Dr. Pandya discusses the role of topical ruxolitinib (Opzelura) in vitiligo, explaining how inhibition of the JAK-STAT pathway can reduce chemokine signaling and allow melanocytes to repopulate affected skin. He reviews clinical trial outcomes and practical considerations for patient assessment, including treatment goals, signs of active disease, anatomic location, the presence of hair within depigmented areas, and the use of dermoscopy and Wood’s lamp examination. Dr. Pandya also emphasizes setting realistic expectations for gradual repigmentation, noting that early changes may appear after several months and hair-bearing areas generally respond better than acral sites. Patient selection, consistent treatment use, prior treatment history, and the potential role of phototherapy or systemic treatment in rapidly progressive disease are also addressed.
Topics Covered:
- JAK-STAT inhibition and mechanism of action of repigmentation with ruxolitinib
- Patient selection, disease assessment, and predictors of treatment response
- Repigmentation timeline, adherence, and long-term treatment expectations
