inclusion criteria.

The authors made 42 recommendations on diagnosis of vitiligo and optimal topical therapeutics; 33 of the recommendations obtained a 70 percent or higher composite agreement and strong agreement. Evidence-based first-line therapies in the management of pediatric and adolescent patients included topical calcineurin inhibitors twice daily, topical corticosteroids with time limitation due to atrophy risk, and topical ruxolitinib (1.5 percent) cream -- used off-label for patients younger than 12 years and limited to nonsegmental vitiligo. Specific guidance was provided using age-based data, a minimum therapeutic trial of six months or longer, prolonged therapy to prevent recurrence, and the positive benefit of coordinated use of ultraviolet therapeutic sources.

"Suggested next steps include development of a long-term vitiligo registry and head-to-head short- and long-term comparisons of all three major classes of topical therapy," the authors write. "Future studies of vitiligo should aim to identify the role of early intervention as a means of controlling long-term disease activity and preventing T-memory cell accumulation."

Several authors disclosed ties to pharmaceutical companies, including Incyte Pharmaceuticals, which funded the study.