The hypothesis was that its immunomodulatory properties and safety profile of corticosteroids, tacrolimus ointment may be a better benefit-toxicity ratio and a new therapeutic alternative to topical corticosteroids in children with vitiligo, known that from experience that corticoids Clobetasol is more effective for vitiligo, the pigment often than other topical steroids have failed. That is why they decided instead Clobetasol propionate midpotency other steroids for this study.
The 20 children in this study had untreated vitiligo with topical or systemic more than two months before the study. In each child, two symmetrical lesions of about the size and development time was treated with topical tacrolimus 0.1% and the other with 0.05% Clobetasol propionate two months.
Of the 20 patients, 18 (90%) experienced some repigmentation in digital morphometry, Clobetasol repigmentation of 49.3% and 41.3% for tacrolimus. Adverse events were atrophy and telangiectasia three lesions in two lesions with Clobetasol and a burning sensation in two lesions with tacrolimus.
Tacrolimus is almost as effective as Clobetasol propionate to restore skin color in lesions of vitiligo in children. "Because there was no atrophy or other adverse effects, tacrolimus may be useful for younger patients and for sensitive areas of skin such as eyelids, and must be taken into account other skin disorders currently treated with topical steroids for a long time. It would be interesting to see whether longer periods of treatment, the combination of tacrolimus with other topical agents, or elevated concentrations of tacrolimus can lead to better results than the ones in this series and whether the negative results in Acral can be overwritten with each of these approaches.
In an accompanying editorial, Heidi Plettenberg, MD, to Assmann, MD, and Thomas Ruzicka, MD, of Heinrich-Heine University in Dusseldorf, Germany, considering the photo-therapy and other options for the treatment of vitiligo last. Suggest that tacrolimus is usually more effective in head and neck injuries, and suggest that the low response rate in this study were the limited duration of therapy.
The current data suggest that tacrolimus may represent ... a new option for "vitiligo effective treatment" of childhood vitiligo, with the appropriate use and limited adverse effects," they write. "The efficacy of this immunomodulatory drug provides new evidence for the hypothesis of self-destruction of melanocytes in vitiligo.
copyright 2009 vitiligo
