Pearl E. Grimes, MD, FAAD, honors mentor, reflects on 45 years of vitiligo advancements

Key takeaways:

• Pearl E. Grimes, MD, FAAD, was the recipient of this year’s John Kenney Jr., MD, Lifetime Achievement Award.
• During her lecture, she recounted the 45-year history of vitiligo advancements.

ORLANDO — John Kenney Jr., MD, Lifetime Achievement Award and Lectureship recipient Pearl E. Grimes, MD, FAAD, delivered a tribute to her predecessor as she discussed the history and advancements of vitiligo.

“This award is very special to me because I was trained by Dr. Kenney,” Grimes, director of the Vitiligo and Pigmentation Institute of Southern California and clinical professor of dermatology at the David Geffen School of Medicine at the University of California, Los Angeles, said during the plenary at the American Academy of Dermatology Annual Meeting. “He was the chair of my department, and he really had such a profound influence on my life.”

In her speech, “Vitiligo: A 45-Year Journey of Science and Service,” Grimes reflected on the strides made in vitiligo research over the decades.

Not just a cosmetic condition

“In the old days, no one wanted to treat it,” Grimes said about vitiligo. “It was a cosmetic disease, with an unknown cause and no treatment.”

But this was far from the truth. In 2004, Grimes wrote a paper called “White patches and bruised souls,” which revealed the enormous burden of vitiligo, with patients experiencing high levels of anxiety and depression, especially those with skin of color, largely affected surface areas and facial involvement.

“If you look at where we are now, we really have moved far in the journey,” she said. “We truly have come very far.”

Discovery and innovation

According to Grimes, researchers have identified three causes of vitiligo: genetics, oxidative stress and autoimmunity. The destruction of melanocytes is also heavily implicated in the pathophysiology of vitiligo; however, researchers have discovered that this damage extends to keratinocytes as well.

Grimes also stated there is “emerging data” suggesting fibroblasts are key drivers of vitiligo as they contribute to the destruction of melanocytes.

According to Grimes, these discoveries have “facilitated new treatments and new paradigms” with combination therapies, including narrowband ultraviolet B therapy, eliciting strong outcomes thus far.

In the future, Grimes expects the FDA to approve three Janus kinase inhibitors to be used in combination with phototherapy for the treatment of vitiligo. These therapies are ritlecitinib (Litfulo, Pfizer), baricitinib (Olumiant, Eli Lilly) and tofacitinib (Xeljanz, Pfizer).

Serving patients

In addition to her research, Grime’s contributions to the vitiligo field include serving her patients through community outreach. She participates in many programs that are designed to support patients and family members burdened by vitiligo.

Those projects include “UNITE, a worldwide virtual support group that launched in December 2024; Camp Victory, an encounter for children with the condition and their parents; and CARRY, a local coalition that provides pro-bono dermatology services, as well as instruction in leadership and etiquette to at-risk youths to enhance self-esteem and restore self-worth,” according to a press release from the AAD.

Carrying the torch

As Grimes follows in the footsteps of her mentor, she emphasized that she will never stop pursuing her commitment to the vitiligo community.

“I will always be in the trenches looking for that new horizon for vitiligo,” she said. “I think if [Kenney] were in the audience today, he would certainly be so proud and overwhelmed and overjoyed regarding the magnificent progress that we have made in the last 45 years.”

The landscape of vitiligo has been forever changed, Grimes said, as she thanked the Academy for recognizing her contributions to the field.

“My passion, my dedication and my work continue,” she said. “And I thank Dr. Kenney for long ago seeing things in me that I never would have seen in myself. I would not be here today if it were not for him.”