Vitiligo Improvement in a Patient with Ankylosing Spondylitis Treated with Infliximab

Abstract

Ankylosing spondylitis (AS) is a disabling disease affecting the enthesis and joints of the spine and peripheral sites. Tumour necrosis factor α (TNF-α) is a proinflammatory mediator which plays a significant role in the pathogenesis of AS. Infliximab (a chimeric monoclonal antibody which blocks the activity of TNF-α) is one of the most effective therapies of AS thus far. Vitiligo is a depigmenting disorder of the skin of unknown aetiology affecting 0.5–1% of the population. Here we describe the effect of infliximab on vitiligo in a patient with AS.

Autoinflammation: From monogenic syndromes to common skin diseases

“…One report documented improvement of vitiligo after administration of infliximab. 221 However, an open-label, pilot study (N = 4) using etanercept at 50 mg weekly for 12 weeks and 25 mg weekly for an additional 4 weeks showed no repigmentation of vitiligo lesions. 222 The past 2 decades of research have highlighted the important role of IL-1-RA polymorphisms in SLE.…”

Vitiligo: A comprehensive overview

“…A patient receiving infliximab for ankylosing spondylitis experienced a halt in progression of his vitiligo and repigmentation of some lesions. 179 Several patients taking TNFa inhibitors for psoriasis also experienced improvement of their vitiligo. 137,180,181 Additional research is needed to determine if TNFa inhibitors have a role in treating patients with vitiligo.…”

Novel approaches to vitiligo treatment via modulation of mTOR and NF-κB pathways in human skin melanocytes

“…Cytokines such as tumor necrosis factor (TNF)-alpha or TNFα, a paracrine inhibitor of melanocytes, play critical roles in the pathogenesis of several autoimmune diseases including vitiligo29. Anti-TNFα has been tested for the treatment of vitiligo30-32. And yet, the cellular and molecular mechanisms of the actions of cytokines have not been thoroughly studied in cultured human melanocytes.…”