VITÍLIGO EN 2026: ESCALADA TERAPÉUTICA Y PAPEL DE LOS INHIBIDORES DE JANUS QUINASA
Palabras clave:
Vitiligo, Inhibidores de Janus quinasa, Fototerapia, Calidad de vida, Terapia farmacológicaResumen
DOI: https://doi.org/10.46296/yc.v10i18.0870
Resumen
El vitíligo no segmentario se consolidó como una enfermedad autoinmune visible, crónica y con carga psicosocial relevante. Esta revisión crítica analizó la escalada terapéutica contemporánea, con énfasis en inhibidores de Janus quinasa. Se revisó literatura biomédica reciente, priorizando ensayos clínicos, revisiones sistemáticas, consensos y documentos regulatorios. La fototerapia con luz ultravioleta B de banda estrecha y los tópicos convencionales continuaron siendo pilares, pero ruxolitinib tópico aportó la primera opción aprobada específicamente para repigmentación en enfermedad no segmentaria. Los inhibidores orales mostraron señales de eficacia en enfermedad activa o extensa, aunque su seguridad sistémica y uso fuera de indicación exigen selección rigurosa. La combinación con fototerapia fue racional y prometedora, pero aún requiere protocolos comparativos. En Latinoamérica, costo, acceso y adherencia condicionan la aplicabilidad. Se propone un algoritmo escalonado basado en extensión, actividad, localización y riesgo individual.
Palabras claves: Vitiligo, Inhibidores de Janus quinasa, Fototerapia, Calidad de vida, Terapia farmacológica.
Abstract
Nonsegmental vitiligo has become recognized as a visible, chronic autoimmune disease with substantial psychosocial burden. This critical review analyzed contemporary therapeutic escalation, emphasizing Janus kinase inhibitors. Recent biomedical literature was reviewed, prioritizing clinical trials, systematic reviews, consensus statements and regulatory documents. Narrowband ultraviolet B phototherapy and conventional topical agents remained core interventions, but topical ruxolitinib provided the first approved option specifically aimed at repigmentation in nonsegmental disease. Oral inhibitors showed efficacy signals in active or extensive disease, although systemic safety and off-label use require rigorous patient selection. Combination with phototherapy was biologically plausible and promising, but comparative protocols remain insufficient. In Latin America, cost, access and adherence strongly influence applicability. A stepwise algorithm is proposed according to extent, activity, location and individual risk.
Keywords: Vitiligo, Janus Kinase Inhibitors, Phototherapy, Quality of Life, Drug Therapy.
Información del manuscrito:
Fecha de recepción: 09 de febrero de 2026.
Fecha de aceptación: 15 de abril de 2026.
Fecha de publicación: 13 de mayo de 2026.
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