Tumor necrosis factor-α in vitiligo: Direct correlation between tissue levels and clinical parameters

Nancy H. Kim, Daniele Torchia, Panta Rouhani, Brenda Roberts, Paolo Romanelli

Research output: Contribution to journalArticlepeer-review

29 Scopus citations


Background: Experimental evidences have shown that tumor necrosis factor (TNF)-α may play a role in the pathogenesis of nonsegmental vitiligo, and successful cases of vitiligo treated with TNF-α inhibitors have been recently reported. Materials and methods: Two cases of refractory generalized vitiligo, which showed high tissue levels of TNF-α, were commenced anti-TNF-α antibody etanercept 50 mg weekly. A retrospective study, considering chart review and immunohistochemical staining for TNF-α, was then carried out on eight additional patients affected by untreated vitiligo. Results: Etanercept achieved improvement of vitiligo in two patients at 6-month follow-up. Five out of eight specimens showed a strong cytoplasmic staining for TNF-α. Considering all 10 cases, patients with a strong TNF-α staining were characterized by a higher vitiligo disease activity score than patients with a weak staining. Discussion: These findings, albeit limited in significance by the low number of cases and the retrospective nature of the study, confirm a probable role of TNF-α in the pathogenesis of vitiligo. The intensity of TNF-α staining in vitiligo lesions may be worth to be further studied as a biomarker for potentially successful anti-TNF-α treatment of nonsegmental vitiligo in cases refractory to conventional treatment.

Original languageEnglish (US)
Pages (from-to)225-227
Number of pages3
JournalCutaneous and Ocular Toxicology
Issue number3
StatePublished - Sep 2011


  • Biologic agents
  • etanercept
  • immunohistochemistry

ASJC Scopus subject areas

  • Toxicology


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