Seemal R. Desai, MD, FAAD

Age shapes more than pill-swallowing ability in pediatric vitiligo care. Dr. Lal explains how activity level, motivation, and comorbidities guide the choice between topical and oral therapy in younger patients, more than any single BSA threshold.

Trial enrollment ranges become policy boundaries in practice. Dr. Desai explains how broader BSA inclusion supports patients with widespread disease, while Jason describes how narrower criteria let payers manage the bulk of cases through topical therapy first.

Different inclusion criteria, different primary endpoints, different eras of the pandemic: Dr. Rosmarin unpacks why the pivotal topical and oral vitiligo trials resist direct comparison, and where a meta-analysis might still help.

A payer's view of competing JAK mechanisms centers less on selectivity data and more on price. Jason explains why a wide cost gap between topical and oral therapies will likely keep the topical option as first-line policy.

JAK inhibitors mark a genuine shift in vitiligo care, offering stabilization before repigmentation and color that matches native skin tone. Dr. Desai and Dr. Lal weigh their promise against the patience and compliance they demand.

From corticosteroids and calcineurin inhibitors to phototherapy, oral supplements, and emerging JAK inhibitors, Dr. Rosmarin walks through a treatment landscape defined by combination therapy rather than any single modality working alone.

A recent JAMA Dermatology analysis refines mild-moderate-severe cutoffs for vitiligo, but Dr. Desai and Dr. Lal argue that psychosocial burden, anatomic site, and cultural context can make even limited disease profoundly severe for patients.

Halting progression early is more achievable than reversing it. Dr. Rosmarin details how oral steroids control active disease while payer barriers persist for later-line options, and Jason explains how benefit design and step therapy shape access.

Body surface area offers a simple starting point for gauging vitiligo severity, but the panel argues that phenotype markers, anatomic location, and disease activity carry more weight in shaping treatment urgency than surface area alone.

Vitiligo's clinical course splits into segmental and non-segmental presentations, each carrying a distinct prognosis. Dr. Rosmarin explains how disease activity, not just extent, determines whether a patient needs urgent intervention or watchful monitoring.

Seemal R Desai, MD, FAAD, president of the American Academy of Dermatology (AAD), emphasized his commitment to enhancing the upcoming 2025 annual meeting by introducing new events and expanding educational offerings to better serve and engage members.