Short-term efficacy and safety of upadacitinib combined with 308 excimer light versus upadacitinib alone and 308 excimer light alone in patients with progressing facial vitiligo.

Patients with progressing facial vitiligo who had been treated with upadacitinib, 308 nm excimer light and upadacitinib combined with 308 nm excimer light were selected for retrospective analysis and comparison of their efficacy and safety. Efficacy was evaluated using the Vitiligo Area Severity Index (VASI) and Dermatology Life Quality Index (DLQI) at baseline, after 8 weeks, and after 20 weeks. The progression of skin lesions was monitored through reflectance confocal microscopy (RCM), while adverse reactions were documented. In the combination treatment group, the average VASI at baseline was 0.875 ± 0.4111, which decreased to 0.56 ± 0.32 at week 8 and 0.23 ± 0.218 at week 20 of follow-up (F = 9.918, p = 0.001). RCM analysis indicated that cases achieving VASI100 showed restoration to normalcy regarding loss of integrity within the pigment ring in lesion areas. Although one patient experienced exacerbation of acne, this condition was manageable with topical medication. In contrast, the average VASI score in the 308 nm excimer light group prior to treatment was recorded at 0.908 ± 0.334; by week twenty, it further declined to an average of 0.495 ± 0.4196. The differences observed were statistically significant (F = 28.644, p < 0.001). For patients in the upadacitinib group, the initial average VASI score was noted as being 0.825 ± 0.34; by twenty weeks it averaged approximately 0.53 ± 0.33; however, these differences did not reach statistical significance (F = 2.87, p = 0.14). The efficacy of the combined treatment group was significantly superior compared to both other groups (F = 3.927, p = 0.026). In conclusion, upadacitinib combined with308nm excimer light represents an effective therapeutic option for progressive facial vitiligo and is associated with fewer adverse reactions as well as improved quality of life for patients.