Topical 1.5% ruxolitinib cream for facial refractory segmental vitiligo: a retrospective single-center case series

This study hypothesized that topical 1.5% ruxolitinib cream is effective and safe for facial segmental vitiligo (SV), especially during the progressive stage.
In a retrospective review of 40 patients with treatment-resistant facial SV, all applied the cream twice daily for 24 weeks. Patients were grouped as progressive-stage (n=25) or stable-stage (n=15). The main goal was to see how many achieved ≥75% improvement on the Vitiligo Area Scoring Index (VASI75) by week 24.
The results showed that 45% of all patients (18/40) reached this goal, with an average VASI score improvement of 71.3%.
This study found that topical 1.5% ruxolitinib cream is an effective and safe treatment for refractory facial segmental vitiligo (SV). The most notable finding was the significant difference in response based on disease activity: 64% of progressive-stage patients achieved substantial repigmentation (VASI75), compared to only 13% of stable-stage patients. Improvement continued over time, with significantly better results at 24 weeks than at 12 weeks. The treatment was well-tolerated, with only minor side effects. These results suggest that ruxolitinib works best in active, inflammatory disease. For clinicians, this supports its use especially for progressive SV, with the understanding that longer treatment may be needed for maximum benefit and that stable disease may respond less effectively. The favorable safety profile makes it suitable for medium-term facial use.
Limitations to Consider:
The retrospective design and lack of a control group limit the strength of the conclusions.
The small sample size may introduce bias and limits generalizability.
Therefore, these results should be seen as promising real-world evidence that needs confirmation in larger, prospective, randomized controlled trials.