Management of Facial Immune Checkpoint Inhibitor-Induced Vitiligo with Topical Ruxolitinib: Quantitative Assessment Using a Semi-Automatic Tool.

Breakell T, Neri P, Staats L, Kramer R, Berking C, Erdmann M, Hartmann A (2026)

Publication Type: Journal article

Publication year: 2026

Journal

Current Oncology Multimed Inc.

Book Volume: 33

Journal Issue: 5

DOI: 10.3390/curroncol33050300

Abstract

Immune checkpoint inhibitors (ICIs) have substantially improved outcomes in advanced melanoma but are frequently linked to immune-related adverse events (irAEs). Vitiligo is a common cutaneous irAE and has been consistently associated with improved patient outcome, including prolonged progression-free and overall survival. It also represents significant visual stigma, particularly when the face is involved. Traditional treatment comprises topical steroids, calcineurin inhibitors, laser, and phototherapy which often have insufficient effects. Since 2023, the first approved drug for non-segmental vitiligo (NSV) with facial involvement, the topical Janus kinase inhibitor ruxolitinib, has been available. However, experience with its use in ICI-induced vitiligo remains limited. In this exploratory analysis, three patients who developed facial vitiligo following ICI therapy applied 1.5% ruxolitinib cream to affected facial areas twice daily. After six (two patients), and twelve months (one patient), extensive repigmentation was observed, quantified at 95.7%, 78.9%, and 99.1% using a novel semi-automatic tool. Quality-of-life questionnaires showed mean reductions of 57.6% (Vitiligo DLQI) and 68.2% (Vitiligo-specific Quality of Life) in disease burden. Treatment was associated with substantial repigmentation without observed side effects. Further evaluation in larger, prospective cohorts is warranted to better define treatment effects, clinical applicability, and long-term safety.

Authors with CRIS profile

Thomas Breakell Department of Dermatology Leonie Staats Department of Dermatology Rafaela Kramer Department of Dermatology Carola Berking Lehrstuhl für Haut- und Geschlechtskrankheiten Michael Erdmann Department of Dermatology Arndt Hartmann Lehrstuhl für Allgemeine Pathologie und Pathologische Anatomie

Involved external institutions

University of Pisa / Università di Pisa (UniPi) IT Italy (IT)

How to cite

APA:

Breakell, T., Neri, P., Staats, L., Kramer, R., Berking, C., Erdmann, M., & Hartmann, A. (2026). Management of Facial Immune Checkpoint Inhibitor-Induced Vitiligo with Topical Ruxolitinib: Quantitative Assessment Using a Semi-Automatic Tool. Current Oncology, 33(5). https://doi.org/10.3390/curroncol33050300

MLA:

Breakell, Thomas, et al. "Management of Facial Immune Checkpoint Inhibitor-Induced Vitiligo with Topical Ruxolitinib: Quantitative Assessment Using a Semi-Automatic Tool." Current Oncology 33.5 (2026).

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