使用托法替尼治疗的难治性白癜风和停药后的持续再色素沉着

Skinmed Pub Date : 2024-10-22 eCollection Date: 2024-01-01
Rohan R Shah, Amy McMichael
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引用次数: 0

摘要

64 岁的女性曾有食道狭窄病史,2015 年因前一年出现的进行性色素沉着斑块前来就诊。医生给她开了外用类固醇药物,但没有任何改善。最终在口服类固醇的同时,在外用类固醇的基础上增加了窄带紫外线 B(NB-UVB)和外用他克莫司。由于刺激性,患者停用了外用他克莫司。在接下来的 3 年里,患者失去了随访机会,在此期间她没有采取任何治疗措施,白癜风病情加重(图 1)。3 年后复诊时,她再次口服泼尼松,并重新开始使用中效外用类固醇激素。2020 年 1 月,患者获准开始口服托法替尼,每次 5 毫克,每天两次。随后在 2020 年 3 月和 2020 年 11 月的就诊中观察到病情持续改善。患者报告的唯一不良反应是骨盆和大腿上的疖肿增多。
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Resistant Vitiligo Treated with Tofacitinib and Sustained Repigmentation after Discontinuation.

64-year-old woman with a history of esophageal strictures presented in 2015 for evaluation of progressive depigmented patches that developed over the preceding year. She was prescribed topical steroids with no improvement. Narrow-band ultraviolet B (NB-UVB) and topical tacrolimus were eventually added to the topical steroids accompanying an oral steroid taper. The patient discontinued topical tacrolimus because of irritation. The patient was lost to follow-up for the next 3 years, during which she did not take any treatment and her vitiligo had worsened (Figure 1). At her visit 3 years later, she repeated an oral prednisone taper and restarted mid-potency topical steroid. In January 2020, the patient was approved for and started oral tofacitinib 5 mg twice daily. Consistent improvement was observed on the subsequent visits in March 2020 and November 2020. The only adverse reaction reported by the patient was an increase in furuncles on her pelvis and thighs.

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