Worldwide expert recommendations for the diagnosis and management of vitiligo: Position statement from the international Vitiligo Task Force—Part 2: Specific treatment recommendations

Abstract

BackgroundThe treatment of vitiligo can be challenging. Up‐to‐date agreed consensus recommendations on the use of topical and systemic therapies to facilitate the clinical management of vitiligo are currently lacking.ObjectivesTo develop internationally agreed‐upon expert‐based recommendations for the treatment of vitiligo.MethodsIn this consensus statement, a consortium of 42 international vitiligo experts and four patient representatives participated in different online and live meetings to develop a consensus management strategy for vitiligo. At least two vitiligo experts summarized the evidence for different topics included in the algorithms. A survey was then given to a core group of eight experts to resolve the remaining issues. Subsequently, the recommendations were finalized and validated based on further input from the entire group during two live meetings.ResultsThe recommendations provided summarize the latest evidence regarding the use of topical therapies (steroids, calcineurin inhibitors and Jak‐inhibitors) and systemic therapies, including steroids and other systemic immunomodulating or antioxidant agents. The different modalities of phototherapies (NB‐UVB, photochemotherapy, excimer devices and home phototherapy), which are often combined with other therapies, are also summarized. Interventional approaches as well as depigmentation strategies are presented for specific indications. Finally, the status of innovative and targeted therapies under development is discussed.ConclusionsThis international consensus statement culminated in expert‐based clinical practice recommendations for the treatment of vitiligo. The development of new therapies is ongoing in vitiligo, and this will likely improve the future management of vitiligo, a disease that still has many unmet needs.

Progress in Dermatology and Venereology in 2023 as reflected in the Journal of the European Academy of Dermatology and Venereology

“…For the first time, worldwide expert recommendations for the diagnosis and management of vitiligo have been given as a Position Statement from the international vitiligo task force concentrating first on classification and diagnosis and secondly on new specific treatment recommendations also including new options with, for instance, JAK inhibitors. 5,6 For decades, Kligman's trio combining hydroquinone, retinoic acid and corticosteroid is considered the gold standard in treating melasma. With the new substance isobutylamido-thiazolyl-resorcinol (Thiamidol), a new trio has been created and compared with the classical preparation: There was a significant effect in both treatment groups, the quality of life score for melasma (MelasQOL) showing even higher improvement with the new trio compared to the classic substances.…”

“…For the first time, worldwide expert recommendations for the diagnosis and management of vitiligo have been given as a Position Statement from the international vitiligo task force concentrating first on classification and diagnosis and secondly on new specific treatment recommendations also including new options with, for instance, JAK inhibitors 5,6 …”

Global recommendations for vitiligo management

“…In the part 2, specific treatment options are discussed in depth. 3 The group agrees that unfortunately many vitiligo patients are considerably undertreated. Parameters for selection of treatment modality should be the activity, the extent and the location of vitiligo lesions.…”

“…1 It is therefore to be welcomed that an international expert group consisting of 42 experts and 4 patient representatives from all over the world gathering as 'international vitiligo task force' in several online and physical meetings was able to produce global recommendations for diagnosis and management of vitiligo. 2,3 These experts found together across five continents some of them via existing expert groups like the East Asian Vitiligo Association (EAVA), the Global Vitiligo Foundation (GVF), the Vitiligo European Task Force (VETF), the Vitiligo International Patient Organisation Committee (VIPOC) building the Vitiligo Task Force (VTF). They were able to summarize evidence-based and expert-based recommendations at an S1 level-although not in the strict methodology of a systematic review-intended for use in daily clinical routine.…”

“…In this first theme issue on vitiligo, two parts of these global recommendations are published, part 1 focusing on newly designed algorithms for vitiligo management 2 whereas in part 2 individual treatment modalities are discussed in depth. 3 In the first part, a consensus on nomenclature/terminology has been achieved with vitiligo (non-segmental), segmental vitiligo, focal vitiligo and undetermined/unclassified forms.…”