Noninvasive imaging for the evaluation of JAK inhibitors efficacy in the management of facial vitiligo

INTRODUCTION: Vitiligo is an acquired depigmenting disorder characterized by white macules resulting from the loss of functional melanocytes. MATERIAL AND METHODS: This multicenter, real-life observational study evaluated the efficacy of topical Ruxolitinib (15 mg/g) in 100 patients with non-segmental facial vitiligo treated twice daily for three months, combining clinical scales and noninvasive imaging techniques. Assessments at baseline, 30 days, and 90 days included Facial Vitiligo Area Scoring Index (F-VASI), Facial Vitiligo Extent Score - Body Surface Area (F-VES BSA), Vitiligo Extent Score (VES) grade, Physician's and Patient's Global Vitiligo Assessments, and Dermatology Life Quality Index. Quality of life also improved substantially, as reflected by DLQI reduction. Although F-VASI showed a smaller mean change, it remained statistically significant. DISCUSSION: Instrumental evaluation, including VISIA imaging, Wood's lamp examination, reflectance confocal microscopy, and LC-OCT, confirmed clinical findings by demonstrating repigmentation and a reduction in affected areas. Overall, topical Ruxolitinib proved effective in reducing facial vitiligo lesions and improving patient-reported outcomes. CONCLUSIONS: These findings support the therapeutic potential of JAK inhibitors, although further controlled studies are warranted to confirm long-term efficacy and safety.