 |
|
A Double-blind Randomized Trial of 0.1% Tacrolimus vs 0.05% Clobetasol for the Treatment of Childhood Vitiligo
Veronica Lepe, MD;
Benjamin Moncada, MD;
Juan Pablo Castanedo-Cazares, MD;
Maria Bertha Torres-Alvarez, MD;
Carlos A. Ortiz;
Antonio B. Torres-Rubalcava, MD
Arch Dermatol. 2003;139:581-585.
Objective To assess the safety and efficacy of topical 0.1% tacrolimus vs 0.05% clobetasol propionate.
Design Randomized double-blind trial.
Setting Department of Dermatology, Hospital Central "Dr Ignacio Morones Prieto," San Luis Potosí, México.
Participants From 20 children with vitiligo, 2 symmetrical lesions of about the same size and evolution time were selected. They were devoid of any topical or systemic therapy for 2 months prior to inclusion.
Interventions Treatment with topical tacrolimus and clobetasol for a 2-month period.
Main Outcomes Measures The grade of repigmentation was evaluated by color slides at baseline and again at every 2-week visit. The slides were analyzed by 2 clinicians unrelated to the study and by a morphometric digitalized computer program. Characteristics of pigment, time of response, symptoms, telangiectasias, and atrophy were evaluated every 2 weeks.
Results Eighteen (90%) of the 20 patients experienced some repigmentation. The mean percentage of repigmentation was 49.3% for clobetasol and 41.3% for tacrolimus. Lesions in 3 patients using clobetasol presented atrophy, and 2 lesions incurred telangiectasias; tacrolimus caused a burning sensation in 2 lesions.
Conclusions Tacrolimus proved almost as effective as clobetasol propionate to restore skin color in lesions of vitiligo in children. Because it does not produce atrophy or other adverse effects, tacrolimus may be very useful for younger patients and for sensitive areas of the skin such as eyelids, and it should be considered in other skin disorders currently treated with topical steroids for prolonged periods.
From the Dermatology Department, Hospital Central "Dr Ignacio Morones Prieto" (Drs Lepe, Moncada, Castanedo-Cazares, and Torres-Alvarez), Public Health Department (Dr Torres-Rubalcava), School of Medicine, and the Graphic Design School (Mr Ortiz), Universidad Autónoma de San Luis Potosí, San Luis Potosí, Mexico. The authors have no relevant financial interest in this article.
RELATED LETTER
Lack of Efficacy of Tacrolimus in the Treatment of Vitiligo in the Absence of UV-B Exposure
Nima Ostovari, Thierry Passeron, Jean-Philippe Lacour, and Jean-Paul Ortonne
Arch Dermatol. 2006;142(2):252-253.
EXTRACT
| FULL TEXT
RELATED ARTICLES
Successful Treatment of Vitiligo With 0.1% Tacrolimus Ointment
Lisa B. Travis, Jeffrey M. Weinberg, and Nanette B. Silverberg
Arch Dermatol. 2003;139(5):571-574.
EXTRACT
| FULL TEXT
Childhood Vitiligo and Tacrolimus: Immunomodulating Treatment for an Autoimmune Disease
Heidi Plettenberg, Till Assmann, and Thomas Ruzicka
Arch Dermatol. 2003;139(5):651-654.
EXTRACT
| FULL TEXT
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Little white spots: an approach to hypopigmented macules
Lio
EDUCATION AND PRACTICE 2008;93:98-102.
FULL TEXT
Vitiligo: To Treat or Not to Treat
Lim and Hexsel
Arch Dermatol 2007;143:643-646.
FULL TEXT
Lack of Efficacy of Tacrolimus in the Treatment of Vitiligo in the Absence of UV-B Exposure.
Ostovari et al.
Arch Dermatol 2006;142:252-253.
FULL TEXT
Tacrolimus for Vitiligo
Dubik
AAP Grand Rounds 2005;13:27-28.
FULL TEXT
Topical Tacrolimus and the 308-nm Excimer Laser: A Synergistic Combination for the Treatment of Vitiligo
Passeron et al.
Arch Dermatol 2004;140:1065-1069.
ABSTRACT
| FULL TEXT
Parametric Modeling of Narrowband UV-B Phototherapy for Vitiligo Using a Novel Quantitative Tool: The Vitiligo Area Scoring Index
Hamzavi et al.
Arch Dermatol 2004;140:677-683.
ABSTRACT
| FULL TEXT
Editors' Reply
AAP Grand Rounds 2003;10:66-67.
FULL TEXT
Tacrolimus Treatment of Vitiligo in Childhood
JWatch Pediatrics 2003;2003:8-8.
Treatment of Childhood Vitiligo
Krowchuk
AAP Grand Rounds 2003;10:21-21.
FULL TEXT
Tacrolimus Treatment of Vitiligo in Childhood
Journal Watch Dermatology 2003;2003:10-10.
FULL TEXT
Childhood Vitiligo and Tacrolimus: Immunomodulating Treatment for an Autoimmune Disease
Plettenberg et al.
Arch Dermatol 2003;139:651-654.
FULL TEXT
|
