Efficacy of microneedling combined with tacrolimus versus either one alone for vitiligo treatment

Ebrahim, Howyda Mohamed; Albalate, Waleed

doi:10.1111/jocd.13304

Cited by 21 publications

(53 citation statements)

References 22 publications

(33 reference statements)

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“…The patient received 6 to 12 sessions with 2 weeks interval. 14,16 A clinical response was seen in 38.5% of patients among which 17.5% had excellent repigmentation. The best response was seen on the face followed by the trunk.…”

Section: Microneedling Monotherapymentioning

confidence: 99%

“…(poor: no repigmentation). 11,[13][14][15][16][17][18] Visual analog scale was used in three studies. 10,[18][19][20] Other studies used investigator's global assessment (IGA) scoring and the measure of repigmentation diameter.…”

Section: Grading Scalementioning

confidence: 99%

“…Using a five grading scale to assess repigmentation, two clinical trials proved that microneedling is effective in treating vitiligo. 14,16 A total of 57 patients with localized stable vitiligo for at least 3 years were included. Topical anesthetic cream (lidocaine) was applied on the lesion.…”

Section: Microneedling Monotherapymentioning

confidence: 99%

“…Since microneedling enhances drug delivery across skin barrier, 16 tacrolimus ointment was applied after microneedling under occlusive dressing for 6 hours and patients were then advised to apply it once daily every 2 weeks. 13,16 All patients received 12 sessions (at 2 weeks interval) of microneedling except in one study where the patients received 4 sessions with 15 days interval. 3,15,16 Microneedling combined with tacrolimus was more efficient than microneedling monotherapy.…”

Section: Microneedling With Topical Tacrolimusmentioning

confidence: 99%

“…13,16 All patients received 12 sessions (at 2 weeks interval) of microneedling except in one study where the patients received 4 sessions with 15 days interval. 3,15,16 Microneedling combined with tacrolimus was more efficient than microneedling monotherapy. 16 A clinical response was seen in 83.6% (n = 97) of patients receiving combined therapy.…”

Section: Microneedling With Topical Tacrolimusmentioning

confidence: 99%

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Microneedling in vitiligo: A systematic review

Salloum

Bazzi

Maalouf

et al. 2020

Dermatologic Therapy

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Microneedling was initially introduced for skin rejuvenation; however, this minimally invasive procedure is now being used for the treatment of multiple dermatological conditions. Recent reports have shown its efficacy in the treatment of vitiligo. This review analyzes the current literature on microneedling techniques, efficacy, and safety for vitiligo treatment. An extensive PubMed was done to identify the literature on microneedling treatment for vitiligo. Case reports, case series, and clinical trials were included in this review. All 14 articles evaluated showed improvement of vitiligo lesions after microneedling treatment. The combination of microneedling and topical tacrolimus, 5-fluorouracil, topical calcipotriol and betamethasone, narrowband ultraviolet B with or without photodynamic therapy, and triamcinolone acetonide solution yielded more efficacy than microneedling monotherapy. Microneedling is a safe and efficient technique in the treatment of vitiligo. Thus, it can be an alternative treatment for vitiligo especially when the latter is resistant to conventional therapies.

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Section: Microneedling Monotherapymentioning

confidence: 99%

Section: Grading Scalementioning

confidence: 99%

Section: Microneedling Monotherapymentioning

confidence: 99%

Section: Microneedling With Topical Tacrolimusmentioning

confidence: 99%

Section: Microneedling With Topical Tacrolimusmentioning

confidence: 99%

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Microneedling in vitiligo: A systematic review

Salloum

Bazzi

Maalouf

et al. 2020

Dermatologic Therapy

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Expert Recommendations on Use of Topical Therapeutics for Vitiligo in Pediatric, Adolescent, and Young Adult Patients

Renert-Yuval,

Ezzedine,

Grimes

et al. 2024

JAMA Dermatol

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ImportanceEvidence-based recommendations for the treatment of vitiligo in pediatric, adolescent, and young adult patients in the US are needed.ObjectiveTo develop evidence- and consensus-based expert recommendations on the diagnosis and treatment of vitiligo in young patients.Evidence ReviewA process was developed to produce consensus recommendations addressing questions regarding pediatric vitiligo. A librarian-conducted literature review was performed using articles that met the inclusion criteria: published in English, containing primary data (including meta-analysis) and pediatric-specific data, and analysis of 6 or more patients. Included articles were graded by the Strength of Recommendation Taxonomy criteria and Oxford Centre for Evidence-based Medicine’s Levels of Evidence and Grades of Recommendation. Research questions were reviewed on May 9, 2022, through a video conference. One month after the conference, participants participated in an online survey documenting their level of agreement with the generated statements, using a 5-point Likert scale.FindingsArticles on topical corticosteroids and/or topical calcineurin inhibitors (n = 50), topical Janus kinase inhibitors (n = 5), pseudocatalase (n = 2), and microdermabrasion (n = 2) met inclusion criteria. Forty-two recommendations were made on the diagnosis of vitiligo and optimal topical therapeutics, with 33 recommendations obtaining a 70% or greater composite agreement and strong agreement. Topical calcineurin inhibitors twice daily, topical corticosteroids with time limitation due to atrophy risk, and topical ruxolitinib, 1.5%, cream—used off-label for patients younger than 12 years and limited to nonsegmental vitiligo—were identified as evidence-based first-line therapies in the management of pediatric and adolescent patients, with specific guidance on age-based data, minimum therapeutic trial of 6 months or greater, prolonged therapy to prevent recurrence, and the positive benefit of coordinated use of UV therapeutic sources.Conclusions and RelevanceEvidence supports the use of topical calcineurin inhibitors, topical corticosteroids, and topical Janus kinase inhibitors as effective therapeutics for vitiligo in pediatric, adolescent, and young adult patients, with specific decisions on choice of agent based on factors such as site location, body surface area, and age.

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Report of novel treatment of segmental vitiligo using combined microneedling and topical ruxolitinib

Abdin,

Kaiser,

Issa

2023

JEADV Clinical Practice

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Vitiligo is a chronic disease which manifests as patchy loss of skin pigmentation. It can be classified into two main types: segmental and nonsegmental. The condition can result in significant negative psychosocial effects, especially in skin of colour patients. These implications are particularly important in the social development of children and adolescents. As such, rapid‐acting, effective therapeutic options should be pursued when treating these patients. Topical ruxolitinib is the only approved drug for the treatment of vitiligo. Other procedural therapeutic options have also been explored including microneedling both alone and in conjunction with topical agents. Microneedling is thought to stimulate repigmentation through the induction of cytokines and growth factors which activate melanocytes and their precursors as well as through the creation of microchannels which allow for enhanced topical drug delivery. Its efficacy has been described in nonsegmental vitiligo cases, but its utility in segmental vitiligo has not been consistently characterised in the literature. We describe the first case of segmental vitiligo treated with combined microneedling and topical ruxolitinib in a skin of colour adolescent patient and review the purported mechanism of action of treatment.

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Efficacy of microneedling combined with tacrolimus versus either one alone for vitiligo treatment

Cited by 21 publications

References 22 publications

Microneedling in vitiligo: A systematic review

Microneedling in vitiligo: A systematic review

Expert Recommendations on Use of Topical Therapeutics for Vitiligo in Pediatric, Adolescent, and Young Adult Patients

Report of novel treatment of segmental vitiligo using combined microneedling and topical ruxolitinib

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