Gina Mangin, PA-C

Vitiligo Pipeline and Practice Gaps, With Gina Mangin, MPAS, PA-C

2025 Society of Dermatology Physician Assistant (SDPA) annual summer meeting

 spoke with Gina Mangin, MPAS, PA-C, from Sand Lake Dermatology Center, on her approaches to treating 

 and advice she would give other physician assistants on treating this condition.

“The advice I'd [give] to my PA colleague’s [is] keeping up to date with vitiligo; attend as many conferences as you can right now,” Mangin said. “This is a hot topic, so we're going to be talking about vitiligo, and we're going to be talking about a lot of autoimmune diseases. That is where dermatology is going. Dermatology is going down the line of immunology.”

In the first part of the interview, she discussed the importance of using a wood lamp every time a patient expresses concern about white spots or discoloration. Thinking you can diagnose vitiligo without a wood lamp can lead you to miss cases. She also addressed a misconception that no treatment exists for vitiligo, which is not true.

In the latter half of the interview, she shared specific patient profiles or characteristics that would make a patient a strong candidate for a JAK inhibitor, how to navigate treatment expectations, underutilized strategies, strategies for long-term disease control, and gaps in the vitiligo treatment landscape.

Mangin said that all patients with vitiligo are a good candidate for the JAK inhibitor of the FDA-approved Ruxolitinib. This topical has great safety and efficacy. In the pipeline there are oral JAK inhibitors, and once they are approved Mangin will consider a patients’ age before prescribing those.

Mangin shared underutilized strategies for treating vitiligo, which is narrowband UBV.

“Where I am in Orlando, Florida, we are only 1 of 2 offices that have narrowband light to offer our patients,” Mangin said. “It's sad that there's only 2 offices that actually offer this treatment, and there's tons of data to support it with safety backing it up. It still is great that we have these new medications, but I do feel that the narrow band light treatments are underutilized.”

A gap in vitiligo treatment is that only one FDA-approved medication is available: Ruxolitinib. However, drugs in the pipeline focus on attacking memory T cells, which cause the relapse of deep pigmentation.

“One thing we need to do better with our patients is educating them [that], once they establish repigmentation, staying on some type of treatment,” Magnin said. “Do not stop your treatment cold turkey because that's where those memory T cells are going to come in, and they're going to attack again, and our patients are going to regress. Compliance, from our patient standpoint, is key.”

Mangin, G. Vitiligo in Practice: Clinical Insights and Management Supported by Incyte. Presented at the Society of Dermatology Physician Assistant (SDPA) 2025 meeting on Thursday, June 26th in Washington, DC.

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At SDPA 2025, Mangin emphasized the importance of wood lamp use, JAK inhibitors, and phototherapy in managing vitiligo and preventing relapse.

Breaking Down Vitiligo Misconceptions at SDPA 2025, With Gina Mangin, PA-C

 on Thursday, June 26th, in Washington, DC, Gina Mangin, MPAS, PA-C, from Sand Lake Dermatology Center, presented “Vitiligo in Practice: Clinical Insights and Management Supported by Incyte.”

at the meeting, Mangin discussed her approach to treating 

, particularly in patients with skin of color.

“I use my wood lamp every single time I have a patient that comes in with any type of concern, where it's white spots or discoloration,” Mangin said. “Years prior, I may have thought, ‘Oh, I can make this diagnosis of vitiligo without the Woods lamp.’ No, a Woods lamp is essential to evaluating your patients for vitiligo.”

She also addressed a common vitiligo misconception, which is that no treatment exists for vitiligo. A misconception patients often have is that since they have had this condition for years, it will not re-pigment. It does not matter if a patient has had vitiligo for 2 years or 20 years—there is still potential to re-pigment the skin.

“So, when I have patients coming into the office now, I'm excited, because we have FDA-approved medications for them,” Mangin said.

Alongside the gold standard of using narrowband UVB for vitiligo, new medications will reach the market soon.

Mangin determines a systemic therapy over a topical or phototherapy if the disease is active. Markers for an active disease include a 1% increase in body surface area within 4 weeks, confetti-style depigmentation, an active Kebner phenomenon or trichome, or an inflammatory border around the vitiligo.

She noted that some areas are harder to pigment, including the hand, feet, and ankles, because of the lack of hair follicles. In this case, she may prescribe a topical along with phototherapy to really help with the re-pigmentation.

“We want to stop that autoimmune attack against the melanocytes,” Mangin said. “We want to re-pigment the skin, and we want to maintain that pigmentation. So that's usually where the aggressive approach is going to come into play, where I am going to use topicals, narrow band, and then, for the active disease patients, those systemics as well.”

Mangin, G. Vitiligo in Practice: Clinical Insights and Management Supported by Incyte. Presented at the Society of Dermatology Physician Assistant (SDPA) 2025 meeting on Thursday, June 26th in Washington, DC

At SDPA 2025, Mangin discussed her vitiligo approach, misconceptions, and how to determine when the disease is active.

Gina Mangin, PA-C

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