Early systemic intervention for vitiligo: A prospective bicentric interventional study
Abstract
Background Vitiligo is a complex autoimmune skin disease characterized by loss of melanocytes resulting in the appearance of white skin patches. Recent advances in treatment have improved patient outcomes, but the process of repigmentation is prolonged and often incomplete. Objectives To evaluate the effects of early systemic intervention in newly diagnosed vitiligo patients compared to those with a longer disease duration, including both long‐standing and recently developed depigmented lesions, on clinical outcome, melanocytes and melanocyte precursor reservoir at lesional sites across groups. Methods Prospective bicentric interventional study. Fifty‐one eligible patients were enrolled in three groups depending on duration and activity of their vitiligo (G1: long‐lasting disease (more than 2 years) with no active lesions; G2: long‐lasting disease with recent lesions; G3: newly diagnosed, less than 6 months, with active lesions). All subjects received Nb‐UVB and oral mini pulse of corticosteroids twice a week for 6 months. Clinical scores were used to assess extent (VES) and disease activity (V‐SAS). Primary objective was to compare efficacy of treatment at 6 months between the groups. Secondary objectives include the analysis of melanocyte and melanocyte precursor reservoir using skin immunohistofluorescence of lesional vitiligo skin. Results Of 51 randomized patients, 44 (86%) completed the 6‐month assessment. Mean disease duration was 13.4 years in G1, 8.3 years in G2 and 4.8 months in G3. VES75 (75% improvement from baseline extent of vitiligo) at 6 months after treatment was achieved in 0% in G1, 16% in G2 and 46% in G3 ( p = 0.01). Epidermal mature melanocytes persisted in 50% of G3 patients, 20% of G2 and none of the G1 patients. All patients had remaining melanocyte precursors in the lesional skin. Conclusions Early systemic therapeutic approach allows a significantly better response in recently diagnosed patients, highlighting the importance of an early window of opportunity in vitiligo.
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BibTeX
@article{bertold2026early,
title = {{Early systemic intervention for vitiligo: A prospective bicentric interventional study}},
author = {Clemence Bertold and Julien Seneschal and Eric Fontas and Manon Blaise and Hanene Bzioueche and Marie Irondelle and Katia Boniface and Meri K Tulic and Thierry Passeron},
journal = {Journal of the European Academy of Dermatology and Venereology},
year = {2026},
month = sep,
doi = {10.1111/jdv.70748},
url = {https://u-bordeaux.hal.science/hal-05771669v1},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Early systemic intervention for vitiligo: A prospective bicentric interventional study
AU - Clemence Bertold
AU - Julien Seneschal
AU - Eric Fontas
AU - Manon Blaise
AU - Hanene Bzioueche
AU - Marie Irondelle
AU - Katia Boniface
AU - Meri K Tulic
AU - Thierry Passeron
PY - 2026
DA - 2026/09/25
JO - Journal of the European Academy of Dermatology and Venereology
DO - 10.1111/jdv.70748
UR - https://u-bordeaux.hal.science/hal-05771669v1
AB - Background Vitiligo is a complex autoimmune skin disease characterized by loss of melanocytes resulting in the appearance of white skin patches. Recent advances in treatment have improved patient outcomes, but the process of repigmentation is prolonged and often incomplete. Objectives To evaluate the effects of early systemic intervention in newly diagnosed vitiligo patients compared to those with a longer disease duration, including both long‐standing and recently developed depigmented lesions, on clinical outcome, melanocytes and melanocyte precursor reservoir at lesional sites across groups. Methods Prospective bicentric interventional study. Fifty‐one eligible patients were enrolled in three groups depending on duration and activity of their vitiligo (G1: long‐lasting disease (more than 2 years) with no active lesions; G2: long‐lasting disease with recent lesions; G3: newly diagnosed, less than 6 months, with active lesions). All subjects received Nb‐UVB and oral mini pulse of corticosteroids twice a week for 6 months. Clinical scores were used to assess extent (VES) and disease activity (V‐SAS). Primary objective was to compare efficacy of treatment at 6 months between the groups. Secondary objectives include the analysis of melanocyte and melanocyte precursor reservoir using skin immunohistofluorescence of lesional vitiligo skin. Results Of 51 randomized patients, 44 (86%) completed the 6‐month assessment. Mean disease duration was 13.4 years in G1, 8.3 years in G2 and 4.8 months in G3. VES75 (75% improvement from baseline extent of vitiligo) at 6 months after treatment was achieved in 0% in G1, 16% in G2 and 46% in G3 ( p = 0.01). Epidermal mature melanocytes persisted in 50% of G3 patients, 20% of G2 and none of the G1 patients. All patients had remaining melanocyte precursors in the lesional skin. Conclusions Early systemic therapeutic approach allows a significantly better response in recently diagnosed patients, highlighting the importance of an early window of opportunity in vitiligo.
SN - 0926-9959
SN - 1468-3083
ER -