Worldwide expert recommendations for the diagnosis and management of vitiligo: Position statement from the International Vitiligo Task Force Part 1: towards a new management algorithm

Abstract

BackgroundThe treatment of vitiligo can be challenging and depends on several factors such as the subtype, disease activity, vitiligo extent, and treatment goals. Vitiligo usually requires a long‐term approach. To improve the management of vitiligo worldwide, a clear and up‐to‐date guide based on international consensus with uniform stepwise recommendations is needed.ObjectivesTo reach an international consensus on the nomenclature and to develop a management algorithm for the diagnosis, assessment, and treatment of vitiligo.MethodsIn this consensus statement, a consortium of 42 international vitiligo experts and four patient representatives participated in online and live meetings to develop a consensus management strategy for vitiligo. At least two vitiligo experts summarized the evidence of topics included in the algorithms. A survey was utilized to resolve remaining issues among a core group of eight experts. Subsequently, the unanimous recommendations were finalized and validated based on further input from the entire group during two live meetings.ResultsThe algorithms highlight the importance of shared decision‐making. Dermatologists are encouraged to provide patients with detailed explanations of the prognosis and expected therapeutic outcomes based on clinical examination. The treatment goal should be discussed and clearly emphasized to patients given the different approaches for disease stabilization and repigmentation. The evaluation of disease activity remains a cornerstone in the tailor‐made approach to vitiligo patients.ConclusionsThese new treatment algorithms are intended to guide clinical decision‐making in clinical practice. Promising novel therapies for vitiligo are on the horizon, further highlighting the need for reliable outcome measurement instruments and greater emphasis on shared decision‐making.

Phototherapy for vitiligo: A narrative review on the clinical and molecular aspects, and recent literature

“…NBUVB guidelines by BAD have been recently updated, and global vitiligo guidelines by International vitiligo task force were recently published 3,135,136 . The BAD guidelines on NBUVB strongly recommend NB‐UVB, either whole body or localized (e.g., home‐based/handheld), as a first‐line treatment for individuals who show inadequate response to topical therapy or have extensive/progressive disease.…”

Progress in Dermatology and Venereology in 2023 as reflected in the Journal of the European Academy of Dermatology and Venereology

“…For the first time, worldwide expert recommendations for the diagnosis and management of vitiligo have been given as a Position Statement from the international vitiligo task force concentrating first on classification and diagnosis and secondly on new specific treatment recommendations also including new options with, for instance, JAK inhibitors. 5,6 For decades, Kligman's trio combining hydroquinone, retinoic acid and corticosteroid is considered the gold standard in treating melasma. With the new substance isobutylamido-thiazolyl-resorcinol (Thiamidol), a new trio has been created and compared with the classical preparation: There was a significant effect in both treatment groups, the quality of life score for melasma (MelasQOL) showing even higher improvement with the new trio compared to the classic substances.…”

“…For the first time, worldwide expert recommendations for the diagnosis and management of vitiligo have been given as a Position Statement from the international vitiligo task force concentrating first on classification and diagnosis and secondly on new specific treatment recommendations also including new options with, for instance, JAK inhibitors 5,6 …”

Global recommendations for vitiligo management

“…1 It is therefore to be welcomed that an international expert group consisting of 42 experts and 4 patient representatives from all over the world gathering as 'international vitiligo task force' in several online and physical meetings was able to produce global recommendations for diagnosis and management of vitiligo. 2,3 These experts found together across five continents some of them via existing expert groups like the East Asian Vitiligo Association (EAVA), the Global Vitiligo Foundation (GVF), the Vitiligo European Task Force (VETF), the Vitiligo International Patient Organisation Committee (VIPOC) building the Vitiligo Task Force (VTF). They were able to summarize evidence-based and expert-based recommendations at an S1 level-although not in the strict methodology of a systematic review-intended for use in daily clinical routine.…”