Clinical and Dermoscopic Evaluation of the Safety and Efficacy of Oral baricitinib (JAK Inhibitor) in Treatment of Localized Vitiligo Either Alone or with Topical Tacrolimus

Background: Baricitinib is used in dermatology as a novel molecular-targeted therapy and it is suggested to be effective against vitiligo. Objective: To evaluate efficacy and safety of oral baricitinib only and with topical tacrolimus in the treatment of localized stable vitiligo. Patients and methods: 10 cases (> 18 years) with at least 2 separated vitiligo lesions were treated with oral baricitinib (4 mg / day) for a total of 24 weeks. In the same patient, topical tacrolimus 0.1% was applied twice every day to one of the lesions. The patients were recruited from the outpatient clinics of Dermatology Department, Kafrelsheik University Hospital between August 2023 and August 2024. Results: The current study demonstrated that there was a significant repigmentation in all lesions but more improvement in lesions treated also by topical tacrolimus without any side effects. The percentage of improvement in the lesions treated by oral therapy only was about 77% and the percentage of improvement in the lesions treated by oral therapy and topical tacrolimus was about 82% with no significance (P=0.177). Only 2 patients (20%) were unsatisfied with lesions treated by oral therapy only with no significance (P=0.5). Conclusions: Baricitinib is efficient and safe in treatment of adult localized vitiligo as monotherapy or in combination of topical tacrolimus.