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Slide 4

Prescribing Decisions

Treatment advances in patients with vitiligo

I start with a topical immunomodulator like tacrolimus qd and a topical steroid qd and after 4-6 weeks see patient back and switch to opzelura which can usually get covered after failure of the first two meds. opzelura is a game changer in that it can be be used head to toe. Unfortunately, it takes a long time to work and compliance can be an issue. i notify patients it may take 6 months to see repigmentation that is significant but it can help even if vitiligo is long-standing. Will use oral jaks in future upon FDA approval.

Slide 3

Prescribing Decisions

Treatment advances in patients with vitiligo

To date, since there are no oral JAK inhibitors FDA-approved to treat vitiligo, I have mainly used topical ruxolitinib when covered by insurance as first-line therapy for my patients and have been happy with the results. I do have some patients with atopic dermatitis and alopecia areata as comorbidities that have utilized oral JAK inhibitors and I have seen improvement in their vitiligo simultaneously while using the oral JAK inhibitor for their atopic dermatitis or alopecia areata. Long-term safety is a big concern with the oral JAK inhibitors and I discuss at length with my families. My goal is to utilize oral JAK inhibitors with narrowband UVB to stimulate re-pigmentation and then hopefully taper off oral JAK inhibitor and maintain results with NBUVB and topical JAK inhibitors in the future.

Slide 1

Prescribing Decisions

Effect of Cyclosporine A-Tempol topical gel for the treatment of alopecia and anti-inflammatory disorders

This is an intriguing new topical compound that may indeed stimulate hair regrowth in AGA, as well as AA. The enhancing absorptive effect of tempol on CsA would seem to be beneficial. However, as we all know, many patients are resistant to using topical gels in their scalp on a daily basis because they are both cumbersome and often not cosmetically elegant.

DERMATOLOGIST NATION

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Dermatologist Nation by the Numbers

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