In patients with generalized vitiligo refractory to topical ruxolitinib and phototherapy who desire systemic treatment, how do you select among off-label oral JAK inhibitors (e.g., upadacitinib, tofacitinib, baricitinib, ritlecitinib)?
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When escalating a vitiligo patient who failed topical ruxolitinib plus phototherapy to an off-label oral JAK inhibitor, which agent is your primary initial choice?
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