New-onset vitiligo and progression of pre-existing vitiligo during treatment with biological agents in chronic inflammatory diseases
Affiliation auteurs | !!!! Error affiliation !!!! |
Titre | New-onset vitiligo and progression of pre-existing vitiligo during treatment with biological agents in chronic inflammatory diseases |
Type de publication | Journal Article |
Year of Publication | 2017 |
Auteurs | Mery-Bossard L., Bagny K., Chaby G., Khemis A., Maccari F., Marotte H., Perrot J.L, Reguiai Z., Sigal M.L, Avenel-Audran M., Boye T., Grasland A., Gillard J., Jullien D., Toussirot E. |
Journal | JOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY AND VENEREOLOGY |
Volume | 31 |
Pagination | 181-186 |
Date Published | JAN |
Type of Article | Article |
ISSN | 0926-9959 |
Résumé | Background The development of vitiligo during treatment with biological agents is an unusual event and only a few isolated cases have been reported. Objectives To describe the clinical characteristics and evolution of patients developing new-onset vitiligo following initiation of a biological agent for chronic inflammatory disease; and also to report the clinical course of pre-existing vitiligo under biological therapy. Methods This nationwide multicentre, retrospective study, carried out between July 2013 and January 2015, describes the characteristics of a large series of 18 patients (psoriasis N = 8, inflammatory rheumatic diseases N = 8, ulcerative colitis N = 1, uveitis N = 1) who developed new-onset vitiligo while receiving a biological agent. Results TNF alpha inhibitors were the most common biological agent involved (13/18) while anti-IL-12/23 and anti-IL-17 agents or abatacept were less common (4/18 and 1/18 respectively). Mean duration of biological agent exposure before vitiligo onset was 13.9 +/- 16.5 months. Outcome was favourable for most patients (15/17) while maintaining the biological agent. Data were also collected for 18 patients (psoriasis N = 5, inflammatory rheumatic diseases N = 10, inflammatory bowel diseases N = 2, SAPHO N = 1) who had pre-existing vitiligo when treatment with a biological agent started (TNFa inhibitors N = 15, ustekinumab N = 1, rituximab N = 1, tocilizumab N = 1). Vitiligo progressed in seven patients and was stable or improved in eight cases. Conclusion Vitiligo may thus emerge and/or progress during treatment with various biological agents, mainly TNFa inhibitors and could be a new paradoxical skin reaction. De novo vitiligo displays a favourable outcome when maintaining the biological agent, whereas the prognosis seems worse in cases of pre-existing vitiligo. |
DOI | 10.1111/jdv.13759 |