{Reference Type}: Randomized Controlled Trial
{Title}: Apremilast and narrowband ultraviolet B combination therapy suppresses Th17 axis and promotes melanogenesis in vitiligo skin: a randomized, split-body, pilot study in skin types IV-VI.
{Author}: Kim HJ;Del Duca E;Pavel AB;Singer GK;Abittan BJ;Chima MA;Kimmel G;Bares J;Baum D;Gagliotti M;Genece J;Chu J;Lebwohl MG;Guttman-Yassky E;
{Journal}: Arch Dermatol Res
{Volume}: 315
{Issue}: 2
{Year}: Mar 2023
{Factor}: 3.033
{DOI}: 10.1007/s00403-022-02343-1
{Abstract}: Improved repigmentation of generalized vitiligo in skin types IV-VI has been reported in clinical response to combined therapy with apremilast and narrowband (NB)-UVB; however, tissue responses to combined therapy versus NB-UVB monotherapy have not been elucidated. We compared the change from baseline in cellular and molecular markers in vitiligo skin after combined therapy versus NB-UVB monotherapy. We assessed lesional and nonlesional skin samples from enrolled subjects and evaluated for immune infiltrates, inflammatory, and melanogenesis-related markers which were compared across different treatment groups. Combined therapy resulted in significant reduction of CD8+T cells and CD11c+ dendritic cells, downregulation of PDE4B and Th17-related markers, and upregulation of melanogenesis markers. This study was limited to small sample size, skin types IV-VI, and high dropout rate. Our molecular findings support the clinical analysis that apremilast may potentiate NB-UVB in repigmentation of generalized vitiligo in skin types IV-VI.