Recent advances in non-invasive imaging technologies, such as Line-field Confocal Optical Coherence Tomography (LC-OCT), offer new opportunities for early diagnosis, monitoring, and understanding of the pathological mechanisms underlying vitiligo. This study aimed to longitudinally analyze the morphological and structural changes in vitiligo-affected skin compared to healthy skin, using a combined approach of dermoscopy and LC-OCT. In addition, the study assessed the effectiveness of topical ruxolitinib treatment over time, identifying potential predictive patterns of therapeutic response or resistance. The study involved patients with stable non-segmental vitiligo, presenting with lesions located on the face and other body areas. For each patient, one lesional area and one adjacent healthy area (used as control) were examined. Evaluations were performed at baseline (T0) and after 3 (T1), 6 (T2), and 12 months (T3) of treatment with ruxolitinib cream. Dermoscopy allowed the observation of clinical signs such as perifollicular pigmentation, erythema, and leukotrichia, while LC-OCT enabled visualization of microstructural alterations such as melanocyte loss, dermo-epidermal junction disruption, and inflammatory infiltrate presence. The analysis revealed progressive perifollicular repigmentation visible under dermoscopy. LC-OCT, aside from confirming repigmentation of the epidermis, was able to detect restoration of the dermo-epidermal junction and a reduction in inflammatory infiltrate in some treated areas. Moreover, both dermoscopy and LC-OCT imaging 3 suggested the presence of subclinical alterations in follicular structures in vitiligo-affected areas. The integration of dermoscopy and LC-OCT proved valuable for the dynamic monitoring of vitiligo and for assessing the response to topical ruxolitinib treatment. In particular, LC-OCT emerged as a promising tool for the early detection of subclinical histological changes, potentially being predictive of clinical response to treatment in the longer term. Future studies with larger sample sizes may validate the use of these tools as predictive aids for therapeutic efficacy.
Longitudinal Dermoscopic and LC-OCT Monitoring of Facial Vitiligo Treated With Topical Ruxolitinib: A Pilot Prospective Study / Ambrosio, L., Kalaja, A., Picardo, M., Chen, Q., Conforti, C., Pellacani, G., Stanganelli, I., Feliciani, C., Paganelli, A.. - In: INTERNATIONAL JOURNAL OF DERMATOLOGY. - ISSN 0011-9059. - 65:8(2026), pp. 1719-1721. [10.1111/ijd.70474]
Longitudinal Dermoscopic and LC-OCT Monitoring of Facial Vitiligo Treated With Topical Ruxolitinib: A Pilot Prospective Study
Ambrosio L.;Kalaja A.;Stanganelli I.;Feliciani C.;
2026-01-01
Abstract
Recent advances in non-invasive imaging technologies, such as Line-field Confocal Optical Coherence Tomography (LC-OCT), offer new opportunities for early diagnosis, monitoring, and understanding of the pathological mechanisms underlying vitiligo. This study aimed to longitudinally analyze the morphological and structural changes in vitiligo-affected skin compared to healthy skin, using a combined approach of dermoscopy and LC-OCT. In addition, the study assessed the effectiveness of topical ruxolitinib treatment over time, identifying potential predictive patterns of therapeutic response or resistance. The study involved patients with stable non-segmental vitiligo, presenting with lesions located on the face and other body areas. For each patient, one lesional area and one adjacent healthy area (used as control) were examined. Evaluations were performed at baseline (T0) and after 3 (T1), 6 (T2), and 12 months (T3) of treatment with ruxolitinib cream. Dermoscopy allowed the observation of clinical signs such as perifollicular pigmentation, erythema, and leukotrichia, while LC-OCT enabled visualization of microstructural alterations such as melanocyte loss, dermo-epidermal junction disruption, and inflammatory infiltrate presence. The analysis revealed progressive perifollicular repigmentation visible under dermoscopy. LC-OCT, aside from confirming repigmentation of the epidermis, was able to detect restoration of the dermo-epidermal junction and a reduction in inflammatory infiltrate in some treated areas. Moreover, both dermoscopy and LC-OCT imaging 3 suggested the presence of subclinical alterations in follicular structures in vitiligo-affected areas. The integration of dermoscopy and LC-OCT proved valuable for the dynamic monitoring of vitiligo and for assessing the response to topical ruxolitinib treatment. In particular, LC-OCT emerged as a promising tool for the early detection of subclinical histological changes, potentially being predictive of clinical response to treatment in the longer term. Future studies with larger sample sizes may validate the use of these tools as predictive aids for therapeutic efficacy.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
