Developing the Next Generation of Dermatology Treatments

Vitiligo is a chronic autoimmune disease characterized by depigmentation of skin that results from the loss of pigment-producing cells known as melanocytes. Overactivity of the JAK signaling pathway is believed to drive inflammation involved in the pathogenesis and progression of vitiligo. It affects approximately 0.5% to 2.0% of the population globally¹. In the United States, more than 1.5 million people are diagnosed with vitiligo². The overall prevalence of the condition is estimated to be approximately 2–3 million³, with the majority of patients (approximately 85%) suffering from nonsegmental vitiligo⁴. Vitiligo can occur at any age, although many patients with vitiligo will experience initial onset before the age of 30⁵. Vitiligo is associated with quality-of-life impairments^6,7 and patients are at an increased risk for comorbidities and mental health disorders, including depression^8,9.

References: 

1. Kruger C, Schallreuter KU. A review of the worldwide prevalence of vitiligo in children/adolescents and adults. Int J Dermatol. 2012;51(10):1206-1212.
2. Bergqvist C, Ezzedine K. Vitiligo: A Review. Dermatology. 2020;236:571-592.
3. Gandhi K, Ezzedine K, Anastassopoulos KP, et al. Prevalence of vitiligo among adults in the United States. JAMA Dermatol. 2022;158(1):43-50.
4. Ezzedine K, Eleftheriadou V, Whitton M, van Geel N. Seminar: Vitiligo. Lancet. 2015;386:74-84.
5. Frisoli M, Essien K, Harris JE. Vitiligo: mechanisms of pathogenesis and treatment. Annu Rev Immunol. 2020;38(1):621-648.
6. Morrison B, Burden-Teh E, Batchelor JM, Mead E, Grindlay D, Ratib S. Quality of life in people with vitiligo: a systematic review and meta-analysis. Br J Dermatol. 2017;177(6):e338-e339.
7. Silverberg JI, Silverberg NB. Association between vitiligo extent and distribution and quality-of-life impairment. JAMA Dermatol. 2013;149(2):159-164.
8. Wang G, Qiu D, Yang H, Liu W. The prevalence and odds of depression in patients with vitiligo: a meta-analysis. J Eur Acad Dermatol Venereol. 2018;32(8):1343-1351.
9. Alavi A, Hamzavi I, Brown K, et al. Janus kinase 1 inhibitor INCB054707 for patients with moderate-to-severe hidradenitis suppurativa: results from two phase II studies. Br J Dermatol. 2022;186(5):803-813. doi:10.1111/bjd.20969

Atopic dermatitis (AD) is a common chronic disease characterized by inflammation of the skin. Signs and symptoms of AD include irritated and itchy skin that can cause red lesions that may ooze and crust¹. Patients with AD are also more susceptible to bacterial, viral and fungal infections². The clinical signs and symptoms of the disease can have a profound impact on a patient’s quality of life^3-8.

References: 

1. American Academy of Dermatology Association. Eczema Types: Atopic Dermatitis Symptoms. https://www.aad.org/public/diseases/eczema/types/atopic-dermatitis/symptoms. Accessed on September 11, 2020.
2. Baker BS. The role of microorganisms in atopic dermatitis. Clin Exp Immunol. 2006;144(1):1-9.
3. Eichenfield LF, Tom WL, Berger TJ, et al. Guidelines of care for the management of atopic dermatitis: section 2. Management and treatment of atopic dermatitis with topical therapies. J Am Acad Dermatol. 2014;71(1):116-132.
4. Boguniewicz M, Fonacier L, Guttman-Yassky E, Ong PY, Silverberg J, Farrar JR. Atopic dermatitis yardstick: Practical recommendations for an evolving therapeutic landscape. Ann Allergy Asthma Immunol. 2018;120:10-22.
5. Narla S, Silverberg JI. Association between atopic dermatitis and serious cutaneous, multiorgan and systemic infections in US adults. Ann Allergy Asthma Immunol. 2018;120(1):66-72.
6. Silverberg JI, Gelfand JM, Margolis DJ, et al. Patient burden and quality of life in atopic dermatitis in US adults: A population-based cross-sectional study. Ann Allergy Asthma Immunol. 2018;121(3):340-347.
7. Silverberg JI, Gelfand JM, Margolis DJ, et al. Symptoms and diagnosis of anxiety and depression in atopic dermatitis in U.S. adults. Br J Dermatol. 2019;181(3):554-565.
8. Silverberg JI, Garg NK, Paller AS, Fishbein AB, Zee PC. Sleep disturbances in adults with eczema are associated with impaired overall health: a US population-based study. J Invest Dermatol. 2015;135(1):56-66.

Hidradenitis suppurativa, also known as acne inversa, is an inflammatory skin condition that causes painful bumps to form in the armpit, groin, breast and anal regions of the body¹. The condition typically begins during puberty and is often most active between the ages of 20 and 40 years. Some of the bumps can eventually lead to disfiguring scars. It has a significant impact on daily life and can be debilitating for some patients¹.

Reference: 

1. Morrison B, Burden-Teh E, Batchelor JM, Mead E, Grindlay D, Ratib S. Quality of life in people with vitiligo: a systematic review and meta-analysis. Br J Dermatol. 2017;177(6):e338-e339.

Prurigo nodularis is a chronic inflammatory skin disease characterized by intense itch and thickened red bumps, typically on the arms, legs and trunk¹⁸. Sometimes the bumps may be painful and the constant itch can affect sleep quality¹⁸. Prurigo nodularis appears to be more common in older individuals and can have a substantial impact on a patient’s quality of life¹⁸.

Lichen sclerosus affects women more often than men and is associated with intolerable itch, which can lead to bleeding and scarring, and ultimately, drastic changes to genital anatomy¹⁹. There is an increased risk of squamous cell carcinoma if left untreated^20,21.

Lichen planus can cause lesions, bumps or plaques on the skin that are itchy and purple. Onset of the condition usually affects the wrists, forearms and legs. Lichen planus occurs equally in males and females and tends to appear between 50 to 70 years of age^22,23. While itch is considered the most bothersome symptom²⁴, the condition is associated with relatively high rates of depression and anxiety²⁵.