Background: Vitiligo is a chronic disease that mostly affects children and young adults. Nowadays many treatment options are available; however, most of them have limited efficacy and in most cases would result in undesirable complications. Objective: To determine the extent of repigmentation according to the location of the lesions after applying topical cream pimecrolimus 1% in vitiligo patients. Materials and Methods: Thirty consecutive patients with vitiligo lesions affecting less than 20% of body surface area without any previous history of spontaneous repigmentation were treated with pimecrolimus cream 1% twice daily for 12 weeks. The extent of repigmentation in vitiligo lesions was determined in each patient after 6 and 12 weeks. Results: Moderate to excellent response (repigmentation >26%) was observed in 6.6 and 25.9% of vitiligo lesions 6 and 12 weeks after treatment, respectively. More responsive lesions were located on the trunk, face and elbow (85.7, 75 and 70%). Conclusion: Pimecrolimus cream 1% results in repigmentation in vitiligo in different extents according to the location of the lesion; however, to clearly prove its efficacy as monotherapy or in combination with other available treatment options, double-blind placebo-controlled studies are essential.

Keywords:
Vitiligo, repigmentation, Pimecrolimus 1%
1.
Bleehen SS, Anstey AV: Disorders of skin colour; in Burns T, Breathnach S, Cox N, et al (eds): Rook’s Textbook of Dermatology. Turin, Blackwell Science, 2004, vol 2, p 39.54.
2.
Mayoral FA, Gonzalez C, Shah NS, Arciniegas C: Repigmentation of vitiligo with pimecrolimus cream: a case report. Dermatology 2003;207:322–323.
3.
Parrish JA, Fitzpatrick TB, Shea C, et al: Photochemotherapy of vitiligo. Arch Dermatol 1976;112:1531–1534.
4.
Griffiths CEM, Camp RDR, Barker JNWN: Psoriasis; in Burns T, Breathnach S, Cox N, et al (eds): Rook’s Textbook of Dermatology. Turin, Blackwell Science, 2004, vol 2, pp 35.33–35.35.
5.
Wang SQ, Setlow R, Berwick M, Polsky D, Marghoob AA, Kopf AW, Bart RS: Ultraviolet A and melanoma: a review. J Am Acad Dermatol 2001;44:837–846.
6.
Lebwohl M, Ali S: Treatment of psoriasis. 1. Topical therapy and phototherapy. J Am Acad Dermatol 2001;45:487–498.
7.
Hatchome N, Kato T, Tagami H: Therapeutic success of epidermal grafting in generalized vitiligo is limited by the Koebner phenomenon. Int J Dermatol 1988;27:676–681.
8.
Ongenae K, Dierckxsens L, Brochez L, van Geel N, Naeyaert JM: Quality of life and stigmatization profile in a cohort of vitiligo patients and effect of the use of camouflage. Dermatology 2005;210:279–285.
9.
Kovacs SO: Vitiligo. J Am Acad Dermatol 1998;38:647–666.
10.
Tjioe M, Vissers WH, Gerritsen MJ: Topical macrolide immunomodulators: a role in the treatment of vitiligo? Am J Clin Dermatol 2006;7:7–12.
11.
Kanwar AJ, Dogra S, Parsad D: Topical tacrolimus for treatment of childhood vitiligo in Asians. Clin Exp Dermatol 2004;29:589–592.
12.
Silverberg NB, Lin P, Travis L, et al: Tacrolimus ointment promotes repigmentation of vitiligo in children: a review of 57 cases. J Am Acad Dermatol 2004;51:760–766.
13.
Sidbury R: What’s new in pediatric dermatology: update for the pediatrician. Curr Opin Pediatr 2004;16:410–414.
14.
Plettenberg H, Assmann T, Ruzicka T: Childhood vitiligo and tacrolimus: immunomodulating treatment for an autoimmune disease. Arch Dermatol 2003;139:651–654.
15.
Lepe V, Moncada B, Castanedo-Cazares JP, Torres-Alvarez MB, Ortiz CA, Torres-Rubalcava AB: A double-blind randomized trial of 0.1% tacrolimus vs 0.05% clobetasol for the treatment of childhood vitiligo. Arch Dermatol 2003;139:581–585.
16.
Hultsch T, Kapp A, Spergel J: Immunomodulation and safety of topical calcineurin inhibitors for the treatment of atopic dermatitis. Dermatology 2005;211:174–187.
17.
Coskun B, Saral Y, Turgut D: Topical 0.05% clobetasol propionate versus 1% pimecrolimus ointment in vitiligo. Eur J Dermatol 2005;15:88–91.
18.
Kostovic K, Pasic A: New treatment modalities for vitiligo: focus on topical immunomodulators. Drugs 2005;65:447–459.
19.
Grimes PE: New insights and new therapies in vitiligo. JAMA 2005;293:730–735.
20.
Grimes PE, Morris R, Avaniss-Aghajani E, Soriano T, Meraz M, Metzger A: Topical tacrolimus therapy for vitiligo: therapeutic responses and skin messenger RNA expression of proinflammatory cytokines. J Am Acad Dermatol 2004;51:52–61.
21.
Kawalek AZ, Spencer JM, Phelps RG: Combined excimer laser and topical tacrolimus for the treatment of vitiligo: a pilot study. Dermatol Surg 2004;30:130–135.
22.
Meurer M, Folster-Holst R, Wozel G, et al: Pimecrolimus cream in the long term management of atopic dermatitis in adults: a 6-month study. Dermatology 2002;205:271–277.
23.
Kapp A, Papp K, Bingham A, et al: Long-term management of atopic dermatitis in infants with topical pimecrolimus, a non-steroid anti-inflammatory drug. J Allergy Clin Immunol 2002;110:277–284.
24.
Smith DA, Tofte SJ, Hanifin JM: Repigmentation of vitiligo with topical tacrolimus. Dermatology 2002;205:301–303.
25.
Travis LB, Weinberg JM, Silverberg NB: Successful treatment of vitiligo with 0.1% tacrolimus ointment. Arch Dermatol 2003;139:571–574.
26.
Grimes PE, Soriano T, Dytoc MT: Topical tacrolimus for repigmentation of vitiligo. J Am Acad Dermatol 2002;47:789–791.
27.
Tanghetti EA: Tacrolimus ointment 0.1% produces repigmentation in patients with vitiligo: results of a prospective patient series. Cutis 2003;71:158–162.
28.
Castanedo-Cazares JP, Lepe V, Moncada B: Repigmentation of chronic vitiligo lesions by following tacrolimus plus ultraviolet-B-narrow-band. Photodermatol Photoimmunol Photomed 2003;19:35–36.
29.
Iacovelli P, Sinagra JLM, Vidolin AP: Relevance of thyroiditis and of other autoimmune diseases in children with vitiligo. Dermatology 2005;210:26–30.
30.
Tjioe M, Gerritsen MJ, Juhlin L, van de Kerkhof PCM: Treatment of vitiligo vulgaris with narrow band UVB (311 nm) for one year and the effect of addition of folic acid and vitamin B12. Acta Derm Venereol 2002;82:369–372.
© 2007 S. Karger AG, Basel
2007
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