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In reply On behalf of all coauthors, we would like to thank Dr Passeron for his interest in our publication.1 We agree with the statement that because the melanogenic effect of afamelanotide requires the presence of melanocortin-1 receptor (MC1R), stimulation of melanoblast differentiation by phototherapy is required. This very point was discussed in our previous proof-of-concept article on narrowband UV-B–afamelanotide combination therapy.2 In fact, this was the rationale for the study design, in which patients were treated with narrowband UV-B for 4 weeks prior to the administration of afamelanotide.
Lim HW, Grimes PE, Lebwohl M. Indications and Limitations of Afamelanotide for Treating Vitiligo—Reply. JAMA Dermatol. 2015;151(3):350. doi:10.1001/jamadermatol.2014.4951