Abstract: Objective: To evaluate the clinical efficacy and safety of tofacitinib combined with 308 nm excimer laser in the treatment of vitiligo. Methods: Patients with vitiligo diagnosed and treated in our hospital were enrolled and randomly assigned to the laser group (treated with 308 nm excimer laser monotherapy) and the study group (treated with tofacitinib plus 308 nm excimer laser) using a simple sequential randomization method. The two groups were compared in terms of clinical efficacy, lesion area, Dermatology Life Quality Index (DLQI) scores, serum immunoglobulin (Ig) levels, inflammatory markers of intercellular adhesion molecule 1 (ICAM-1) and interleukin 17 (IL-17), as well as safety profiles. Results: A minimum sample size of 83 cases was estimated for this study. A total of 90 patients were recruited from May 2022 to July 2024. After excluding cases that were withdrawn or lost to follow-up, 42 patients in the laser group and 43 patients in the study group were finally included in the statistical analysis. The overall response rate was significantly higher in the study group than in the laser group (90.70% vs. 73.81%, P＜0.05). Compared with the laser group, the study group showed more significant reductions in DLQI scores and serum levels of IgA, IgG, ICAM-1 and IL-17, with statistically significant differences (Ps＜0.05). There was no significant difference in the incidence of adverse reactions between the study group and the laser group (16.28% vs. 9.52%, P＞0.05). Conclusion: The addition of tofacitinib to 308 nm excimer laser therapy can enhance the therapeutic effect in vitiligo patients, effectively regulate immune function and inflammatory responses, with a favorable safety profile.

Key words: tofacitinib, 308 nm excimer laser, vitiligo