Apremilast and Narrowband Ultraviolet B Combination Therapy Suppresses Th17 Axis and Promotes Melanogenesis in Vitiligo Skin: a Randomized, Split-body, Pilot Study in Skin Types IV-VI

Overview

Journal Arch Dermatol Res

Specialty Dermatology

Date 2022 Mar 13

PMID 35279741

Authors

Hee J Kim

Ester Del Duca

Ana B Pavel

Giselle K Singer

Brian J Abittan

Margot A Chima

Grace Kimmel

Jennifer Bares

Danielle Baum

Matthew Gagliotti

Jordan Genece

Justin Chu

Mark G Lebwohl

Emma Guttman-Yassky

Affiliations

Soon will be listed here.

Abstract

Improved repigmentation of generalized vitiligo in skin types IV-VI has been reported in clinical response to combined therapy with apremilast and narrowband (NB)-UVB; however, tissue responses to combined therapy versus NB-UVB monotherapy have not been elucidated. We compared the change from baseline in cellular and molecular markers in vitiligo skin after combined therapy versus NB-UVB monotherapy. We assessed lesional and nonlesional skin samples from enrolled subjects and evaluated for immune infiltrates, inflammatory, and melanogenesis-related markers which were compared across different treatment groups. Combined therapy resulted in significant reduction of CD8T cells and CD11c dendritic cells, downregulation of PDE4B and Th17-related markers, and upregulation of melanogenesis markers. This study was limited to small sample size, skin types IV-VI, and high dropout rate. Our molecular findings support the clinical analysis that apremilast may potentiate NB-UVB in repigmentation of generalized vitiligo in skin types IV-VI.

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