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Vitiligo Pipeline and Practice Gaps, With Gina Mangin, MPAS, PA-C
At SDPA 2025, Mangin emphasized the importance of wood lamp use, JAK inhibitors, and phototherapy in managing vitiligo and preventing relapse.
At the 2025 Society of Dermatology Physician Assistant (SDPA) annual summer meeting in Washington, DC, HCPLive spoke with Gina Mangin, MPAS, PA-C, from Sand Lake Dermatology Center, on her approaches to treating vitiligo 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.”
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