A Case of Tofacitinib for the Treatment of Resistant Vitiligo and Sustained Repigmentation After Discontinuation

    January 2023 in “ Research Square (Research Square) ”
    Rohan Shah, Amy Mcmichael
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    TLDR A woman's vitiligo improved with tofacitinib treatment, and her skin color remained even after stopping the medication, but there are concerns about cancer risk.
    A 61-year-old woman with progressive vitiligo, unresponsive to multiple topical therapies, experienced significant improvement in her condition after being treated with tofacitinib, an oral Janus Kinase (JAK) 1/3 inhibitor. Tofacitinib is approved for rheumatoid arthritis but has been used off-label for vitiligo and alopecia areata. Despite the positive response, the patient developed primary lung adenocarcinoma 20 months into the treatment, leading to the discontinuation of tofacitinib. While a direct link between the drug and cancer cannot be conclusively established in this case, it raises concerns about the potential increased cancer risk associated with targeted therapies like tofacitinib. Notably, the patient maintained repigmentation 5 months after stopping the medication, suggesting the possibility of sustained treatment effects and the potential for intermittent treatment protocols in vitiligo management.
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